Epidemiological study of physical fitness and physical activity in Flanders

Epidemiological study of physical fitness and physical activity in Flanders

Renaat Philippaerts1,William Duquet (†)2, Johan Lefevre3

1Department of Movement and Sports Sciences,Ghent University

2Faculty of Physical Education and Physiotherapy, VUBrussel3Department of Biomedical Kinesiology, KULeuven

Welcome in Gent

3th most historical city in the world (National Geographic, 2008)

1.Wachau (Austria)2.Ontario (Canada)3.Gent (Belgium)

1. Policy Research Centre in Flanders2. Frame of reference3. Computerised questionnaires4. Results5. Time & Money: some facts

Renaat PhilippaertsDepartment of Movement and Sports Sciences

1. Policy Research Centers

12 Policy Research Centers- according to the policy domains:

- Sport, physical activity and health,- Culture,- Tourism and leisure- Transportation,- Gender and equality,- Education, ...

- provide evidence-based knowledge to policy makers, ministers, …

1. Policy Research Centers

- Periods of 5 years:- 2001-2006, 2007-2011, …

- Consortium between universities, colleges, administrations and scientific institutions

- Budget over 5 years for each center- 4.000.000 – 5.000.000 €

Policy Research Center for Sport, Physical Activity and Health (SPAH)

supported by the Flemish Government(2001-2006: 4.214.200 euro)

1. Policy Research Centers

Theme I: Current status of physical activity, fitness and health in Flanders

Theme II: Associations between physical activity, fitness and health

Theme III: Development of intervention strategies for specific target groups (school, obese, internet use, elderly, …)

Theme IV: prevalence of injuries due to physical activity and sports

2. Frame of reference

Consensus model of Bouchard & Shephard, 1994

2. Frame of reference

Theme I: Current status of physical activity, fitness and health in Flanders

“Correct assessment of physical activity (PA) behavior and energy expenditure (EE) related to physical activity is essential to study the effects of physical activity on fitness and potential health benefits”

3. Computerised questionnaire

How to quantify physical activity?Physical activity is a complex concept, determined by different indicators:

– Frequency– Duration– Intensity

→ different methods

3. Computerised questionnaire

Activity energy expediture

‣Different activities contribute to AEE‧ PA during occupation‧ PA during leisure time – sport activities‧ Home and household activities‧ Transportation‧ Personal care

Renaat PhilippaertsDepartment of Movement and Sports Sciences

3. Computerised questionnaire

Criterion methodsObjective methods- Heart rate monitoring (HRM)- Activity monitors (pedometers andaccelerometers) (AM)

- Combination of HRM and AM

3. Computerised questionnaire

Criterion methodsObjective methodsSubjective methods- Survey techniques (questionnaires)

- Self-reported- Paper and pencil- Electronic surveys

- Interviewer-assisted

3. Computerised questionnaire

Advantages paper-pencil Q:1. The only method feasible for a large

number of people2. Inexpensive3. Specific activities can be identified

together with frequency and duration (intensity?)

3. Computerised questionnaire

Advantages paper-pencil Q:4. Q does not influence the subject’s

activities5. Using energy tables: conversion to

AEE/ADMR6. Usable over a wide range of age7. Good reliability

3. Computerised questionnaire

Limitations paper-pencil Q:1. Recall their activities accurately?

- overstimation- underestimation

2. Questions are not clear3. Instrument is age and group specific4. Time consuming: encoding,

analyzing

3. Computerised questionnaire

Limitations paper-pencil Q:5. “human errors”6. Difficult to assess validity

3. Computerised questionnaire

Tecumseh/MinnesotaFive City/7 day recallBaeckeGodin-ShephardFraminghamLipid Research ClinicBaecke ModificationZutphen QYale PA QPASEAmsterdam Growth Study Q…IPAQ

?

3. Computerised questionnaire

Computerised questionnairesComputer delivered questionnaires…

What?Why?

3. Computerised questionnaire

Advantages:1. administration to a large number of

people simultaneously2. subjects cannot omit questions (no

missing data)3. software can skip superfluous

questions4. subjects report more honestly

undesirable behavior

3. Computerised questionnaire

Advantages:5. avoiding all sources of coding errors6. reducing hours of data entry: less

expensive7. explanation of difficult words or

questions by film clips

…and all advantages of P-P Q

3. Computerised questionnaire

Limitations:1. development of software (need of

technicians)2. development can be expensive3. dependent on hardware, server, …

3. Computerised questionnaire

Children-adolescents- McMurray RG et al., 1998, Med Sci SportsExerc 30: 1238-1245.

- Ridley K et al., 2001, Pediat Exerc Sci 13: 35-46.- Philippaerts RM et al., 2006, Int J Sports Med 27:131-136.

Adults- Vandelanotte C et al., 2005, Journal for Physical

Activity and Health 2 (1): 63-75.- Matton L et al., 2007, Res Quarterly Exerc Sport 78 (4): 293-

306.

BACKOFFICE

3. Computerised questionnaire

The concept of the FPACQ

- similar to IPAQ- specific sub-components- indication of intensity- calculation of EE by using METs- one single administrator

Renaat PhilippaertsDepartment of Movement and Sports Sciences

3. Computerised questionnaire

-all data are directly saved and encoded

-additional variables are directlycalculated by the software

- immediate feedback is possible

The concept of the FPACQ

Renaat PhilippaertsDepartment of Movement and Sports Sciences

3. Computerised questionnaire

- translation to other languages-pilot studies: reliability and validity in international context

renaat.philippaerts@UGent.bejohan.lefevre@faber.kuleuven.be

From FPACQ to IPACQ ??

Renaat PhilippaertsDepartment of Movement and Sports Sciences

4. Results

2001: Subjects (12-18 yrs)

N %

Girls 3738 61.1

Boys 2379 38.9

Total 6117 100Representative sample according to the different educational systems (free, state, official)

This study was supported by the Flemisch Agency for the promotion of Sport BLOSO

4. Results

2002-2004: Adults

46 communities (ad random)

28840 subjects (age 18-75) (ad random)22830 with known telephone number

18453 reached5170 participated

5170/18453 = 28%

4. Results

Boys 12-18 years

Girls 12-18 years

26,0

18,1

17,0

15,1

10,6

10,5

9,1

7,6

5,9

5,5

0 10 20 30 40 50

Basketbal

Volleybal

Turnen

Atletiek

Tennis

Paardensport

Fietssporten

Fitness

Zwemmen

Dansen

Percentage

Results: boys

Inactivity: TV and computer games

15

17

19

21

23

25

27

29

12 13 14 15 16 17 18

lowmiddlehigh

age (yr)

hrs/wkAge: nsSES: L >< HAge x SES: ns

Results: girls

Inactivity: TV and computer games

15

17

19

21

23

25

27

12 13 14 15 16 17 18

lowmiddlehigh

age (yr)

hrs/wkAge: **SES: L,M >< HAge x SES: ns

Results: boys

Passive transport (car, bus, train, …)

0

1

2

3

4

5

6

12 13 14 15 16 17 18

lowmiddlehigh

age (yr)

hrs/wkAge: **SES: nsAge x SES: ns

Results: girls

Passive transport (car, bus, train, …)

0

1

2

3

4

5

6

12 13 14 15 16 17 18

lowmiddlehigh

age (yr)

hrs/wkAge: **SES: L >< HAge x SES: ns

Results: boys

Sport participation leisure time: no differenceActive transport: no differenceTotal activity: no difference

Frequency moderate activities: no differenceFrequency heavy activities: no difference

Results: girls

0

1

2

3

4

5

6

12 13 14 15 16 17 18

lowmiddlehigh

Leisure time sport participation

age (yr)

hrs/wkAge: nsSES: L >< M >< HAge x SES: *

Results: girls

6

8

10

12

14

16

12 13 14 15 16 17 18

lowmiddlehigh

Total activity (sports + active transport + school sports + PE)

age (yr)

hrs/wkAge: **SES: L >< M >< HAge x SES: ns

Results: girls

Frequency moderate activities

0

1

2

3

12 13 14 15 16 17 18

lowmiddlehigh

age (yr)

days/wkAge: **SES: L,M >< HAge x SES: **

Results: girls

Frequency heavy activities

0

1

2

3

12 13 14 15 16 17 18

lowmiddlehigh

age (yr)

n/wkAge: **SES: L,M >< HAge x SES: *

4. Results

In Flanders:

Boys are more physically active than girls

Girls are more prone to sedentary behavior

Physical activity declines with age in youth

Prevalence over Overweight25 > BMI <30

Prevalence of ObesitasBMI > 30

Health-related sport activity for age and gender

• > 1.5 h/week• > 3.5 MET’s (intensity)• according PA guidelines

%

Prevalence of sport inactivity(no sport activity at all)

%

4. Results

Sedentary behaviour

Prevalence of sedentarityPAL < 1.55 (kcal/kg/h or MET)

%

Prevalence of HypertensionSP > 140 mmHg or DP > 90 mmHg

%

Gestalte (cm)

Gewicht(kg)

BMI(kg/m2)

Vetpercentage(%)

LenigheidZittend reiken (cm)

Statische krachtHandknijpkracht (kg)

Wandeltest (m)

Systolische bloeddruk(mm Hg)

Diastolische bloeddruk(mm Hg)

Longinhoud(l)

Totaal cholesterol(mg/100ml)

Uren sport(u/week)

Kijkindex(u/week)

Profiel MANNEN 45-49 jaar

P10 P25 P50 P75 P90

170.0 172.0 176.0 180.0 186.0

109.0

22.2 23.9 25.5 28.5 31.6

70.0 73.0 80.0 89.0

30.5

8.0 14.0 21.0 27.0 32.0

15.2 19.1 23.0 26.6

62.035.0 42.0 49.0 56.0

703.8

116.0 120.7 130.0 140.0 150.0

521.0 557.5 612.4 685.5

95.3

3.9 4.3 4.9 5.4 6.0

73.3 78.7 82.0 90.0

265.0

0.0 0.0 0.0 3.0 8.0

164.0 186.0 209.0 236.0

28.04.5 9.0 16.0 21.0

Recommendations to the policy

%

5. Time & Money: some facts

Budget epidemiological study2.000.000 € (2001-2006)

Subjects• PA: 6117 boys and girls: in a 3-month period• PA & PF & Health test battery: 5170 men and women: during ca. 50

weeks (about 100 subjects per week)

5. Time & Money: some facts

Staff:• 3 promotors• 1 director (on pay roll)• 1 administrator (on pay roll)• 1 test manager (on pay roll)• 3 PhD students (on pay roll)• Call center (1 year: 12 students) (on pay roll)• 4 physicians (free lance),• 2 nurses (free lance)• 8 part-time administrators and test leaders (on pay roll)• ca. 25 master students

Thank you !