The clear public messaging from international health authorities is that individuals should “sit less and move more.” While it is acknowledged that this guidance needs to be tailored to the age of people and also to their health, and abilities, the guidance is not tailored to their current level of physical behaviors. This opinion piece aims to highlight that although people with excessive sitting and insufficient moderate-to-vigorous physical activity should sit more and move less, for other people their health would be promoted by sitting more and moving less. Thus, physical behaviors are not always “poison” or “medicine,” but rather the health impact of changes in physical behaviors depends on people’s initial levels. Policy, research, and practice implications of this realization are presented. Only tailoring messaging to age and health status could be far from optimal for people with very different current levels of physical behaviors. Policy, research, and practice will be enhanced when the potential for physical behaviors to be either health hindering or health promoting is adequately considered.
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What’s Your Poison? Is Sitting Always Health Hindering and Moving Always Health Promoting?
Leon Straker, Charlotte Lund Rasmussen, Nidhi Gupta, and Andreas Holtermann
Trends in Walking, Moderate, and Vigorous Physical Activity Participation Across the Socioeconomic Gradient in New South Wales, Australia From 2002 to 2015
Jessica Gugusheff, Bridget C. Foley, Katherine B. Owen, Bradley Drayton, Ding Ding, Emmanuel Stamatakis, Charlotte Lund Rasmussen, Adrian E. Bauman, and Margaret Thomas
Background: A combination of walking, other moderate physical activity, and vigorous physical activity is recommended for achieving good health. Vigorous activity has unique health benefits but may be less accessible to disadvantaged people. To reduce health inequity, we need to understand the differences in physical activity participation among socioeconomic subgroups and whether this is changing over time. Methods: Data from the 2002 to 2015 Adult New South Wales Population Health Surveys (164,652 responses) were analyzed to investigate trends in walking, moderate and vigorous physical activity participation by socioeconomic status as measured by educational attainment. Analysis used age- and sex-adjusted multivariable linear models that accounted for complex survey design. Results: In 2002, the highest socioeconomic group spent 18.5 (95% confidence interval, 8.2–28.8) minutes per week more than the lowest socioeconomic group being vigorously active. By 2015, this gap had steadily increased to 41.4 (95% confidence interval, 27.6–55.1) minutes per week. Inequity between groups was also found for duration of moderate activity but not for time spent walking. Conclusions: Low participation in vigorous activity in the lowest socioeconomic group is likely driving increasing inequities in physical activity and widening participation gaps over time. Barriers preventing the most disadvantaged people in New South Wales from engaging in vigorous activity should be addressed urgently.
Assessing the Accuracy of Activity Classification Using Thigh-Worn Accelerometry: A Validation Study of ActiPASS in School-Aged Children
Claas Lendt, Pasan Hettiarachchi, Peter J. Johansson, Scott Duncan, Charlotte Lund Rasmussen, Anantha Narayanan, and Tom Stewart
Background: The ActiPASS software was developed from the open-source Acti4 activity classification algorithm for thigh-worn accelerometry. However, the original algorithm has not been validated in children or compared with a child-specific set of algorithm thresholds. This study aims to evaluate the accuracy of ActiPASS in classifying activity types in children using 2 published sets of Acti4 thresholds. Methods: Laboratory and free-living data from 2 previous studies were used. The laboratory condition included 41 school-aged children (11.0 [4.8] y; 46.5% male), and the free-living condition included 15 children (10.0 [2.6] y; 66.6% male). Participants wore a single accelerometer on the dominant thigh, and annotated video recordings were used as a reference. Postures and activity types were classified with ActiPASS using the original adult thresholds and a child-specific set of thresholds. Results: Using the original adult thresholds, the mean balanced accuracy (95% CI) for the laboratory condition ranged from 0.62 (0.56–0.67) for lying to 0.97 (0.94–0.99) for running. For the free-living condition, accuracy ranged from 0.61 (0.48–0.75) for lying to 0.96 (0.92–0.99) for cycling. Mean balanced accuracy for overall sedentary behavior (sitting and lying) was ≥0.97 (0.95–0.99) across all thresholds and conditions. No meaningful differences were found between the 2 sets of thresholds, except for superior balanced accuracy of the adult thresholds for walking under laboratory conditions. Conclusions: The results indicate that ActiPASS can accurately classify different basic types of physical activity and sedentary behavior in children using thigh-worn accelerometer data.
