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Physical Activity and Public Health: Four Decades of Progress

Sarah K. Keadle, Eduardo E. Bustamante, and Matthew P. Buman

Over the past 40 years, physical activity (PA) and public health has been established as a field of study. A robust evidence base has emerged demonstrating that participation in recommended amounts of PA results in a wide array of physical and mental health benefits. This led to the establishment of federal and global PA guidelines and surveillance programs. Strong evidence supports the efficacy of individual-level (e.g., goal setting) and environmental (e.g., policies) interventions to promote PA. There has also been progress in establishing a skilled and diverse workforce to execute the work of PA and public health. Looking forward, major challenges include stemming the obesity and chronic disease epidemics, addressing health inequities, and diversifying the workforce. Given the known benefits of PA and the availability of evidence-based interventions, efforts now must focus on implementing this knowledge to improve population health and reduce inequities through PA.

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Reexamining the Energy Cost of Sedentary Behaviors From the 2011 Adult Compendium

Rachel K. Barnett, Cory Greever, Karen Yagi, Brendan Rhoan, and Sarah Kozey Keadle

Background: This study reexamines the energy cost of lower intensity activities compared to the 2011 Adult Compendium of Physical Activities. Methods: Participants (n = 32, age = 35 [13.8] y, 16 females) wore a portable metabolic system (COSMED), during 5 different conditions: sitting quietly, watching TV, sitting while working, driving, and walking at 2.0 mph. The metabolic equivalent (MET) values (VO2 mL·kg−1·min−1/3.5 mL·kg−1·min−1) were calculated. Results: The mean (SD) MET value for driving (1.46 [0.24]) was significantly lower than the Adult Compendium value of 2.5 (P < .001). Driving and slow walking have similar Adult Compendium values, but driving METs were significantly lower than slow walking (P < .001). Driving was similar to sitting while working (1.32 [0.25] METs, P > .05) and yielded significantly higher MET values than quiet sitting (1.08 [0.23] METs, P < .001) and watching TV (1.12 [0.22] METs, P < .001), both of which were lower than their respective Adult Compendium MET values. Conclusion: Existing Adult Compendium METs are significantly higher than measured METs for driving, which more closely correspond to sedentary behaviors than slow walking. The TV and quiet sitting also differed from their Adult Compendium values, which should be updated to reflect these findings, given that researchers and practitioners rely on Adult Compendium MET values to estimate energy cost.

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Reliability and Validity of the Cancer Prevention Study-3 Physical Activity Survey Items

Erika Rees-Punia, Charles E. Matthews, Ellen M. Evans, Sarah K. Keadle, Rebecca L. Anderson, Jennifer L. Gay, Michael D. Schmidt, Susan M. Gapstur, and Alpa V. Patel

This study examined the test-retest reliability and criterion validity of light (LPA), moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA) physical activity survey items in a subset of participants from a large prospective cohort. Participants included 423 women and 290 men aged 31–72 years in the Cancer Prevention Study-3 (CPS-3). Information on physical activity (PA) was collected using two different surveys: one survey which captures all activity performed during a typical 24-hour period in broad categories (24-hour survey), and a more detailed survey focused primarily on leisure-time PA (LTPA survey). One-year reliability was assessed by computing Spearman correlation coefficients between responses from pre- and post-study periods for both surveys. Validity was assessed by comparing survey-estimated PA with accelerometry, seven-day diaries, and a latent variable representing ‘true’ PA estimated through the method of triads. Reliability was considered acceptable for most items on the LTPA survey (range ρ = 0.45–0.92) and the 24-hour survey (range ρ = 0.37–0.61). LPA validity coefficients were higher for the 24-hour survey, while MPA, VPA, and MVPA coefficients were higher for the LTPA survey. Study results suggest that both CPS-3 PA surveys are suitable for ranking or classifying participants in our population according to overall PA category or intensity-specific activity level.