F ocus Area 22 Physical Activity and Fitness Progress Review April 14, 2004

Physical Activity and Fitness Benefits Builds and maintains healthy bones and muscles, controls weight, builds lean muscle, reduces fat, reduces blood pressure, and improves blood glucose control Decreases the risk of obesity and chronic diseases (CHD, high blood pressure, diabetes, colon cancer, and osteoporosis) Reduces feelings of depression and anxiety and promotes psychological well-being Related to functional independence of older adults and quality of life of people of all ages

2,391,399 Total Deaths 400,000 due to Poor Diet and Physical Inactivity (17%) 1,159,000 Preventable (48%) Source: Anderson, RN. Deaths: Leading Causes for NVSR 50(16). Hyattsville, Maryland: National Center for Health Statistics. 2002; Mokdad, AH, et.al. Actual Causes of Death in the United States, JAMA 291(10): March 10, Estimated Preventable Deaths, 2000

22-1. No leisure time physical activity Moderate regular physical activity Vigorous physical activity Muscular strength and endurance Flexibility Physical Activity among Adults Physical Activity and Fitness Objectives Worksite physical activity and fitness programs Community walking a. Adults b. Children and adolescents Community bicycling a. Adults b. Children and adolescents Worksites and Communities Participation in daily school PE Physical activity in PE class Television viewing Access to school physical activity facilities ImprovingGetting worseLittle or no changeCannot assess (limited data) Moderate physical activity Vigorous physical activity Physical education requirement in schools a. Middle/junior high schools b. Senior high schools Physical Activity among Adolescents

22-1. No leisure-time physical activity in adults Moderate, regular physical activity in adults Vigorous physical activity in adults Vigorous physical activity in adolescents Highlighted Objectives

Data Issues/Gaps  Complex measurement methodology  Time / intensity  Recall period / accuracy  Question order  “Leisure” / “work” / “incidental”  Self-report / measured  Measurement bias  No standard methodology  Data for children

 How often do you do VIGOROUS activities for AT LEAST 10 MINUTES that cause HEAVY sweating or LARGE increases in breathing or heart rate?  How often do you do LIGHT OR MODERATE activities for AT LEAST 10 MINUTES that cause ONLY LIGHT sweating or a SLIGHT TO MODERATE increase in breathing or heart rate? The next questions are about physical activities (exercise, sports, physically active hobbies...) that you may do in your LEISURE time. NHIS Questions for Objectives 22-1, 22-2, and 22-3

Physical Activity among Adults Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population. Moderate physical activity is regular leisure-time physical activity (moderate activity 30+ minutes/5+ times a week or vigorous activity 20+ minutes/3+ times a week). Source: National Health Interview Survey, NCHS, CDC. Objs. 22-1, 2 Some Moderate/ Vigorous None Some Moderate/ Vigorous None

0 Age-adjusted percent 2010 Target Obj No Physical Activity for Adults by Sex and Age Note: Data are for no leisure-time physical activity only; for ages 18 years and over, age adjusted to the 2000 standard population. I = 95% confidence interval. Source: National Health Interview Survey, NCHS, CDC. 60 Total years Female 75 years and over Male years years years Age-adjusted percent 2010 Target

0 Age-adjusted percent 2010 Target Obj No Physical Activity for Adults by Race/Ethnicity Note: Data are for no leisure-time physical activity only; for ages 18 years and over, age adjusted to the 2000 standard population. American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. I = 95% confidence interval. Source: National Health Interview Survey, NCHS, CDC. White American Indian Hispanic Asian Black 60

Obj Note: Data are for no leisure-time physical activity only; for ages 18 years and over, age adjusted to the 2000 standard population. I = 95% confidence interval. *Arthritis data are for 2001 due to a change in the 2002 questionnaire. Source: National Health Interview Survey, NCHS, CDC. With Age-adjusted percent 2010 Target No Physical Activity for Adults by Disability and Arthritis Status Without Disabilities With Without Arthritis *

BRFSS question for objective 22-1 During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?

No Physical Activity for Adults by State, 2003 Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population, for no leisure-time physical activity. Source: Behavioral Risk Factor Surveillance System, NCCDPHP, CDC Age-adjusted percent (Quartiles) Obj. 22-1

0 Age-adjusted percent 2010 Target Obj Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population. Moderate physical activity is regular leisure-time physical activity (moderate activity 30+ minutes/5+ times a week or vigorous activity 20+ minutes/3+ times a week). I = 95% confidence interval. Source: National Health Interview Survey, NCHS, CDC. Moderate Physical Activity for Adults by Sex and Age Total years Female 75 years and over Male years years years Age-adjusted percent 2010 Target

0 Age-adjusted percent 2010 Target Obj Moderate Physical Activity for Adults by Race/Ethnicity Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population. Moderate physical activity is regular leisure-time physical activity (moderate activity 30+ minutes/5+ times a week or vigorous activity 20+ minutes/3+ times a week). American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. I = 95% confidence interval. Source: National Health Interview Survey, NCHS, CDC. White American Indian Hispanic Asian Black

Obj Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population. Moderate physical activity is regular leisure-time physical activity (moderate activity 30+ minutes/5+ times a week or vigorous activity 20+ minutes/3+ times a week). I = 95% confidence interval. *Arthritis data are for 2001 due to a change in the 2002 questionnaire. Source: National Health Interview Survey, NCHS, CDC. With Age-adjusted percent 2010 Target Moderate Physical Activity for Adults by Disability and Arthritis Status Without Disabilities With Without Arthritis *

0 Age-adjusted percent 2010 Target Obj Vigorous Physical Activity for Adults by Sex and Age Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population. Vigorous physical activity is leisure-time vigorous physical activity 20+ minutes/3+ times a week. I = 95% confidence interval. Source: National Health Interview Survey, NCHS, CDC. Total years Female 75 years and over Male years years years Age-adjusted percent 2010 Target

YRBSS question for objective 22-7  On how many of the past 7 days did you exercise or participate in physical activity for at least 20 minutes that made you sweat and breathe hard, such as basketball, soccer, running, swimming laps, fast bicycling, fast dancing, or similar aerobic activities?

0 Note: Black and white exclude persons of Hispanic origin. Hispanic can be any race. Vigorous physical activity is activity that made students in grades 9-12 sweat or breathe hard for 20+ minutes on 3+ of the past 7 days. I = 95% confidence interval. Source: Youth Risk Behavior Surveillance System, NCCDPHP, CDC. Percent 2010 Target Vigorous Physical Activity for Adolescents by Sex and Race/Ethnicity 4020 Total White Female Hispanic Male Black Obj. 22-7

Vigorous Physical Activity for Adolescents by Grade Level: th 10th Obj th Percent 12th Note: Vigorous physical activity is activity that made students in grades 9-12 sweat or breathe hard for 20+ minutes on 3+ of the past 7 days. I = 95% confidence interval. Source: Youth Risk Behavior Surveillance System, NCCDPHP, CDC.

NHANES Physical Activity/ Fitness Data  Questionnaire includes usual daily activity and leisure time activity for ages 12+  Examination data include muscle strength/physical function and cardiovascular fitness for healthy persons years

Physical Activity Monitor  In field since January 2003  Automatically records locomotion movement, duration, and intensity over time  About 4000 sample persons 6+ years annually  Worn on a belt for 7 full days  Will be linked to interview and other health component data (body weight, functional status, bone status, etc.)

Take-away Points  Little change in physical activity measures in past decade  Methodology is complex and varies in different surveys  New technologies may offer improved measurement

Progress review data and slides can be found on the web at: