Active lifestyles related to excellent self-rated health and quality of life: cross sectional findings from 194,545 participants in The 45 and Up Study

BMC Public Health

Gregory S Kolt²  Sara K Rosenkranz¹  Mitch J Duncan³  Richard R Rosenkranz¹ 

[1] Department of Human Nutrition, Kansas State University, Manhattan, KS, USA;School of Science and Health, University of Western Sydney, Sydney, Australia;Institute for Health and Social Science Research, Centre for Physical Activity Studies, Central Queensland University, Rockhampton, Australia

关键词: Quality of life;    Successful aging;    Older adult;    Adult;    Health promotion;    Salutogenic;    Sedentary lifestyle;    Sitting time;    Sedentary behavior;    Physical activity;   

Others  :  1161556
DOI  :  10.1186/1471-2458-13-1071

 received in 2013-10-21, accepted in 2013-10-23,  发布年份 2013

【 摘 要 】

Background

Physical activity and sitting time independently contribute to chronic disease risk, though little work has focused on aspirational health outcomes. The purpose of this study was to examine associations between physical activity, sitting time, and excellent overall health (ExH) and quality of life (ExQoL) in Australian adults.

Methods

The 45 and Up Study is a large Australian prospective cohort study (n = 267,153). Present analyses are from 194,545 participants (48% male; mean age = 61.6 ± 10.7 yrs) with complete baseline questionnaire data on exposures, outcomes, and potential confounders (age, income, education, smoking, marital status, weight status, sex, residential remoteness and economic advantage, functional limitation and chronic disease). The Active Australia survey was used to assess walking, moderate, and vigorous physical activity. Sitting time was determined by asking participants to indicate number of hours per day usually spent sitting. Participants reported overall health and quality of life, using a five-point scale (excellent—poor). Binary logistic regression models were used to analyze associations, controlling for potential confounders.

Results

Approximately 16.5% of participants reported ExH, and 25.7% reported ExQoL. In fully adjusted models, physical activity was positively associated with ExH (AOR = adjusted odds ratio for most versus least active = 2.22, 95% CI = 2.20, 2.47; P_trend < 0.001) and ExQoL (AOR for most versus least active = 2.30, 95% CI = 2.12, 2.49; P_trend < 0.001). In fully adjusted models, sitting time was inversely associated with ExH (AOR for least versus most sitting group = 1.13, 95% CI = 1.09, 1.18; P_trend < 0.001) and ExQoL (AOR for least versus most sitting group = 1.13, 95% CI = 1.10, 1.17; P_trend < 0.001). In fully adjusted models, interactions between physical activity and sitting time were not significant for ExH (P = 0.118) or ExQoL (P = 0.296).

Conclusions

Physical activity and sitting time are independently associated with excellent health and quality of life in this large diverse sample of Australian middle-aged and older adults. These findings bolster evidence informing health promotion efforts to increase PA and decrease sitting time toward the achievement of better population health and the pursuit of successful aging.

【 授权许可】

   
2013 Rosenkranz et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]World Health Organization: Good health adds life to years. Global brief for World Health Day 2012. 2012, 28. http://whqlibdoc.who.int/hq/2012/WHO_DCO_WHD_2012.2_eng.pdf webcite
• [2]Martinez-Gómez D, Guallar-Castillón P, León-Muñoz LM, López-Garcia E, Rodríguez-Artalejo F: Combined impact of traditional and non-traditional health behaviors on mortality: a national prospective cohort study in Spanish older adults. BMC Med 2013, 11:47. BioMed Central Full Text
• [3]Södergren M, McNaughton SA, Salmon J, Ball K, Crawford DA: Associations between fruit and vegetable intake, leisure-time physical activity, sitting time and self-rated health among older adults: cross-sectional data from the WELL study. BMC Public Health 2012, 12:551. BioMed Central Full Text
• [4]Owen N, Healy GN, Matthews CE, Dunstan DW: Too much sitting: the population-health science of sedentary behavior. Exerc Sport Sci Rev 2010, 38:105.
• [5]US Department of Health and Human Services: 2008 physical activity guidelines for Americans: Be active, healthy and happy. Washington DC: US Department of Health and Human Services; 2008.
• [6]León-Muñoz LM, Martínez-Gómez D, Balboa-Castillo T, López-García E, Guallar-Castillón P, Rodríguez-Artalejo F: Continued sedentariness, change in sitting time, and mortality in older adults. Med Sci Sports Exerc 2013. Epub ahead of print
• [7]Pavey TG, Peeters GMEE, Brown WJ: Sitting-time and 9-year all-cause mortality in older women. Br J Sports Med 2012. Epub ahead of print
• [8]Katzmarzyk PT, Church TS, Craig CL, Bouchard C: Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc 2009, 41:998-1005.
• [9]van der Ploeg HP, Chey T, Korda RJ, Banks E, Bauman A: Sitting time and all-cause mortality risk in 222 497 Australian adults. Arch Intern Med 2012, 172:494-500.
• [10]Patel AV, Bernstein L, Deka A, Spencer Feigelson H, Campbell PT, Gapstur SM, Colditz GA, Thun MJ: Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epidemiol 2010, 172:419-429.
• [11]Dunstan DW, Salmon J, Owen N, Armstrong T, Zimmet PZ, Welborn TA, Cameron AJ, Dwyer T, Jolley D, Shaw JE: Associations of TV viewing and physical activity with the metabolic syndrome in Australian adults. Diabetologia 2005, 48:2254-2261.
• [12]Healy GN, Wijndaele K, Dunstan DW, Shaw JE, Salmon J, Zimmet PZ, Owen N: Objectively measured sedentary time, physical activity, and metabolic risk: The Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care 2008, 31:369-371.
• [13]Hu FB, Leitzmann MF, Stampfer MJ, Colditz GA, Willett WC, Rimm EB: Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men. Arch Intern Med 2001, 161:1542-1548.
• [14]Hu FB, Li TY, Colditz GA, Willett WC, Manson JE: Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003, 289:1785-1791.
• [15]George ES, Rosenkranz RR, Kolt GS: Chronic disease and sitting time in middle-aged Australian males: findings from the 45 and Up Study. Int J Behav Nutr Phys Act 2013, 10:20. BioMed Central Full Text
• [16]Patel AV, Rodriguez C, Pavluck AL, Thun MJ, Calle EE: Recreational physical activity and sedentary behavior in relation to ovarian cancer risk in a large cohort of US women. Am J Epidemiol 2006, 163:709-716.
• [17]Peeters GMEE, Burton NW, Brown WJ: Associations between sitting time and a range of symptoms in mid-age women. Prev Med 2013, 56:135-141.
• [18]Davies CA, Vandelanotte C, Duncan MJ, van Uffelen JG: Associations of physical activity and screen-time on health related quality of life in adults. Prev Med 2012, 55:46-49.
• [19]Vallance JK, Eurich D, Marshall AL, Lavallee CM, Johnson ST: Associations between sitting time and health-related quality of life among older men. Mental Health Phys Act 2013, 6:49-54.
• [20]Garatachea N, Molinero O, Martinez-Garcia R, Jiménez-Jiménez R, González-Gallego J, Márquez S: Feelings of well being in elderly people: relationship to physical activity and physical function. Arch Gerontol Geriatr 2009, 48:306-312.
• [21]Rowe JW, Kahn RL: Successful aging. Gerontologist 1997, 37:433-440.
• [22]Antonovsky A: The salutogenic model as a theory to guide health promotion. Health Promot Int 1996, 11:11-18.
• [23]Gallagher KM, Updegraph JA: Health message framing effects on attitudes, intentions, and behavior: a meta-analytic review. Ann Behav Med 2012, 43:101-116.
• [24]Rumsfeld JS, Alexander KP, Goff DC Jr, Graham MM, Ho PM, Masoudi FA, Moser DK, Roger VL, Slaughter MS, Smolderen KG, Spertus JA, Sullivan MD, Treat-Jacobson D, Zerwic JJ, on behalf of the American Heart Association Council on Quality of Care and Outcomes Research, Council on Cardiovascular and Stroke Nursing, Council on Epidemiology and Prevention, Council on Peripheral Vascular Disease, and Stroke Council: Cardiovascular health: the importance of measuring patient-reported health status: a scientific statement from the American Heart Association. Circulation 2013, 127:2233-2249.
• [25]45 and Up Study Collaborators: Cohort profile: The 45 and Up Study. Int J Epidemiol 2008, 35:941-947.
• [26]The Sax Institute: The 45 and Up Study website. https://www.saxinstitute.org.au/our-work/45-up-study/ webcite
• [27]Australian Institute of Health and Welfare (AIHW): The Active Australia Survey: a guide and manual for implementation, analysis, and reporting. Canberra: AIHW; 2003.
• [28]Brown WJ, Trost SG, Bauman A, Mummery K, Owen N: Test-retest reliability of four physical activity measures used in population surveys. J Sci Med Sport 2004, 7:205-215.
• [29]Heesch KC, Hill RL, Van Uffelen JG, Brown WJ: Are Active Australia physical activity questions valid for older adults? J Sci Med Sport 2011, 14:233-237.
• [30]Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF: International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003, 35:1381-1395.
• [31]Atkin AJ, Gorely T, Clemes SA, Yates T, Edwardson C, Brage S, Salmon J, Marshall SJ, Biddle SJ: Methods of measurement in epidemiology: Sedentary behaviour. Int J Epidemiol 2012, 41:1460-1471.
• [32]World Health Organization: World Health Organization – Global database on body mass index. http://apps.who.int/bmi/index.jsp?introPage=intro_1.html webcite
• [33]Stewart A, Kamberg CJ: Physical functioning measures. In Measuring functioning and well-being: The Medical Outcomes Study approach. Edited by Stewart A, Ware JE. Durham, North Carolina: Duke University Press; 1992.
• [34]Haley SM, McHorney CA, Ware JJE: Evaluation of the MOS SF-36 physical functioning scale (PF-10): I. Unidimensionality and reproducibility of the Rasch Item scale. J Clin Epidemiol 1994, 47:671-684.
• [35]Kerr J, Sallis JF, Saelens BE, Cain K, Conway TL, Frank LD, King AC: Outdoor physical activity and self rated health in older adults living in two regions of the U.S. Int J Behav Nutr Phys Act 2012, 9:89. BioMed Central Full Text
• [36]Herber-Gast GC, Jackson CA, Mishra GD, Brown WJ: Self-reported sitting time is not associated with incidence of cardiovascular disease in a population-based cohort of mid-aged women. Int J Behav Nutr Phys Act 2013, 10:55. BioMed Central Full Text
• [37]Trinh L, Plotnikoff RC, Rhodes RE, North S, Courneya KS: Associations between sitting time and quality of life in a population-based sample of kidney cancer survivors. Mental Health Phys Act 2013, 6:16-23.
• [38]New Zealand Ministry of Health: A literature review of evidence on physical activity for older people and a review of existing physical activity guidelines for older people. Wellington; 2011.
• [39]Gilson ND, Burton NW, Van Uffelen JG, Brown WJ: Occupational sitting time: employees’ perceptions of health risks and intervention strategies. Health Promot J Austr 2011, 22:38-43.
• [40]Magnusson ML, Pope MH: A review of the biomechanics and epidemiology of working postures. J Sound Vib 1998, 215:965-976.
• [41]Walker BF, Muller R, Grant WD: Low back pain in Australian adults. Prevalence and associated disability. J Manipulative Physiol Ther 2004, 27:238-244.
• [42]Yorston LC, Kolt GS, Rosenkranz RR: Physical activity and physical function in older adults: the 45 and up study. J Am Geriatr Soc 2012, 60:719-725.
• [43]Faulkner G, Biddle SJH: Standing on top of the world: Is sedentary behavior associated with mental health? Mental Health Phys Act 2013, 6:1-2.
• [44]Lampinen P, Heikkinen RL, Kauppinen M, Heikkinen E: Activity as a predictor of mental well-being among older adults. Aging Ment Health 2006, 10:454-466.
• [45]Fox KR, Stathi A, McKenna J, Davis MG: Physical activity and mental well-being in older people participating in the Better Ageing Project. Eur J Appl Physiol 2007, 100:591-602.