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

David A Crawford²  Kylie Ball²  Jo Salmon²  Sarah A McNaughton²  Marita Södergren¹ 

[1] Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden;Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia

关键词: Interactions;    Ordinal logistic regression;    IPAQ;    Behaviours;    Lifestyle;   

Others  :  1163424
DOI  :  10.1186/1471-2458-12-551

 received in 2012-01-23, accepted in 2012-07-11,  发布年份 2012

【 摘 要 】

Background

Lifestyle behaviours, such as healthy diet, physical activity and sedentary behaviour, are key elements of healthy ageing and important modifiable risk factors in the prevention of chronic diseases. Little is known about the relationship between these behaviours in older adults. The purpose of this study was to explore the relationship between fruit and vegetable (F&V) intake, leisure-time physical activity (LTPA) and sitting time (ST), and their association with self-rated health in older adults.

Methods

This cross-sectional study comprised 3,644 older adults (48% men) aged 55–65 years, who participated in the Wellbeing, Eating and Exercise for a Long Life (“WELL”) study. Respondents completed a postal survey about their health and their eating and physical activity behaviours in 2010 (38% response rate). Spearman’s coefficient (rho) was used to evaluate the relationship between F&V intake, LTPA and ST. Their individual and shared associations with self-rated health were examined using ordinal logistic regression models, stratified by sex and adjusted for confounders (BMI, smoking, long-term illness and socio-demographic characteristics).

Results

The correlations between F&V intake, LTPA and ST were low. F&V intake and LTPA were positively associated with self-rated health. Each additional serving of F&V or MET-hour of LTPA were associated with approximately 10% higher likelihood of reporting health as good or better among women and men. The association between ST and self-rated health was not significant in the multivariate analysis. A significant interaction was found (ST*F&V intake). The effect of F&V intake on self-rated health increased with increasing ST in women, whereas the effect decreased with increasing ST in men.

Conclusions

This study contributes to the scarce literature related to lifestyle behaviours and their association with health indicators among older adults. The findings suggest that a modest increase in F&V intake, or LTPA could have a marked effect on the health of older adults. Further research is needed to fully understand the correlates and determinants of lifestyle behaviours, particularly sitting time, in this age group.

【 授权许可】

   
2012 Sodergren et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]WHO:2008–2013 Action plan for the global strategy for the prevention and control of noncommunicable diseases. Geneva, Switzerland: World Health Organisation; 2008.
• [2]Hamilton M, Healy G, Dunstan D, Zderic T, Owen N: Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behavior. Current Cardiovascular Risk Reports 2008, 2(4):292-298.
• [3]Tremblay MS, Colley RC, Saunders TJ, Healy GN, Owen N: Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab 2010, 35(6):725-740.
• [4]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(5):998-1005.
• [5]Ford ES, Zhao G, Tsai J, Li C: Low-Risk Lifestyle Behaviors and All-Cause Mortality: Findings From the National Health and Nutrition Examination Survey III Mortality Study. Am J Public Health 2011, 101(10):1922-1929.
• [6]Khaw K-T, Wareham N, Bingham S, Welch A, Luben R, Day N: Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study. PLoS Medicine 2008, 5(1):e12.
• [7]Pisinger C, Toft U, Aadahl M, Glumer C, Jorgensen T: The relationship between lifestyle and self-reported health in a general population: the Inter99 study. Prev Med 2009, 49(5):418-423.
• [8]Sugiyama T, Healy GN, Dunstan DW, Salmon J, Owen N: Joint associations of multiple leisure-time sedentary behaviours and physical activity with obesity in Australian adults. Int J Behav Nutr Phys Act 2008, 5:35. BioMed Central Full Text
• [9]Tsai J, Ford ES, Li C, Zhao G, Pearson WS, Balluz LS: Multiple healthy behaviors and optimal self-rated health: findings from the 2007 Behavioral Risk Factor Surveillance System Survey. Prev Med 2010, 51(3–4):268-274.
• [10]World Population Ageing 2007. New York, N.Y; 2007.
• [11]Evenson KR, Rosamond WD, Cai J, Diez-Roux AV, Brancati FL: Influence of retirement on leisure-time physical activity: the atherosclerosis risk in communities study. Am J Epidemiol 2002, 155(8):692-699.
• [12]Nooyens AC, Visscher TL, Schuit AJ, van Rossum CT, Verschuren WM, van Mechelen W, Seidell JC: Effects of retirement on lifestyle in relation to changes in weight and waist circumference in Dutch men: a prospective study. Public Health Nutr 2005, 8(8):1266-1274.
• [13]Tamers SL, Agurs-Collins T, Dodd KW, Nebeling L: US and France adult fruit and vegetable consumption patterns: an international comparison. Eur J Clin Nutr 2009, 63(1):11-17.
• [14]Dehghan M: Akhtar-Danesh N. Merchant AT: Factors associated with fruit and vegetable consumption among adults. J Hum Nutr Diet; 2011.
• [15]National Health Survey - Summary of results. Canberra, ACT: ABS; 2009.
• [16]Mealing NM, Bowles HR, Merom D, Bauman A: Impact of scoring algorithm on physical activity prevalence estimates in Australian adults. J Sci Med Sport 2011, 14(1):27-32.
• [17]Bauman A, Ainsworth BE, Sallis JF, Hagstromer M, Craig CL, Bull FC, Pratt M, Venugopal K, Chau J, Sjostrom M: The Descriptive Epidemiology of Sitting A 20-Country Comparison Using the International Physical Activity Questionnaire (IPAQ). Am J Prev Med 2011, 41(2):228-235.
• [18]Gardiner PA, Healy GN, Eakin EG, Clark BK, Dunstan DW, Shaw JE, Zimmet PZ, Owen N: Associations between television viewing time and overall sitting time with the metabolic syndrome in older men and women: the Australian Diabetes, Obesity and Lifestyle study. J Am Geriatr Soc 2011, 59(5):788-796.
• [19]DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P: Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med 2006, 21(3):267-275.
• [20]Idler EL, Benyamini Y: Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 1997, 38(1):21-37.
• [21]Lekander M, Elofsson S, Neve IM, Hansson LO, Unden AL: Self-rated health is related to levels of circulating cytokines. Psychosom Med 2004, 66(4):559-563.
• [22]Nixon Andreasson A, Jernelov S, Szulkin R, Unden AL, Brismar K, Lekander M: Associations between leptin and self-rated health in men and women. Gend Med 2010, 7(3):261-269.
• [23]Oliveira A, Rodriguez-Artalejo F, Lopes C: The association of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein: sex and body mass index interactions. Eur J Clin Nutr 2009, 63(11):1345-1352.
• [24]Healy GN, Dunstan DW, Salmon J, Cerin E, Shaw JE, Zimmet PZ, Owen N: Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care 2008, 31(4):661-666.
• [25]Laaksonen M, Talala K, Martelin T, Rahkonen O, Roos E, Helakorpi S, Laatikainen T, Prattala R: Health behaviours as explanations for educational level differences in cardiovascular and all-cause mortality: a follow-up of 60 000 men and women over 23 years. Eur J Public Health 2008, 18(1):38-43.
• [26]Han MA, Kim KS, Park J, Kang MG, Ryu SY: Association between levels of physical activity and poor self-rated health in Korean adults: The Third Korea National Health and Nutrition Examination Survey (KNHANES), 2005. Public Health 2009, 123(10):665-669.
• [27]Wendel-Vos GC, Schuit AJ, Tijhuis MA, Kromhout D: Leisure time physical activity and health-related quality of life: cross-sectional and longitudinal associations. Qual Life Res 2004, 13(3):667-677.
• [28]Haseli-Mashhadi N, Pan A, Ye X, Wang J, Qi Q, Liu Y, Li H, Yu Z, Lin X, Franco OH: Self-Rated Health in middle-aged and elderly Chinese: distribution, determinants and associations with cardio-metabolic risk factors. BMC Public Health 2009, 9:368. BioMed Central Full Text
• [29]Molarius A, Berglund K, Eriksson C, Lambe M, Nordstrom E, Eriksson HG, Feldman I: Socioeconomic conditions, lifestyle factors, and self-rated health among men and women in Sweden. Eur J Public Health 2007, 17(2):125-133.
• [30]Barros MB, Zanchetta LM, Moura EC, Malta DC: Self-rated health and associated factors, Brazil, 2006. Rev Saude Publica 2009, 43(Suppl 2):27-37.
• [31]Edwards P, Roberts I, Clarke M, DiGuiseppi C, Pratap S, Wentz R, Kwan I, Cooper R: Methods to increase response rates to postal questionnaires. Cochrane Database Syst Rev 2007, 2:MR000008.
• [32]McLennan W, Podger A: National Nutrition Survey Users' Guide. In Catalogue No 48010. Canberra, ACT: Australian Bureau of Statistics; 1998.
• [33]Rutishauser IHE, Webb K, Abraham B, Allsopp R: Evaluation of short dietary questions from the 1995 National Nutrition Survey. National Food and Nutrition Monitoring and Surveillance Project. Canberra, ACT: Commonwealth Department of Health and Aged Care; 2001.
• [34]Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, et al.: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003, 35(8):1381-1395.
• [35]Kaleta D, Makowiec-Dabrowska T, Dziankowska-Zaborszczyk E, Jegier A: Physical activity and self-perceived health status. Int J Occup Med Environ Health 2006, 19(1):61-69.
• [36]Okano G, Miyake H, Mori M: Leisure time physical activity as a determinant of self-perceived health and fitness in middle-aged male employees. J Occup Health 2003, 45(5):286-292.
• [37]Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O'Brien WL, Bassett DR, Schmitz KH, Emplaincourt PO, et al.: Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000, 32(9 Suppl):S498-S504.
• [38]Margetts BM, Rogers E, Widhal K, de Winter AM R, Zunft HJ: Relationship between attitudes to health, body weight and physical activity and level of physical activity in a nationally representative sample in the European Union. Public Health Nutr 1999, 2(1A):97-103.
• [39]Sodergren M, Sundquist J, Johansson SE, Sundquist K: Physical activity, exercise and self-rated health: a population-based study from Sweden. BMC Public Health 2008, 8:352. BioMed Central Full Text
• [40]Ball K, Crawford D: Socio-economic factors in obesity: a case of slim chance in a fat world? Asia Pac J Clin Nutr 2006, 15(Suppl):15-20.
• [41]Chai W, Nigg CR, Pagano IS, Motl RW, Horwath C, Dishman RK: Associations of quality of life with physical activity, fruit and vegetable consumption, and physical inactivity in a free living, multiethnic population in Hawaii: a longitudinal study. Int J Behav Nutr Phys Act 2010, 7:83. BioMed Central Full Text
• [42]Berrigan D, Dodd K, Troiano RP, Krebs-Smith SM, Barbash RB: Patterns of health behavior in U.S. adults. Prev Med 2003, 36(5):615-623.
• [43]Johnson SS, Paiva AL, Cummins CO, Johnson JL, Dyment SJ, Wright JA, Prochaska JO, Prochaska JM, Sherman K: Transtheoretical model-based multiple behavior intervention for weight management: effectiveness on a population basis. Prev Med 2008, 46(3):238-246.
• [44]Spring B, Schneider K, McFadden H, Vaughn J, Kozak AT, Smith M, Moller AC, Epstein L, Russell SW, DeMott A, et al.: Make Better Choices (MBC): Study design of a randomized controlled trial testing optimal technology-supported change in multiple diet and physical activity risk behaviors. BMC Public Health 2010, 10:586. BioMed Central Full Text
• [45]AIHW:Risk factors contributing to chronic disease. Canberra: AIHW: Australian Institute of Health and Welfare; 2012.
• [46]Ball K: People, places…and other people? Integrating understanding of intrapersonal, social and environmental determinants of physical activity. J Sci Med Sport 2006, 9(5):367-370.
• [47]Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, Troiano RP: Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol 2008, 167(7):875-881.
• [48]Ferrari P, Friedenreich C, Matthews CE: The role of measurement error in estimating levels of physical activity. Am J Epidemiol 2007, 166(7):832-840.
• [49]Richardson MT, Ainsworth BE, Jacobs DR, Leon AS: Validation of the Stanford 7-day recall to assess habitual physical activity. Ann Epidemiol 2001, 11(2):145-153.
• [50]Rzewnicki R, Vanden Auweele Y, De Bourdeaudhuij I: Addressing overreporting on the International Physical Activity Questionnaire (IPAQ) telephone survey with a population sample. Public Health Nutr 2003, 6(3):299-305.