Health-Enhancing Physical Activity in Europe-Combined Aerobic Physical Activity and Muscle-Strengthening Exercise Guideline Adherence Among 280,605 Adults From 28 European Countries.

BACKGROUND: Compared with engaging in aerobic physical activity (aerobic PA; eg, walking, running, cycling) or muscle-strengthening exercise (MSE; eg, weight/resistance training) alone, epidemiological evidence suggests that combining both is linked to better health. However, the assessment of both PA modes is rare in health surveillance. This article provides the first multicountry study on the descriptive epidemiology of combined moderate to vigorous PA-MSE guideline adherence. METHODS: Data were drawn from the European Health Interview Survey wave 2 (2013-2014), comprising samples from 28 European countries (n = 280,605). Self-reported aerobic PA and MSE were assessed using the validated European Health Interview Survey Physical Activity Questionnaire. The authors calculated the weighted proportions meeting the health-enhancing PA guideline (aerobic PA ≥ 150 min/wk and MSE ≥ 2 sessions/wk). Poisson regression assessed the prevalence ratios for meeting the combined guideline across sociodemographic factors and by country. RESULTS: A total of 15.0% met the health-enhancing PA guideline. The lowest prevalence was from respondents from Southern and Central European countries (Romania, Poland, and Croatia, range: 0.5%-5.7%). Poorer self-rated health, older age, lower income, being female, and being obese had a lower likelihood of meeting the combined guideline. CONCLUSIONS: Most European adults do not meet the health-enhancing PA guideline that includes both aerobic PA and MSE.

The epidemiology of muscle-strengthening exercise in Europe: A 28-country comparison including 280,605 adults.

OBJECTIVE: Muscle-strengthening exercise (use of weight machines, free weights, push-ups, sit-ups), has multiple independent health benefits, and is a component of the Global physical activity guidelines. However, there is currently a lack of multi-country muscle-strengthening exercise prevalence studies. This study describes the prevalence and correlates of muscle-strengthening exercise across multiple European countries. METHODS: Data were drawn from the European Health Interview Survey Wave 2 (2013-14), which included nationally representative samples (n = 3,774-24,016) from 28 European countries. Muscle-strengthening exercise was assessed using the European Health Interview Survey Physical Activity Questionnaire. Population-weighted proportions were calculated for (1) "insufficient" (0-1 days/week) or (2) "sufficient" muscle-strengthening exercise (≥2 days/week). Prevalence ratios were calculated using multivariate Poisson regression for those reporting sufficient muscle-strengthening by country and by sociodemographic/lifestyle characteristics (sex, age, education, income, self-rated health etc.). RESULTS: Data were available for 280,605 European adults aged ≥18 years. Overall, 17.3% (95% CI = 17.1%-17.5%) reported sufficient muscle-strengthening exercise (≥2 days/week). Muscle-strengthening exercise was geographically patterned with the lowest prevalence reported in South-eastern European countries (Romania, Malta and Cyprus: range: 0.7%-7.4%), and the highest prevalence in the Nordic countries (Iceland, Sweden, and Denmark: range: 34.1%-51.6%). Older age, insufficient aerobic activity, poorer self-rated health, lower income/education, being female, and being overweight/obese were significantly associated with lower likelihood of reporting sufficient muscle-strengthening exercise, independently of other characteristics. CONCLUSIONS: Most European adults do not report sufficient muscle-strengthening exercise, and prevalence estimates varied considerably across countries. Low participation in muscle-strengthening exercise is widespread across Europe, and warrants public health attention.

Muscle-Strengthening Exercise Among 397,423 U.S. Adults: Prevalence, Correlates, and Associations With Health Conditions.

INTRODUCTION: Although muscle-strengthening exercise has multiple independent health benefits, little is known about muscle-strengthening exercise participation and associations with adverse health conditions among U.S. adults. METHODS: In 2017, data were analyzed from the U.S. 2015 Behavioral Risk Factor Surveillance System. During telephone surveys, respondents reported how many times during the past week they engaged in muscle-strengthening exercise. Weighted weekly muscle-strengthening exercise frequencies were calculated for the total sample and across sociodemographic and lifestyle characteristics. A multivariable logistic regression assessed the odds of having self-reported adverse health conditions (e.g., diabetes, coronary heart disease) according to weekly muscle-strengthening exercise frequency. RESULTS: Data were available on 397,423 adults (aged 18-80 years). Overall, 30.2% (95% CI=29.9, 30.5) met the muscle-strengthening exercise recommendations (two or more times/week) and 57.8% (95% CI=57.5, 58.2) reported no muscle-strengthening exercise. Older age, insufficient aerobic activity, lower income, lower education, poorer self-rated health, being female, and being overweight/obese were significantly associated with lower odds of meeting the muscle-strengthening exercise recommendations independently of other characteristics. After adjusting for confounders (e.g., age, sex, income, smoking, aerobic activity), when compared with those who did none, muscle-strengthening exercise was associated with lower odds for several adverse health conditions, including prevalent diabetes, cancer (non-skin), poor self-rated health, and obesity. CONCLUSIONS: Three in five U.S. adults do not engage in any muscle-strengthening exercise, despite an association for muscle-strengthening exercise with better health conditions. Future muscle-strengthening exercise promotion strategies should target older adults, females, those with low education/income, and those with a poor health status.

Economic evaluation of a randomized controlled trial of an intervention to reduce office workers' sitting time: the "Stand Up Victoria" trial.

Objectives This study aimed to assess the economic credentials of a workplace-delivered intervention to reduce sitting time among desk-based workers. Methods We performed within-trial cost-efficacy analysis and long-term cost-effectiveness analysis (CEA) and recruited 231 desk-based workers, aged 24-65 years, across 14 worksites of one organization. Multicomponent workplace-delivered intervention was compared to usual practice. Main outcome measures including total device-measured workplace sitting time, body mass index (BMI), self-reported health-related quality of life (Assessment of Quality of Life-8D, AQoL-8D), and absenteeism measured at 12 months. Results Compared to usual practice, the intervention was associated with greater cost (AU$431/person), benefits in terms of reduced workplace sitting time [-46.8 minutes/8-hour workday, 95% confidence interval (CI): -69.9- -23.7] and increased workplace standing time (42.2 minutes/8-hour workday, 95% CI 23.8-60.6). However, there were no significant benefits for BMI [0.148 kg/m 2(95% CI-1.407-1.703)], QoL-8D [-0.006 (95% CI -0.074-0.063)] and absenteeism [2.12 days (95% CI -2.01-6.26)]. The incremental cost-efficacy ratios (ICER) ranged from AU$9.94 cost/minute reduction in workplace sitting time to AU$13.37/minute reduction in overall sitting time. CEA showed the intervention contributed to higher life year (LY) gains [0.01 (95% CI 0.009-0.011)], higher health-adjusted life year (HALY) gains [0.012 (95% CI 0.0105 - 0.0135)], and higher net costs [AU$344 (95% CI $331-358)], with corresponding ICER of AU$34 443/LY and AU$28 703/HALY if the intervention effects were to be sustained for five-years. CEA results were sensitive to assumptions surrounding intervention-effect decay rate and discount rate. Conclusions The intervention was cost-effective over the lifetime of the cohort when scaled up to the national workforce and provides important.

Feasibility for the Use of a Standardized Fitness Testing Protocol Among Australian Fitness Industry Professionals.

PURPOSE: There is currently no standardized testing protocol for assessing clients' fitness/health within the Australian fitness industry. This study examined the perceptions of the feasibility of using a standardized testing protocol among Australian fitness industry professionals. METHOD: In 2014, 1,206 registered fitness industry professionals (aged 17-69 years) completed an online survey. Perceived feasibility for using a standardized testing protocol was assessed based on responses to 6 items. Respondents were classified as having a high level of perceived feasibility if they reported all 6 items to be "definitely feasible." A multivariate logistic regression analysis, adjusting for demographic and fitness industry-related factors (e.g., qualification/years of experience), assessed the likelihood of having a high level of perceived feasibility. RESULTS: Overall, 25.5% (95% CI [23.1%, 28.0%]) of the sample perceived the use of a standardized testing protocol as highly feasible. Items ranked most often as "definitely feasible" were "undertaking training to use the protocol" (55%) and "conducting follow-up testing every 6 to 12 weeks" (52%). After adjustment for the effect of confounding factors, casually employed professionals (OR = 0.63; 95% CI [0.45, 0.90]) and group instructors (OR = 0.58; 95% CI [0.41, 0.82]) were less likely to perceive standardized testing protocols as highly feasible. CONCLUSIONS: Among a large sample of Australian fitness industry professionals, slightly more than a quarter perceived using a standardized testing protocol to be highly feasible. Group instructors and casual employees perceived lower feasibility. Further research should determine the barriers to implementing a standardized testing protocol across the fitness industry.

Assessment and monitoring practices of Australian fitness professionals.

OBJECTIVES: Assessment and monitoring of client health and fitness is a key part of fitness professionals' practices. However, little is known about prevalence of this practice. This study describes the assessment/monitoring practices of a large sample of Australian fitness professionals. DESIGN: Cross-sectional. METHODS: In 2014, 1206 fitness professionals completed an online survey. Respondents reported their frequency (4 point-scale: [1] 'never' to [4] 'always') of assessment/monitoring of eight health and fitness constructs (e.g. body composition, aerobic fitness). This was classified as: (i) 'high' ('always' assessing/monitoring ≥5 constructs); (ii) 'medium' (1-4 constructs); (iii) 'low' (0 constructs). Classifications are reported by demographic and fitness industry characteristics. The odds of being classified as a 'high assessor/monitor' according to social ecological correlates were examined using a multiple-factor logistic regression model. RESULTS: Mean age of respondents was 39.3 (±11.6) years and 71.6% were female. A total of 15.8% (95% CI: 13.7%-17.9%) were classified as a 'high' assessor/monitor. Constructs with the largest proportion of being 'always' assessed were body composition (47.7%; 95% CI: 45.0%-50.1%) and aerobic fitness (42.5%; 95% CI: 39.6%-45.3%). Those with the lowest proportion of being 'always' assessed were balance (24.0%; 95% CI: 24.7%-26.5%) and mental health (20.2%; 95% CI: 18.1%-29.6%). A perceived lack of client interest and fitness professionals not considering assessing their responsibility were associated with lower odds of being classified as a 'high assessor/monitor'. CONCLUSIONS: Most fitness professionals do not routinely assess/monitor client fitness and health. Key factors limiting client health assessment and monitoring include a perceived lack of client interest and professionals not considering this their role.

Sources of practice knowledge among Australian fitness trainers.

Few studies have examined the sources of practice knowledge fitness trainers use to inform their training methods and update knowledge. This study aims to describe sources of practice knowledge among Australian fitness trainers. In July 2014, 9100 Australian fitness trainers were invited to complete an online survey. Respondents reported the frequency of use of eight sources of practice knowledge (e.g. fitness magazines, academic texts). In a separate survey, exercise science experts (n = 27) ranked each source as either (1) 'high-quality' or (2) 'low-quality'. Proportions of users of 'high-quality' sources were calculated across demographic (age, sex) and fitness industry-related characteristics (qualification, setting, role). A multivariate logistic regression analysis assessed the odds of being classified as a user of high-quality sources, adjusting for demographic and fitness industry-related factors. Out of 1185 fitness trainers (response rate = 13.0%), aged 17-72 years, 47.6% (95% CI, 44.7-50.4%) were classified as frequent users of high-quality sources of practice knowledge. In the adjusted analysis, compared to trainers aged 17-26 years, those aged ≥61 years (OR, 2.15; 95% CI, 1.05-4.38) and 40-50 years (OR, 1.54; 95% CI, 1.02-2.31) were more likely to be classified as a user of high-quality sources. When compared to trainers working in large centres, those working in outdoor settings (OR, 1.81; 95% CI, 1.23-2.65) and medium centres (OR, 1.59; 95% CI, 1.12-2.29) were more likely to be classified as users of high-quality sources. Our findings suggest that efforts should be made to improve the quality of knowledge acquisition among Australian fitness trainers.