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PURPOSE: Assess the agreement between commonly used self-report methods compared with objectively measured physical activity (PA) in defining the prevalence of individuals compliant with PA recommendations. METHODS: Time spent in moderate and vigorous PA (MVPA) was measured at two time points in 1713 healthy individuals from nine European countries using individually calibrated combined heart rate and movement sensing. Participants also completed the Recent Physical Activity Questionnaire (RPAQ), short form of the International Physical Activity Questionnaire (IPAQ), and short European Prospective Investigation into Cancer and Nutrition Physical Activity Questionnaire (EPIC-PAQ). Individuals were categorized as active (e.g., reporting ≥150 min of MVPA per week) or inactive, based on the information derived from the different measures. Sensitivity and specificity analyses and Kappa statistics were performed to evaluate the ability of the three PA questionnaires to correctly categorize individuals as active or inactive. RESULTS: Prevalence estimates of being sufficiently active varied significantly (P for all <0.001) between self-report measures (IPAQ 84.2% [95% confidence interval {CI}, 82.5-85.9], RPAQ 87.6% [95% CI, 85.9-89.1], EPIC-PAQ 39.9% [95% CI, 37.5-42.1] and objective measure 48.5% [95% CI, 41.6-50.9]. All self-report methods showed low or moderate sensitivity (IPAQ 20.0%, RPAQ 18.7%, and EPIC-PAQ 69.8%) to correctly classify inactive people and the agreement between objective and self-reported PA was low (ĸ = 0.07 [95% CI, 0.02-0.12], 0.12 [95% CI, 0.06-0.18], and 0.19 [95% CI, 0.13-0.24] for IPAQ, RPAQ, and EPIC-PAQ, respectively). CONCLUSIONS: The modest agreement between self-reported and objectively measured PA suggests that population levels of PA derived from self-report should be interpreted cautiously. Implementation of objective measures in large-scale cohort studies and surveillance systems is recommended. ; The preparation of this paper was supported by the DEterminants of DIet and Physical ACtivity (DEDIPAC) knowledge hub. This work is supported by the Joint Programming Initiative 'Healthy Diet for a Healthy Life'. The funding agencies supporting this work are Ireland: The Health Research Board (HRB); The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw); Norway: The Research Council of Norway, Division for Society and Health The data collection was supported by funding from the European Union (Integrated Project LSHM-CT-2006-037197 in the Framework Programme 6 of the European Community) and the MRC Epidemiology Unit Programmes (MC_UU_12015/3). We would like to thank the Interact validation group* and MRC Epidemiology Unit physical activity technical team and data management team, in particular Mark Betts, Laura Lamming, Stefanie Mayle, Kate Westgate and Nicola Kerrison who assisted with data reduction, cleaning and processing. The InterAct validation working group* are Anne M May, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Wanda Wendel-Vos, National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands; Kristin Benjaminsen Borch, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Kim Overvad, Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark and Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Marie-Aline Charles, Inserm, Centre for research in Epidemiology and Population Health, U1018, Lifelong epidemiology of obesity, diabe`tes and chronic renal disease Team, F-94807, Villejuif, France; Univ Paris-Sud, UMRS 1018, F-94807, Villejuif, France; Maria Jose Tormo Diaz, Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain, CIBER Epidemiologıa y Salud Publica (CIBERESP), Spain and Department Sociosanitary Sciences, Murcia School of Medicine, Murcia, Spain; Pilar Amiano, Public Health Division of Gipuzkoa, BioDonostia Research Isntitute, Basque Region, San Sebastian ; CIBER Epidemiologıa y Salud Publica (CIBERESP), Madrid, Spain; Domenico Palli ,Molecular and Nutritional Epidemiology Unit, ISPO, Cancer Prevention and Research Institute, Florence, Italy; Eliavet Valanou, Hellenic Health Foundation (HHF), Athens, Greece;, Department of Epidemiology; Mattheaus Vigl, German Institute of Human Nutrition (DIfE) Potsdam-Rehbruecke, Germany and Paul W Franks, Department of Clinical Sciences, Genetic & Molecular Epidemiology Unit, Skåne University Hospital, Lund University, Malmö, Sweden, Genetic Epidemiology & Clinical Research Group, Department of Public Health & Clinical Medicine, Section for medicine, Umeå University, Sweden. The results of the current study do not constitute an endorsement by the American College of Sports Medicine. The authors have no conflict of interest to report. ; This is the author accepted manuscript. The final version is available from Lippincott Williams & Wilkins via http://dx.doi.org/10.1249/MSS.0000000000000760

Funder: PAL Technologies ; Funder: Public Health Agency of Canada; doi: http://dx.doi.org/10.13039/100011094 ; Funder: Government of Norway ; BACKGROUND: In 2018, the World Health Organisation (WHO) commenced a program of work to update the 2010 Global Recommendations on Physical Activity for Health, for the first-time providing population-based guidelines on sedentary behaviour. This paper briefly summarizes and highlights the scientific evidence behind the new sedentary behaviour guidelines for all adults and discusses its strengths and limitations, including evidence gaps/research needs and potential implications for public health practice. METHODS: An overview of the scope and methods used to update the evidence is provided, along with quality assessment and grading methods for the eligible new systematic reviews. The literature search update was conducted for WHO by an external team and reviewers used the AMSTAR 2 (Assessment of Multiple Systematic Reviews) tool for critical appraisal of the systematic reviews under consideration for inclusion. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to rate the certainty (i.e. very low to high) of the evidence. RESULTS: The updated systematic review identified 22 new reviews published from 2017 up to August 2019, 14 of which were incorporated into the final evidence profiles. Overall, there was moderate certainty evidence that higher amounts of sedentary behaviour increase the risk for all-cause, cardiovascular disease (CVD) and cancer mortality, as well as incidence of CVD, cancer, and type 2 diabetes. However, evidence was deemed insufficient at present to set quantified (time-based) recommendations for sedentary time. Moderate certainty evidence also showed that associations between sedentary behaviour and all-cause, CVD and cancer mortality vary by level of moderate-to-vigorous physical activity (MVPA), which underpinned additional guidance around MVPA in the context of high sedentary time. Finally, there was insufficient or low-certainty systematic review evidence on the type or domain of sedentary behaviour, or the frequency and/or duration of bouts or breaks in sedentary behaviour, to make specific recommendations for the health outcomes examined. CONCLUSIONS: The WHO 2020 guidelines are based on the latest evidence on sedentary behaviour and health, along with interactions between sedentary behaviour and MVPA, and support implementing public health programmes and policies aimed at increasing MVPA and limiting sedentary behaviour. Important evidence gaps and research opportunities are identified.

Purpose.To determine the effects of the physical activity promotion programs Rehabilitation & Sports (R&S) and Active after Rehabilitation (AaR) on sport and daily physical activity 1 year after in- or outpatient rehabilitation.Design.Subjects in intervention rehabilitation centers were randomized into a group receiving R&S only (n = 315) and a group receiving R&S and AaR (n = 284). Subjects in six control centers (n = 603) received usual care.Setting.Ten Dutch rehabilitation centers.Subjects.Subjects consisted of 1202 rehabilitation patients. Most frequent diagnoses were stroke, neurological disorders, and back disorders.Intervention.Both the sport stimulation program (R&S) and the daily physical activity promotion program (AaR) consisted of personalized tailored counseling.Measures.Two sport outcomes and two daily physical activity outcomes were assessed with questionnaires at baseline and 1 year after rehabilitation.Analysis.Multilevel analyses comparing both intervention groups to the control group.Results.The R&S program showed no significant effects. Intention-to-treat analyses in the R&S + AaR group showed borderline significant improvements in one sport (odds ratio [OR] = 1.66, p = .02) and both physical activity outcomes (OR = 1.68, p = .01 and regression coefficient = 10.78, p = .05). On-treatment analyses in the R&S + AaR group showed similar but stronger effects.Conclusions.The combination of the R&S and AaR programs improved physical activity behavior and sport participation 1 year after in- or outpatient rehabilitation. The R&S program alone did not have any effects.

Funder: Public Health Agency of Canada ; Funder: Government of Norway ; BACKGROUND: In July, 2019, the World Health Organization (WHO) commenced work to update the 2010 Global Recommendations on Physical Activity for Health and established a Guideline Development Group (GDG) comprising expert public health scientists and practitioners to inform the drafting of the 2020 Guidelines on Physical Activity and Sedentary Behavior. The overall task of the GDG was to review the scientific evidence and provide expert advice to the WHO on the amount of physical activity and sedentary behavior associated with optimal health in children and adolescents, adults, older adults (> 64 years), and also specifically in pregnant and postpartum women and people living with chronic conditions or disabilities. METHODS: The GDG reviewed the available evidence specific to each sub-population using systematic protocols and in doing so, identified a number of gaps in the existing literature. These proposed research gaps were discussed and verified by expert consensus among the entire GDG. RESULTS: Evidence gaps across population sub-groups included a lack of information on: 1) the precise shape of the dose-response curve between physical activity and/or sedentary behavior and several of the health outcomes studied; 2) the health benefits of light-intensity physical activity and of breaking up sedentary time with light-intensity activity; 3) differences in the health effects of different types and domains of physical activity (leisure-time; occupational; transportation; household; education) and of sedentary behavior (occupational; screen time; television viewing); and 4) the joint association between physical activity and sedentary time with health outcomes across the life course. In addition, we acknowledge the need to conduct more population-based studies in low- and middle-income countries and in people living with disabilities and/or chronic disease, and to identify how various sociodemographic factors (age, sex, race/ethnicity, socioeconomic status) modify the health effects of physical activity, in order to address global health disparities. CONCLUSIONS: Although the 2020 WHO Guidelines for Physical Activity and Sedentary Behavior were informed by the most up-to-date research on the health effects of physical activity and sedentary time, there is still substantial work to be done in advancing the global physical activity agenda.

Funder: The Public Health Agency of Canada and the Government of Norway provided financial support, without which this work could not have been completed ; Objectives: To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods: The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results: The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. Conclusion: These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018–2030 and to strengthen surveillance systems that track progress towards national and global targets.

Funder: The Public Health Agency of Canada and the Government of Norway provided financial support, without which this work could not have been completed ; OBJECTIVES: To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. METHODS: The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. RESULTS: The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150-300 min of moderate-intensity, or 75-150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. CONCLUSION: These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018-2030 and to strengthen surveillance systems that track progress towards national and global targets.