Original researchAccelerometer measured sedentary behavior and physical activity in white and black adults: The REGARDS study
Introduction
Many adults in the Unites States (U.S.) do not achieve the recommended amount of physical activity (PA) to fully realize health benefits.1, 2 Adult women, blacks, and persons residing in the Southeast U.S. self-report the lowest levels of PA.1, 3, 4 However, self-reported PA is prone to recall biases, imprecise quantification of intensity, and cultural biases in perceived desirability of PA, which can lead to misclassification of individual and population PA levels.5, 6 Misclassification of PA may be particularly concerning when using self-report in racial/ethnic minorities for whom subgroup-specific questionnaires have not been developed. In addition, older adults are more likely to engage in light intensity activities that are challenging to accurately capture via self-report.7 To help avoid misclassification and other difficulties, objective measures of PA can be employed.
Emerging evidence also reveals the need to measure sedentary behavior as it exerts an effect independent of PA on several health-related outcomes.8, 9 As with PA, objective measures of sedentary behavior are recommended to supplement self-reported assessments.7, 10 However, little is known about objectively measured levels of sedentary behavior among subgroups of adults living in the U.S. What has been reported in much smaller samples than the current study suggests older adults are the most sedentary with little difference noted between white and black older adults.3, 11
Our aim was to obtain objective measures of sedentary behavior (i.e., activities expending <1.5 METs) and PA in a large sample of white and black midlife and older adults living in the U.S. It is possible that health disparities between subgroups are partially due to differences in lifestyle behaviors such as sedentariness and PA. Thus, a more accurate description of these two lifestyle behaviors among midlife and older adults is desirable.
Section snippets
Methods
The REasons for Geographic and Racial Differences Study (REGARDS) comprises a general population sample in the U.S. with oversampling from the Stroke Belt in the Southeast U.S. (comprising the states of North Carolina, South Carolina, Georgia, Tennessee, Mississippi, Alabama, Louisiana, and Arkansas). REGARDS was designed to prospectively examine racial and regional disparities in stroke risk and mortality with methods described elsewhere.12 Overall, 30,239 black and white participants, aged
Results
Table 1 displays demographic and accelerometer compliance characteristics. There was a statistically significant difference among race/sex groups for mean age, valid wear days and daily wear time. The mean age for white men was significantly higher than other race/sex groups who did not vary by age. There were significant differences in the distribution of proportions within and across race/sex groups for income, education, BMI, diabetes, hypertension, and smoking. White men and women had
Discussion
This study employed an objective measurement of time spent in sedentary behavior and varying intensities of PA in a large sample of community-dwelling midlife and older adults in the U.S. Overall, results indicated midlife and older adults rarely undertook MVPA and accumulated very high levels of sedentary behavior (11–13 h/day). The subgroups most affiliated with this pattern were those >85 years of age, Stroke Belt residents, and black women. The proportion of wear time spent in sedentary
Conclusions
The findings reveal persons >85 years, those classified obese, those in the Stroke Belt, and white and black women were the most sedentary and least active segments studied. However, the vast majority of white and black midlife and older adults in the study, regardless of sex, age, residential location, race, or BMI status, engaged sparingly in MVPA and accumulated tremendous amounts of sedentary behavior each day. In addition, they seldom engaged in continuous bouts of health-enhancing PA.
Practical implications
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The objective measure of sedentary behavior and PA reveals midlife and older adults seldom engage in continuous bouts of health-enhancing PA.
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The miniscule level of moderate or higher intensity PA accompanied by 11–13 h of sedentary behavior during wake time reiterates the need for effective interventions targeting both behaviors, especially in high risk subgroups.
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Midlife and older adults accrue substantial amounts of LIPA daily and, although health benefits are not well known, promotion of LIPA
Contributors
SPH conceived of the study, participated in its design, performed the statistical analysis, interpreted the results, and drafted the manuscript. BH, SNB, NC, and JEV participated in design of the study, interpreted the results, and helped draft the manuscript. DR and VJH participated in the design and coordination of the study, interpreted results, and helped draft the manuscript. WZ performed the statistical analyses, interpreted the results, and helped draft the manuscript. All authors read
Competing interests
None.
Ethics approval
This study as approved by the Institutional Review Boards at the University of Alabama at Birmingham, University of South Carolina, University of Georgia, and Arizona State University.
Acknowledgements
This research project is supported by a cooperative agreement U01 NS041588 and investigator-initiated grant R01NS061846 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service. Additional funding was provided by an unrestricted research grant from The Coca-Cola Company. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of
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