Original research
Accelerometer measured sedentary behavior and physical activity in white and black adults: The REGARDS study

https://doi.org/10.1016/j.jsams.2015.04.006Get rights and content

Abstract

Objectives

Health disparities between subgroups may be partially due to differences in lifestyle behaviors such as sedentariness and physical activity. To obtain a more accurate description of these two lifestyle behaviors, accelerometry was employed among a large sample of white and black adults (ages 49–99 years) living in the United States.

Design

Cross-sectional.

Methods

7967 participants from the REasons for Geographic and Racial Differences in Stroke cohort wore an Actical™ accelerometer ≥10 h/day for ≥4 days. Time (mean minutes/day and proportion of total wear time) spent in sedentary behavior, light intensity physical activity, and moderate-vigorous intensity physical activity was compared by sex, age, body mass index, race, and geographic location.

Results

Proportion of total wear time spent in sedentary behavior was 75–90%, light intensity physical activity was 10–23%, and moderate-vigorous intensity physical activity was 0–1.7% across subgroups. Mean moderate-vigorous intensity physical activity was 0–16 min/day and associated with 3–12% accumulating ≥150 min/wk using a 10-min bout criterion. Persons ≥85 years, those classified obese, persons living in the southeastern United States, and black women were the most inactive. The proportion achieving at least one 10-min bout of moderate-vigorous intensity physical activity per week was only 36%. The number of 10-min bouts/week was 1.5 ± 0.08 bouts/week. The distribution of weekly moderate-vigorous intensity physical activity was similar across nearly all subgroups with a distinct reverse J-shaped configuration.

Conclusions

The vast majority of white and black midlife and older adults in this study engaged sparingly in moderate-vigorous intensity physical activity, accumulated tremendous amounts of sedentary behavior, and seldom engaged in continuous bouts of health-enhancing physical activity.

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

  • The objective measure of sedentary behavior and PA reveals midlife and older adults seldom engage in continuous bouts of health-enhancing PA.

  • 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.

  • 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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