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  1. Women and Physical Activity Barbara Ainsworth Arizona State University

  2. PA, Women, and Health • Physical Activity and Health • Physical Activity Patterns • Using Right Measurement Tools to Assess the Patterns

  3. PA in Women and Disease Endpoints Slides borrowed from Professor Wendy Brown

  4. Relative risk of cvd outcomes by approximate quintiles of physical activity Meeting guidelines 1-3 hours/week moderate intensity PA → 20-30% reduction in risk of cvd or stroke

  5. Relative risk of cvd outcomes by approximate quintiles of walking Meeting guidelines As little as ONE HOUR OF WALKING PER WEEK (3.2 – 4.8 km/h) is associated with RR reduction of 25-30% - meeting guidelines confers greater benefit .

  6. Relative risk of cvd outcomes by walking pace Meeting guidelines

  7. Conclusions • Inverse relationship between PA and primary prevention of cvd, diabetes, mental health, some cancers • Benefits related to volume of activity, not intensity • Brisk walking has significant health benefits

  8. PA Questions in Prior Studies 3. Did you do sports and recreational activities in the past week? If yes, identify: Activity 1 _____________ day/wk _____ time/event ____ wk/yr ___ Activity 2 _____________ day/wk _____ time/event ____ wk/yr ___

  9. Physical Activity 2000 BRFSS Prevalence of Walking Adults > 18 Years Old 25-65 years old

  10. Physical Activity 2001 BRFSS Prevalence of Regular PAfor Men & Women 18 - 90 Years Old

  11. Physical Activity 2001 BRFSS Prevalence of Inactivity for Men & Women 18 - 90 Years Old 100 Men 90 Women 80 70 60 Prevalence (%) 50 40 30 20 10 0 18 22 26 30 34 38 42 46 50 54 58 62 66 70 74 78 82 86 90 Age (years)

  12. Are women really inactive as we are led to believe? Or are we not measuring well the activity they are doing?

  13. Career Choices

  14. 17010 1 05050 4 5 13020 Daily Activity in 160 Minority Women Min/day

  15. Daily Activity in 160 Minority Women

  16. Awake time: 11.8 hrsOccupation, Leisure, Housework 9.3 hours 2.5 hours N = 160

  17. Light Intensity: 9.5 hrOcc, Leisure, House, Trans, Walk Total 9.5 hrs/day N = 160

  18. Moderate Intensity: 1.7 hrOcc, Walk, House, Yard, Care, Cond Total 1.7 hrs/day 23 min 9 min N = 160

  19. Health & Retirement Study 1992 (51-61 years) N = 5,116 women How often do you participate in light PA, such as walking, dancing, gardening, golfing, etc? LTPA How often do you participate in vigorous exercise or sports, such as running, swimming, or bicycling? My job requires lots of physical effort, such as lifting heavy loads, stooping, kneeling, or crouching? OCC How often do you do heavy housework like scrubbing floors or washing windows? HOUSE He, X et al. J Gen Intern Med 2005;20:259-266

  20. PA by Race/Ethnicity(> 3 times/week) % He, X et al. J Gen Intern Med 2005;20:259-266

  21. PA by Education (> 3 times/week) Years Education %

  22. Shanghai Women’s Health Study1997-2000 (40-70 yrs) N = 74, 942 77% exercised in teen years (~ 2 hr/wk) 35.5% exercised in past 5 yrs Tai Chi (79%) Dancing (14%) Walking (3.8%) 80% did non-exercise activities in past year Jurj, et al. BMC Public Health 2007;7(213)

  23. Shanghai Women’s Health Study: Non-Exercise PA % 84 flts/wk w 5.4 hr/wk 14 hr/wk w 10.5 hr/wk c 4.5 hr/wk c 3.5 hr/wk

  24. Kaiser Physical Activity Studyn = 2,636 (mean age 42.3 + 11 yr) Sports & Exercise Active Living Occupational Household/Care giving Total PA 1 to 4 pt ordinal scale All women answered Each question Sternfeld, B. et al. Prev. Med 1999; 28:313-323

  25. Odds of Performing Activities Sports/ExHouse/Care Increased Age Non white < College Kids < 5 yr > 2 1 Inc BMI No motivation External obstacles High social support High self efficacy Inc Age Black Asian Latino Employed Children 2+ 1 Married Time const.

  26. Multi-DomainQuestionnaires Available • Int’l PAQ – long • Global PAQ (GPAQ) • Typical Week PA Survey • Multiethnic Study of Atherosclerosis (MESA) • Modifiable PAQ • Kaiser PA Survey • CHAMPS • LTPA household supplement

  27. Dilemma • More activities you ask about  more active people appear to be • Need complex scoring and data analysis programs • Caution when combining all PA’s for summary score as the light intensity cancels out the vigorous intensity • What is background PA and what is not? • Not assessing all dimensions in women

  28. 3 Ways to Improve Understanding aboutPA in Women

  29. Assess Relevant PA Dimensions • American Time Use Data • 1 hour personal care • 3 hours home care, errands, shopping • 1-2 hours caring for others • 1 to 2 hours transportation • 7 hours work and school • 1 hour eating and drinking • 4 hour socializing and relaxing From Sandi Ham

  30. Report Data for each Questionnaire Domain • We will know the impact of varying domains of PA on various health outcomes • It will be helpful for intervention and dissemination studies

  31. Collect, Analyze, & ReportData by Sex and Race/Ethnicity Don’t adjust it out! Plan your studies with sufficient power (enough subjects & valid measures!) to stratify by sex -- race/ethnicity -- … and, age, if possible

  32. Thank you Acknowledgements Sandi Ham, CDC Wendy Brown, University of Queensland