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Focus Area 22: Physical Activity and Fitness Richard J. Klein National Center for Health Statistics Progress Review June 26, 2008. Physical Activity and Fitness Benefits. Decreases the risk of obesity and chronic diseases, including osteoporosis

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Decreases the risk of obesity and chronic diseases, including osteoporosis


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    1. Focus Area 22:Physical Activity and Fitness Richard J. KleinNational Center for Health StatisticsProgress ReviewJune 26, 2008

    2. Physical Activity and Fitness Benefits • Decreases the risk of obesity and chronic diseases, including osteoporosis • Better control of body weight, blood pressure, blood glucose, and cholesterol • Improved mood and feelings of well-being • Enhances independent living among older adults • Improves quality of life for people of all ages

    3. Highlighted Objectives Individual behavior 22-1. No physical activity 22-2. Moderate or vigorous physical activity for adults 22-7. Vigorous physical activity for adolescents Organizational policy 22-8a,b. Physical education requirement in schools 22-12. Access to school physical activity facilities Environmental intervention and programs 22-9. Participation in daily physical education in schools 22-10. Physical activity in physical education class 22-11. Television viewing Target met Improving Little or no change* Getting worse Baseline only Note: *Percent of targeted change achieved is between -10% and 10%, and/or change not statistically significant.

    4. Leisure Time Physical Activity Among Adults Some 28% Some 30% None 40% None 39% Regular 32% Regular 31% 1997 2006 Note: Data are for ages 18 years and over, age adjusted to the 2000 standard population. Regular leisure-time physical activity is a moderate/vigorous physical activity (moderate activity 30+ minutes/5+ times per week or vigorous activity 20+ minutes/3+ times per week). Source: National Health Interview Survey (NHIS), NCHS, CDC. Objs. 22-1,2

    5. No Leisure TimePhysical Activity Among Adults Percent Decrease desired 1997 2010 Target 2006 2010 Target: 20 Total Female Male 18-24 years 25-44 years 45-64 years 65-74 years 75 years + 0 20 40 60 80 Percent Note: Data are for ages 18 years and over. Except for age-specific estimates data are age adjusted to the 2000 standard population. I = 95% confidence interval. Source: National Health Interview Survey (NHIS), NCHS, CDC. Obj. 22-1

    6. No Leisure TimePhysical Activity Among Adults, 2006 Decrease Desired 2010 Target: 20 Total American Indian Asian Black White Hispanic Less than high school High school graduate Some college College graduate or higher Percent Note: Except for education levels, data are for adults 18 years and over; education-level data are for adults 25 years and over. Data areage adjusted to the 2000 standard population.American Indian includes Alaska Native. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. I = 95% confidence interval. Source: National Health Interview Survey (NHIS), NCHS, CDC. Obj. 22-1

    7. Regular Leisure TimePhysical Activity Among Adults Percent Increase Desired 2010 Target 1997 2006 Age-adjusted percent Total Female Male 2010 Target: 50 18-24 years 25-44 years 45-64 years 65-74 years 75 years + 0 20 40 60 80 Percent Note: Except for age-specific estimates, data are for adults 18 years and over and are age adjusted to the 2000 standard population. Regular leisure-time physical activity is a moderate or vigorous physical activity (moderate activity 30+ minutes/5+ times per week or vigorous activity 20+ minutes/3+ times per week). I = 95% confidence interval. Source: National Health Interview Survey (NHIS), NCHS, CDC. Obj. 22-2

    8. Regular Leisure TimePhysical Activity Among Adults, 2006 Increase Desired Total American Indian Asian 2010 Target: 50 Black White Hispanic Less than high school High school graduate Some college College graduate or higher Percent Note: Except for education levels, data are for adults 18 years and over; education-level data are for adults 25 years and over. Data are age adjusted to the 2000 standard population. Regular leisure-time physical activity is moderate or vigorous physical activity (moderate activity 30+ minutes/5+ times per week or vigorous activity 20+ minutes/3+ times per week). American Indian includes Alaska Native. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. I = 95% confidence interval. Source: National Health Interview Survey (NHIS), NCHS, CDC. Obj. 22-2

    9. Likelihood of Selected Health Problems by Leisure Time Physical Activity Level, 2006 Inactive Some activity Regular activity Odds Ratio Fair or poor health Diagnosed diabetes Serious psychological distress Note: Data are for adults 18 years and older. Odds ratios are adjusted for sex, age, race/ethnicity, educational, and poverty status. Data are age adjusted to the 2000 standard population. Inactive is no moderate or vigorous physical activity; some activity is physical activity less than the regular activity. Regular activity is a moderate (30+ min /5+ time per week) or vigorous activity (20+ min/ 3+ times per week) or both. Serious psychological distress includes negative moods during the past 30 days: sad, nervous, restless, hopeless, feeling everything is an effort, and worthless. I = 95% confidence interval. Source: National Health Interview Survey (NHIS), NCHS, CDC.

    10. Regular Vigorous Physical Activity Among Adolescents Increase Desired 1999 2007 Percent 2010 Target Total Female Male 2010 Target: 85 Black White Hispanic 0 20 40 60 80 100 Percent Note: Data are for students in grades 9 through 12. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select one or more races. The categories black and white include persons who reported only one racial group. Regular vigorous physical activity is a regular activity 20+ minutes on 3+ of the past 7 days that make students sweat or breathe hard. I = 95% confidence interval. Source: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC. Obj. 22-7

    11. Physical Activity Measured by Accelerometer • Physical activity monitor component of NHANES 2003-06 • Measures intensity and duration of common activities such as walking and running • Has a pedometer (step-counter) feature • Worn over the right hip on an elasticized belt for 7 days • More than 12,000 persons 6+ years wore accelerometers. • Results may be linked to interview, health (BMI, functional status, bone status, blood pressure, etc.), and laboratory data.

    12. Recommended Levels of Physical Activity 60+ min/5-7 days Female 6-11 years 12-15 years 16-19 years Male 6-11 years 12-15 years 16-19 years 30+ min/5-7 days Female 16-19 years 20-59 years 60+ years Male 16-19 years 20-59 years 60+ years 0 10 20 30 40 50 60 Percent Note: Adherence: for ages 6–19 years - 60 or more minutes of moderate- or greater-intensity activity on 5 of 7 days; for ages 16 years and older – 30 or more minutes of moderate- or greater-intensity activity on 5 of 7 days, accumulated in 10-min “bouts.” I = 95% confidence interval. Source: Troiano, RP, et al. Physical Activity in the United States Measured by Accelerometer. Medicine & Science in Sports & Exercise. 2008, 40(1): 181-188. National Health and Nutrition Examination Survey (NHANES), NCHS, CDC.

    13. Daily Physical Education Requirement in Schools IncreaseDesired 2000 2006 Percent 2010 Target: 14.5 2010 Target: 9.4 Senior high schools Middle and junior high schools Note: Data are for public and private middle, junior, and senior high schools. Source: School Health Policies and Programs Study (SHPPS), NCCDPHP, CDC Obj. 22-8a,b

    14. Participation in Daily Physical Education in Schools Increase Desired 1999 2007 Percent 2010 Target: 50 Total 9th grade 10th grade 11th grade 12th grade Note: Data are for students in grades 9 through 12. I = 95% confidence interval. Source: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC. Obj. 22-9

    15. Physical Activity in Physical Education Class Increase Desired 1999 2007 Percent 2010 Target: 50 Total 9th grade 10th grade 11th grade 12th grade Note: Data are for students in grades 9 through 12 enrolled in physical education class. Physical activity in physical education class includes 21+ minutes exercising or playing sports 3 to 5 times a week. I = 95% confidence interval. Source: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC. Obj. 22-10

    16. Community Access to School Physical Activity Facilities Increase Desired Percent 2010 Target: 50 2000 2006 Note: Data are for public and private elementary, middle/junior, and senior high schools, that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. Source: School Health Policies and Programs Study (SHPPS), NCCDPHP,CDC. Obj. 22-12

    17. Adolescents Who View Television Two or Fewer Hours on a School Day Increase Desired 1999 2007 Percent 2010 Target: 75 Total Female Male Black White Hispanic Note: Data are for students in grades 9 through 12. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select one or more races. The categories black and white include persons who reported only one racial group. I = 95% confidence interval. Source: Youth Risk Behavior Surveillance System, NCCDPHP, CDC. Obj. 22-11

    18. Physical Activity and Fitness Objectives Target met Improving Little or no change* Physical Activity among Adults 22-1. No leisure time physical activity 22-2. Moderate regular physical activity 22-3. Vigorous physical activity 22-4. Muscular strength and endurance 22-5. Flexibility 22-9. Participation in daily school PE 22-10. Physical activity in PE class 22-11. Television viewing 22-12. Access to school physical activity facilities Physical Activity among Adolescents Worksites and Communities 22-6. Moderate physical activity 22-7. Vigorous physical activity 22-8. Physical education requirement in schools a. Middle/junior high schools b. Senior high schools 22-13. Worksite physical activity and fitness programs 22-14. Community walking a. Adults b. Children and adolescents 22-15. Community bicycling a. Adults b. Children and adolescents Getting worse Baseline only Note: *Percent of targeted change achieved is between -10% and 10%, and/or change not statistically significant.

    19. Methodological Issues • Time / intensity • Recall period / accuracy • Question order • “Leisure” / “work” / “incidental” • Self-report / measured • No standard methodology • Changes in measurement over time

    20. Summary • Individual physical activity behaviors for adolescents and adults are essentially unchanged. • Physical education requirements levels in middle and junior school remain low. Senior high school levels are very low and have declined. • Most high school students do not participate in daily physical education. • Disparities persist for many objectives. • Complex measurement issues

    21. Acknowledgements • Asel Ryskulova • CDC/National Center for Health Statistics • avr0@cdc.gov • Contributors: • Sandra Ham, CDC/NCCDPHP • Jane Wargo, DHHS/OS/OPHS • Christine Spain, DHHS/OS/OPHS • Sarah Lee, CDC/NCCDPHP • Timothy McManus,CDC/NCCDPHP • Ellis Davis, HHS/ODPHP • Elizabeth Jackson, CDC/NCHS • Leda Gurley, CDC/NCHS • Charlotte Schoenborn, CDC/NCHS • Margaret Mc Dowel, CDC/NCHS • Lesley Agress, CDC/NCHS • Christopher Barrett, HHS/ODPHP

    22. Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/hphome.htm