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Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Published online by Cambridge University Press:  02 January 2007

Nicholas J Wareham ,
Rupert W Jakes ,
Kirsten L Rennie ,
Jantine Schuit ,
Jo Mitchell ,
Susie Hennings  and
Nicholas E Day
Nicholas J Wareham*
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 2SR, UK
Rupert W Jakes
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 2SR, UK
Kirsten L Rennie
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 2SR, UK
Jantine Schuit
Affiliation:
Department of Chronic Disease and Environmental Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
Jo Mitchell
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 2SR, UK
Susie Hennings
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 2SR, UK
Nicholas E Day
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 2SR, UK
*
*Corresponding author: Email [email protected]
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Abstract

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Objective:

To assess the validity and repeatability of a simple index designed to rank participants according to their energy expenditure estimated by self-report, by comparison with objectively measured energy expenditure assessed by heart-rate monitoring with individual calibration.

Design:

Energy expenditure was assessed over one year by four separate episodes of 4-day heart-rate monitoring, a method previously validated against whole-body calorimetry and doubly labelled water. Cardio-respiratory fitness was assessed by four repeated measures of sub-maximum oxygen uptake. At the end of the 12-month period, participants completed a physical activity questionnaire that assessed past-year activity. A simple four-level physical activity index was derived by combining occupational physical activity together with time participating in cycling and other physical exercise (such as keep fit, aerobics, swimming and jogging).

Subjects:

One hundred and seventy-three randomly selected men and women aged 40 to 65 years.

Results:

The repeatability of the physical activity index was high (weighted kappa = 0.6, P < 0.0001). There were positive associations between the physical activity index from the questionnaire and the objective measures of the ratio of daytime energy expenditure to resting metabolic rate (P = 0.003) and cardio-respiratory fitness (P = 0.001). As an indirect test of validity, there was a positive association between the physical activity index and the ratio of energy intake, assessed by 7-day food diaries, to predicted basal metabolic rate.

Conclusions:

The summary index of physical activity derived from the questions used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study suggest it is useful for ranking participants in terms of their physical activity in large epidemiological studies. The index is simple and easy to comprehend, which may make it suitable for situations that require a concise, global index of activity.

Keywords

Physical activityHeart-rate monitoringQuestionnaireValidation
Type
Research Article
Information
Public Health Nutrition , Volume 6 , Issue 4 , June 2003 , pp. 407 - 413
Copyright
Copyright © CABI Publishing 2003

References

1Riboli, E. Nutrition and cancer: background and rationale of the European Prospective Investigation into Cancer and Nutrition (EPIC). Ann. Oncol. 1993; 3(10): 783–91.CrossRefGoogle Scholar
2Day, N, Oakes, S, Luben, R, Khaw, K-T, Bingham, S, Welch, A, et al. EPIC in Norfolk: study design and characteristics of the cohort. Br. J. Cancer 1999; 80(Suppl. 1): 95–103.Google ScholarPubMed
3US Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.Google Scholar
4Pols, MA, Peeters, PHM, Ocke, MC, Slimani, N, Bueno-De-Mesquita, HB, Collette, HJA. Estimation of reproducibility and relative validity of the questions included in the EPIC physical activity questionnaire. Int. J. Epidemiol. 1997; 26(Suppl. 1): S181–9.CrossRefGoogle ScholarPubMed
5Wong, MY, Day, NE, Wareham, NJ. Measurement error in epidemiology: the design of validation studies II: bivariate situation. Stat. Med. 1999; 18: 2831–45.3.0.CO;2-3>CrossRefGoogle ScholarPubMed
6Ainsworth, BE, Haskell, WL, Whitt, MC, Irwin, ML, Swartz, AM, Strath, SJ, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med. Sci. Sports Exerc. 2000; 32(Suppl. 9): S498–516.CrossRefGoogle ScholarPubMed
7Jacobs, DR, Ainsworth, BE, Hartman, TJ, Leon, AS. A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med. Sci. Sports Exerc. 1993; 25: 81–91.CrossRefGoogle ScholarPubMed
8Wareham, NJ, Byrne, CD, Williams, R, Day, NE, Hales, CN. Fasting proinsulin concentrations predict the development of type 2 diabetes. Diabetes Care 1999; 22: 262–70.CrossRefGoogle ScholarPubMed
9Wareham, NJ, Wong, M-Y, Day, NE. Glucose intolerance and physical inactivity: the relative importance of low habitual energy expenditure and cardiorespiratory fitness. Am. J. Epidemiol. 2000; 152: 132–9.CrossRefGoogle ScholarPubMed
10Williams, DRR, Wareham, NJ, Brown, DC, Clark, PMS, Cox, BD, Cox, LJ, et al. Glucose intolerance in the community: the Isle of Ely Diabetes Project. Diabetic Med. 1995; 12: 30–5.CrossRefGoogle ScholarPubMed
11Wareham, NJ, Hennings, SJ, Prentice, AM, Day, NE. Feasibility of heart-rate monitoring to estimate total level and pattern of energy expenditure in a population-based epidemiological study: the Ely young cohort feasibility study 1994–5. Br. J. Nutr. 1997; 78: 889–900.CrossRefGoogle Scholar
12Elia, M, Livesey, G. Energy expenditure and fuel selection in biological systems: theory and practice of calculations based on indirect calorimetry and tracer methods. In: Simopoulus, AP, ed. Metabolic Control of Eating, Energy Expenditure and The Bioenergetics of Obesity. Basel: Karger 1992; 68–131.Google Scholar
13James, WPT, Schofield, EC. Human Energy Requirements. Oxford: Oxford University Press, 1990.Google Scholar
14Stata Corporation. Stata Statistical Software, Release 7.0 version [program]. College Station, TX: Stata Corporation, 2001.Google Scholar
15Ainsworth, BE, Jacobs, DR Jr, Leon, AS, Richardson, MT, Montoye, HJ. Assessment of the accuracy of physical activity questionnaire occupational data. J. Occup. Med. 1993; 35(10): 1017–27.Google ScholarPubMed