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Validation of reported physical activity for cholesterol control using two different physical activity instruments

Authors Amy Z Fan, Sandra A Ham, Shravani Reddy Muppidi, et al

Published 6 August 2009 Volume 2009:5 Pages 649—661

DOI http://dx.doi.org/10.2147/VHRM.S6164

Review by Single-blind

Peer reviewer comments 2

Amy Z Fan1, Sandra A Ham2, Shravani Reddy Muppidi3, Ali H Mokdad4

1Behavioral Surveillance Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion; 2Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; 3College of Public Health, University of Georgia, Athens, GA, USA; 4Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA

Abstract: The National Cholesterol Education Program recommends increasing physical activity to improve cholesterol levels and overall cardiovascular health. We examined whether US adults who reported increasing their physical activity to control or lower blood cholesterol following physician’s advice or on their own efforts had higher levels of physical activity than those who reported that they did not. We used data from the National Health and Nutrition Examination Survey 2003–2004, which implemented two physical activity assessment instruments. The physical activity questionnaire (PAQ) assessed self-reported frequency, intensity, and duration of leisure-time, household, and transportation-related physical activity in the past month. Physical movement was objectively monitored using a waist accelerometer that assessed minute-by-minute intensity (counts of movement/minute) during waking time over a 7-day period. We adjusted our analysis for age, gender, race/ethnicity, educational attainment, and body mass index. Participants who reported increasing physical activity to control blood cholesterol had more PAQ-assessed physical activity and more accelerometer-assessed active days per week compared to those who did not. However, there were no significant differences in cholesterol levels between comparison groups. These findings suggest that self-report of exercising more to control or lower cholesterol levels among US adults might be valid.

Keywords: accelerometer, cardiovascular diseases, hypercholesterolemia, physical activity, risk reduction behavior

General overview

Physical activity is beneficial to control healthy blood cholesterol levels and maintain heart health. Doctor's advice may help individuals to increase physical activity level. In this study we investigated whether participants who reported increasing their physical activity to control blood cholesterol following physician's advice or on their own efforts indeed are more active than their counterparts. We verified participants' report by a survey questionnaire and an actual instrument carried by the participants. We found that participants who reported increasing physical activity to control blood cholesterol are indeed more active. However, there were no significant differences in cholesterol levels between respective comparison groups. These findings suggest that self-report of exercising more to control or lower cholesterol levels among US adults might be valid but insufficient. More intensive interventions are needed to encourage exercise and increase physical activity in the general population and in individuals who had high cholesterol conditions.

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