Scottish Health Survey - topic report: physical activity

1. Introduction

This topic report presents the results of regression analyses into significant demographic, socioeconomic and health and lifestyle factors associated with adult (age 16+ years) physical activity levels using data from the 2012 Scottish Health Survey (SHeS)^[1]. The relationship between physical activity and age, sex and some socioeconomic variables has been described in the SHeS annual reports since 1995, however, regression analysis has not been done to date.

Exploratory analysis was also carried out on whether factors have changed as a result of a change in the physical activity guidelines which took place in 2011. The recommended level of activity for adults prior to 2011 was that they should do at least 30 minutes of moderate activity on most days of the week (i.e. on at least five), which could be accrued in bouts of at least 10 minutes' duration. In July 2011, drawing on recent evidence about activity and health, the Chief Medical Officers of each of the four UK countries agreed and introduced revised guidelines on physical activity. The revisions followed new guidance issued by the WHO and are in line with similar changes made to advice on activity levels in both the USA^[2] and Canada^[3].

The new guidance, tailored to specific age groups over the life course, are as follows:

• Early years (under 5 years)
  • Physical activity should be encouraged from birth, particularly through floor-based play and water-based activities in safe environments.
  • Children of pre-school age who are capable of walking unaided should be physically active daily for at least 180 minutes (3 hours), spread throughout the day.
  • All under 5s should minimise the amount of time spent being sedentary (being restrained or sitting) for extended periods (except time spent sleeping).
• Children and young people aged 5 to 18
  • Should engage in moderate to vigorous activity for at least 60 minutes and up to several hours every day.
  • Vigorous activities, including those that strengthen muscles and bones, should be carried out on at least 3 days a week.
  • Extended periods of sedentary activities should be limited.
• Adults aged 19 to 64
  • Should be active daily.
  • Should engage in at least moderate activity for a minimum of 150 minutes a week (accumulated in bouts of at least 10 minutes) - for example by being active for 30 minutes on five days a week.
  • Alternatively, 75 minutes of vigorous activity spread across the week will confer similar benefits to 150 minutes of moderate activity (or a combination of moderate and vigorous activity).
  • Activities that strengthen muscles should be carried out on at least two days a week.
  • Extended periods of sedentary activities should be limited.
• Adults aged 65 and over
  • In addition to the guidance set out above for adults aged 19-64, older adults are advised that any amount of physical activity is better than none, and more activity provides greater health benefits.
  • Older adults at risk of falls should incorporate activities to improve balance and coordination on at least two days a week.

Monitoring the adherence to the revised guidelines required some changes to the SHeS questions on physical activity in 2012. The revised guidelines for adults still advise people to accumulate 150 minutes of moderate activity per week, but critically removes the stipulation of achieving this by accumulating 30 minutes on at least 5 days per week (though this remains one way to meet guidelines). It is clear that the change in guidelines has led to a marked increase in the proportion of adults who now meet the physical activity guidelines, however, no analysis has been done to date on how the guideline change may have impacted on the demographic, socioeconomic and health patterning of physical activity.

A third aspect of this study was to explore the key factors associated with the different domains of physical activity that contribute to overall physical activity and whether there were differences in associated factors by domain compared to meeting physical activity guidelines. The domains investigated were: sport and exercise; walking; housework; gardening/manual/DIY and occupational physical activity. To date, there has been far less focus on most of these domains, with a tendency to concentrate on leisure time physical activity which may include sport and exercise and walking.

In summary the report has three key aims:

1. to investigate factors that are significantly associated with meeting the adult physical activity guidelines in the Scottish population
2. to investigate whether the change in physical activity guidelines in 2011 affected the factors associated with meeting the guidelines
3. to investigate the factors significantly associated with taking part in activity in the different domains that make up total physical activity