Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Sports Medicine
Published in: Sports Medicine 9/2017

01-09-2017 | Systematic Review

Health Benefits of Light-Intensity Physical Activity: A Systematic Review of Accelerometer Data of the National Health and Nutrition Examination Survey (NHANES)

Authors: Eszter Füzéki, Tobias Engeroff, Winfried Banzer

Published in: Sports Medicine | Issue 9/2017

Login to get access

Abstract

Background

The health effects of light-intensity physical activity (PA) are not well known today.

Objective

We conducted a systematic review to assess the association of accelerometer-measured light-intensity PA with modifiable health outcomes in adults and older adults.

Methods

A systematic literature search up to March 2016 was performed in the PubMed, EMBASE, Web of Science and Google Scholar electronic databases, without language limitations, for studies of modifiable health outcomes in adults and older adults in the National Health and Nutrition Examination Survey accelerometer dataset.

Results

Overall, 37 cross-sectional studies and three longitudinal studies were included in the analysis, with considerable variation observed between the studies with regard to their operationalization of light-intensity PA. Light-intensity PA was found to be beneficially associated with obesity, markers of lipid and glucose metabolism, and mortality. Few data were available on musculoskeletal outcomes and results were mixed.

Conclusions

Observational evidence that light-intensity PA can confer health benefits is accumulating. Currently inactive or insufficiently active people should be encouraged to engage in PA of any intensity. If longitudinal and intervention studies corroborate our findings, the revision of PA recommendations to include light-intensity activities, at least for currently inactive populations, might be warranted.
Literature
1.
Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012;2(2):1143–211.PubMedPubMedCentral
2.
Lee I, Shiroma EJ. Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges. Br J Sports Med. 2014;48(3):197–201.CrossRefPubMed
3.
4.
Finger JD, Tafforeau J, Gisle L, et al. Development of the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ) to monitor physical activity in the European Union. Arch Public Health. 2015;2(73):59.CrossRef
5.
6.
Healy GN, Wijndaele K, Dunstan DW, et al. Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care. 2008;31(2):369–71.CrossRefPubMed
7.
8.
9.
McClain JJ, Sisson SB, Tudor-Locke C. Actigraph accelerometer interinstrument reliability during free-living in adults. Med Sci Sports Exerc. 2007;39(9):1509–14.CrossRefPubMed
10.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.CrossRefPubMedPubMedCentral
11.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.CrossRefPubMedPubMedCentral
12.
Tudor-Locke C, Camhi SM, Troiano RP. A catalog of rules, variables, and definitions applied to accelerometer data in the National Health and Nutrition Examination Survey, 2003–2006. Prev Chronic Dis. 2012;9:E113.PubMedPubMedCentral
13.
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283:2008–12.CrossRefPubMed
14.
Sanderson S, Tatt ID, Higgins JP. Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int J Epidemiol. 2007;36(3):666–76.CrossRefPubMed
15.
Shamliyan T, Kane RL, Dickinson S. A systematic review of tools used to assess the quality of observational studies that examine incidence or prevalence and risk factors for diseases. J Clin Epidemiol. 2010;63(10):1061–70.CrossRefPubMed
16.
von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Prev Med. 2007;45:247–51.CrossRef
17.
Ariëns GA, van Mechelen W, Bongers PM, et al. Physical risk factors for neck pain. Scand J Work Environ Health. 2000;26:7–19.CrossRefPubMed
18.
Cliff DP, Hesketh KD, Vella SA, et al. Objectively measured sedentary behaviour and health and development in children and adolescents: systematic review and meta-analysis. Obes Rev. 2016;17:330–44.CrossRefPubMed
19.
Buman MP, Winkler EA, Kurka JM, et al. Reallocating time to sleep, sedentary behaviors, or active behaviors: associations with cardiovascular disease risk biomarkers, NHANES 2005–2006. Am J Epidemiol. 2014;179(3):323–34.CrossRefPubMed
20.
Camhi SM, Sisson SB, Johnson WD, et al. Accelerometer-determined moderate intensity lifestyle activity and cardiometabolic health. Prev Med. 2011;52:358–60.CrossRefPubMed
21.
Chastin SFM, Mandrichenko O, Helbostadt JL, et al. Associations between objectively-measured sedentary behaviour and physical activity with bone mineral density in adults and older adults, the NHANES study. Bone. 2014;64:254–62.CrossRefPubMed
22.
Chastin SFM, Palarea-Albaladejo J, Dontje ML, et al. Combined effects of time spent in physical activity, sedentary behaviors and sleep on obesity and cardio-metabolic health markers: a novel compositional data analysis approach. PLoS One. 2015;10:e0139984.CrossRefPubMedPubMedCentral
23.
Dansie EJ, Turk DC, Martin KR, et al. Association of chronic widespread pain with objectively measured physical activity in adults: findings from the National Health and Nutrition Examination survey. J Pain. 2014;15(5):507–15.CrossRefPubMed
24.
Gay JL, Buchner DM, Schmidt MD. Dose–response association of physical activity with HbA1c: intensity and bout length. Prev Med. 2016;86:58–63.CrossRefPubMed
25.
Gerber L, Otgonsuren M, Mishra A, et al. Non-alcoholic fatty liver disease (NAFLD) is associated with low level of physical activity: a population-based study. Aliment Pharmacol Ther. 2012;36:772–81.CrossRefPubMed
26.
Hawkins M, Belalcazar LM, Schelbert KB, et al. The effect of various intensities of physical activity and chronic inflammation in men and women by diabetes status in a national sample. Diabetes Res Clin Pract. 2012;97:e6–8.CrossRefPubMed
27.
Hawkins M, Pekow P, Chasan-Taber L. Physical activity, sedentary behavior, and C-reactive protein in pregnancy. Med Sci Sports Exerc. 2014;46:284–92.CrossRefPubMed
28.
Hawkins MS, Gabriel KP, Conroy MB, et al. Physical activity intensity and cardiovascular risk by ankle-brachial index. Vasc Med. 2013;18:79–84.CrossRefPubMed
29.
Hawkins MS, Sevick MA, Richardson CR, et al. Association between physical activity and kidney function: National Health and Nutrition Examination Survey. Med Sci Sports Exerc. 2011;43:1457–64.CrossRefPubMed
30.
Howard B, Winkler EA, Sethi P, et al. Associations of low- and high-intensity light activity with cardiometabolic biomarkers. Med Sci Sports Exerc. 2015;47:2093–101.CrossRefPubMed
31.
Liu S, Waring ME, Eaton CB, et al. Association of objectively measured physical activity and metabolic syndrome among US adults with osteoarthritis. Arthritis Care Res. 2015;67:1371–8.CrossRef
32.
Loprinzi PD. Objectively measured light and moderate-to-vigorous physical activity is associated with lower depression levels among older US adults. Aging Ment Health. 2013;17:801–5.CrossRefPubMed
33.
Loprinzi PD. Accelerometer-determined sedentary and physical activity estimates among older adults with diabetes: considerations by demographic and comorbidity characteristics. J Aging Phys Act. 2014;22:432–40.CrossRefPubMed
34.
Loprinzi PD. Effects of light-intensity physical activity on red blood cell distribution width: implications for a novel mechanism through which light-intensity physical activity may influence cardiovascular disease. Int J Cardiol. 2016;203:724–5.CrossRefPubMed
35.
Loprinzi PD, Brosky JA Jr. Objectively measured physical activity and balance among U.S. adults. J Strength Cond Res. 2014;28:2290–6.CrossRefPubMed
36.
Loprinzi PD, Kohli M. Effect of physical activity and sedentary behavior on serum prostate-specific antigen concentrations: results from the National Health and Nutrition Examination Survey (NHANES), 2003–2006. Mayo Clin Proc. 2013;88:11–21.CrossRefPubMed
37.
Loprinzi PD, Lee H. Rationale for promoting physical activity among cancer survivors: literature review and epidemiologic examination. Oncol Nurs Forum. 2014;41:117–25.CrossRefPubMed
38.
Loprinzi PD, Lee H, Cardinal BJ. Dose response association between physical activity and biological, demographic, and perceptions of health variables. Obes Facts. 2013;6:380–92.CrossRefPubMed
39.
Loprinzi PD, Lee H, Cardinal BJ. Objectively measured physical activity among US cancer survivors: considerations by weight status. J Cancer Surviv. 2013;7:493–9.CrossRefPubMed
40.
Loprinzi PD, Lee H, Cardinal BJ. Evidence to support including lifestyle light-intensity recommendations in physical activity guidelines for older adults. Am J Health Promot. 2015;29:277–84.CrossRefPubMed
41.
Loprinzi PD, Lee H, Gilham B, et al. Association between accelerometer-assessed physical activity and tinnitus, NHANES 2005–2006. Res Q Exerc Sport. 2013;84:177–85.CrossRefPubMed
42.
Loprinzi PD, Pariser G. Physical activity intensity and biological markers among adults with diabetes: considerations by age and gender. J Diabetes Complicat. 2013;27:134–40.CrossRefPubMed
43.
Loprinzi PD, Pariser G, Ramulu PY. Accelerometer-assessed sedentary and physical activity behavior and its association with vision among U.S. adults with diabetes. J Phys Act Health. 2014;11:1156–61.CrossRefPubMed
44.
Loprinzi PD, Ramulu PY. Objectively measured physical activity and inflammatory markers among US adults with diabetes: implications for attenuating disease progression. Mayo Clin Proc. 2013;88:942–51.CrossRefPubMed
45.
Loprinzi PD, Sheffield J, Tyo BM, et al. Accelerometer-determined physical activity, mobility disability, and health. Disabil Health J. 2014;7:419–25.CrossRefPubMed
46.
Loprinzi PD, Walker JF, Lee H. Association between physical activity and inflammatory markers among U.S. adults with chronic obstructive pulmonary disease. Am J Health Promot. 2014;29:81–8.CrossRefPubMed
47.
Lynch BM, Dunstan DW, Winkler E, et al. Objectively assessed physical activity, sedentary time and waist circumference among prostate cancer survivors: findings from the National Health and Nutrition Examination Survey (2003–2006). Eur J Cancer Care. 2011;20:514–9.CrossRef
48.
Lynch BM, Dunstan DW, Healy GN, et al. Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003–2006). Cancer Causes Control. 2010;21:283–8.CrossRefPubMed
49.
Lynch BM, Friedenreich CM, Winkler EA, et al. Associations of objectively assessed physical activity and sedentary time with biomarkers of breast cancer risk in postmenopausal women: findings from NHANES (2003–2006). Breast Cancer Res Treat. 2011;130:183–94.CrossRefPubMed
50.
Park SK, Larson JL. The relationship between physical activity and metabolic syndrome in people with chronic obstructive pulmonary disease. J Cardiovasc Nurs. 2014;29:499–507.CrossRefPubMedPubMedCentral
51.
Park SK, Richardson CR, Holleman RG, et al. Physical activity in people with COPD, using the National Health and Nutrition Evaluation Survey dataset (2003–2006). Heart Lung. 2013;42:235–40.CrossRefPubMedPubMedCentral
52.
Prizer LP, Gay JL, Gerst-Emerson K, et al. The role of age in moderating the association between disability and light-intensity physical activity. Am J Health Promot. 2016;30:e101–9.CrossRefPubMed
53.
54.
Smuck M, Kao MJ, Brar N, et al. Does physical activity influence the relationship between low back pain and obesity? Spine J. 2014;14:209–16.CrossRefPubMed
55.
Song MR, Lee Y, Baek J, et al. Physical activity status in adults with depression in the National Health and Nutrition Examination Survey, 2005–2006. Public Health Nurs. 2012;29:208–17.CrossRefPubMed
56.
Beddhu S, Wei G, Marcus RL, et al. Light-intensity physical activities and mortality in the United States general population and CKD subpopulation. Clin J Am Soc Nephrol. 2015;10:1145–53.CrossRefPubMedPubMedCentral
57.
Fishman EI, Steeves JA, Zipunnikov V, et al. Association between objectively measured physical activity and mortality in NHANES. Med Sci Sports Exerc. 2016;48(7):1303–11.CrossRefPubMedPubMedCentral
58.
59.
Perri MG, Anton SD, Durning PE, et al. Adherence to exercise prescriptions: effects of prescribing moderate versus higher levels of intensity and frequency. Health Psychol. 2002;21:452–8.CrossRefPubMed
60.
Gando Y, Murakami H, Kawakami R, et al. Light-intensity physical activity is associated with insulin resistance in elderly Japanese women independent of moderate-to vigorous-intensity physical activity. J Phys Act Health. 2014;11:266–71.CrossRefPubMed
61.
Green AN, McGrath R, Martinez V, et al. Associations of objectively measured sedentary behavior, light activity, and markers of cardiometabolic health in young women. Eur J Appl Physiol. 2014;114:907–19.CrossRefPubMed
62.
Li J, Zhang W, Guo Q, et al. Duration of exercise as a key determinant of improvement in insulin sensitivity in type 2 diabetes patients. Tohoku J Exp Med. 2012;227:289–96.CrossRefPubMed
63.
Houmard JA, Tanner CJ, Slentz CA, et al. Effect of the volume and intensity of exercise training on insulin sensitivity. J Appl Physiol. 2004;96:101–6.CrossRefPubMed
64.
Henson J, Davies MJ, Bodicoat DH, et al. Breaking up prolonged sitting with standing or walking attenuates the postprandial metabolic response in postmenopausal women: a randomized acute study. Diabetes Care. 2016;39:130–8.CrossRefPubMed
65.
Lin X, Zhang X, Guo J, et al. Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2015;4(7). pii:e002014.
66.
Kim I, Park S, Trombold JR, et al. Effects of moderate- and intermittent low-intensity exercise on postprandial lipemia. Med Sci Sports Exerc. 2014;46:1882–90.CrossRefPubMed
67.
Duncan JJ, Gordon NF, Scott CB. Women walking for health and fitness. How much is enough? JAMA. 1991;266:3295–9.CrossRefPubMed
68.
Foong YC, Aitken D, Winzenberg T, et al. The association between physical activity and reduced body fat lessens with age—results from a cross-sectional study in community-dwelling older adults. Exp Gerontol. 2014;55:107–12.CrossRefPubMed
69.
Bann D, Hire D, Manini T, et al. Light intensity physical activity and sedentary behavior in relation to body mass index and grip strength in older adults: cross-sectional findings from the Lifestyle Interventions and Independence for Elders (LIFE) study. PLoS One. 2015;10:e0116058.CrossRefPubMedPubMedCentral
70.
Philipsen A, Hansen AS, Jørgensen ME, et al. Associations of objectively measured physical activity and abdominal fat distribution. Med Sci Sports Exerc. 2015;47:983–9.CrossRefPubMed
71.
Dowd KP, Harrington DM, Hannigan A, et al. Light-intensity physical activity is associated with adiposity in adolescent females. Med Sci Sports Exerc. 2014;46:2295–300.CrossRefPubMed
72.
Davenport MH, Giroux I, Sopper MM, et al. Postpartum exercise regardless of intensity improves chronic disease risk factors. Med Sci Sports Exerc. 2011;43:951–8.CrossRefPubMed
73.
Slentz CA, Duscha BD, Johnson JL, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE-a randomized controlled study. Arch Intern Med. 2004;164:31–9.CrossRefPubMed
74.
Lindström J, Louheranta A, Mannelin M, et al. The Finnish Diabetes Prevention Study (DPS): lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003;26:3230–6.CrossRefPubMed
75.
Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.CrossRefPubMed
76.
Herzig K, Ahola R, Leppäluoto J, et al. Light physical activity determined by a motion sensor decreases insulin resistance, improves lipid homeostasis and reduces visceral fat in high-risk subjects: PreDiabEx study RCT. Int J Obes. 2014;38:1089–96.CrossRef
77.
Kim J, Tanabe K, Yokoyama N, et al. Objectively measured light-intensity lifestyle activity and sedentary time are independently associated with metabolic syndrome: a cross-sectional study of Japanese adults. Int J Behav Nutr Phys Act. 2013;10:30.CrossRefPubMedPubMedCentral
78.
Scheers T, Philippaerts R, Lefevre J. SenseWear-determined physical activity and sedentary behavior and metabolic syndrome. Med Sci Sports Exerc. 2013;45:481–9.CrossRefPubMed
79.
Xu J, Lombardi G, Jiao W, et al. Effects of exercise on bone status in female subjects, from young girls to postmenopausal women: an overview of systematic reviews and meta-analyses. Sports Med. 2016;46:1165–82.CrossRefPubMed
80.
Johansson J, Nordström A, Nordström P. Objectively measured physical activity is associated with parameters of bone in 70-year-old men and women. Bone. 2015;81:72–9.CrossRefPubMed
81.
Pau M, Leban B, Collu G, et al. Effect of light and vigorous physical activity on balance and gait of older adults. Arch Gerontol Geriatr. 2014;59:568–73.CrossRefPubMed
82.
Cooney GM, Dwan K, Greig CA, et al. Exercise for depression. Cochrane Database Syst Rev. 2013;(9):CD004366.
83.
84.
Hupin D, Roche F, Gremeaux V, et al. Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged ≥60 years: a systematic review and meta-analysis. Br J Sports Med. 2015;49(19):1262–7.CrossRefPubMed
85.
Stensvold D, Nauman J, Nilsen TI, et al. Even low level of physical activity is associated with reduced mortality among people with metabolic syndrome, a population based study (the HUNT 2 study, Norway). BMC Med. 2011;9:109.CrossRefPubMedPubMedCentral
86.
Wen CP, Wai JP, Tsai MK, et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet. 2011;378(9798):1244–53.CrossRefPubMed
87.
Achten J, Jeukendrup AE. Effects of pre-exercise ingestion of carbohydrate on glycaemic and insulinaemic responses during subsequent exercise at differing intensities. Eur J Appl Physiol. 2003;88:466–71.CrossRefPubMed
88.
Nygaard H, Tomten SE, Høstmark AT. Slow postmeal walking reduces postprandial glycemia in middle-aged women. Appl Physiol Nutr Metab. 2009;34:1087–92.CrossRefPubMed
89.
Kraus WE, Houmard JA, Duscha BD, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med. 2002;347:1483–92.CrossRefPubMed
90.
Bailey DP, Locke CD. Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not. J Sci Med Sport. 2015;18:294–8.CrossRefPubMed
91.
Kelly LA, McMillan DG, Anderson A, et al. Validity of actigraphs uniaxial and triaxial accelerometers for assessment of physical activity in adults in laboratory conditions. BMC Med Phys. 2013;13(1):5.CrossRefPubMedPubMedCentral
92.
Shiroma EJ, Cook NR, Manson JE, et al. Comparison of self-reported and accelerometer-assessed physical activity in older women. PLoS One. 2015;10:e0145950.CrossRefPubMedPubMedCentral
93.
Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005;37(11 Suppl):S531–43.CrossRefPubMed
94.
Loprinzi PD, Cardinal BJ, Crespo CJ, et al. Differences in demographic, behavioral, and biological variables between those with valid and invalid accelerometry data: implications for generalizability. J Phys Act Health. 2013;10(1):79–84.CrossRefPubMed
95.
96.
Colberg SR, Sigal RJ, Yardley JE, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065–79.CrossRefPubMed
Metadata
Title
Health Benefits of Light-Intensity Physical Activity: A Systematic Review of Accelerometer Data of the National Health and Nutrition Examination Survey (NHANES)
Authors
Eszter Füzéki
Tobias Engeroff
Winfried Banzer
Publication date
01-09-2017
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 9/2017
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-017-0724-0

Other articles of this Issue 9/2017

Sports Medicine 9/2017 Go to the issue

Current Opinion

Team Sports Performance Analysed Through the Lens of Social Network Theory: Implications for Research and Practice

Letter to the Editor

Authors’ Reply to Dotan and Falk: “Are Prepubertal Children Metabolically Comparable to Well-Trained Adult Endurance Athletes?”

Current Opinion

The Impact of Random Individual Differences in Weight Change on the Measurable Objectives of Lifestyle Weight Management Services

Review Article

Endocrinological Roles for Testosterone in Resistance Exercise Responses and Adaptations

Systematic Review

Pedagogical Approaches to and Effects of Fundamental Movement Skill Interventions on Health Outcomes: A Systematic Review

Review Article

How Biomechanical Improvements in Running Economy Could Break the 2-hour Marathon Barrier