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BMC Public Health
Published in: BMC Public Health 1/2020

Open Access 01-12-2020 | Research article

Level of physical activity among middle-aged and older Chinese people: evidence from the China health and retirement longitudinal study

Authors: Xiaowei Li, Wanda Zhang, Weiya Zhang, Ke Tao, Wenli Ni, Kai Wang, Zhanglai Li, Qiang Liu, Jianhao Lin

Published in: BMC Public Health | Issue 1/2020

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Abstract

Background

With data from different regions accumulated, physical inactivity (PI) was found to be pandemic worldwide. Using China Health and Retirement Longitudinal Study (CHARLS), a nationwide longitudinal survey data, we aimed to delineate the prevalence, incidence and risk factors of physical inactivity (PI) among Chinese people aged 45 years and older.

Methods

The CHARLS covered nearly all provinces, autonomous regions, municipalities of mainland China. With data from CHARLS, three cross-sectional analyses and a cohort analysis were conducted. In cross-sectional studies, we used surveys at 2011, 2013 and 2015 to examine the prevalence and its trend of PI. Multivariate generalized linear model was conducted in survey at 2011 to examine the risk factors for prevalent PI. Multiple imputation of missing values was used and results before and after imputation were compared. In cohort analysis, we identified people free of PI at 2011 and followed them up until 2015 to estimate the incidence of PI. Generalized estimating equation was used to examine the risk factors associated with incidence PI. In all analyses, PI was defined as insufficient physical activity according to the International Physical Activity Questionnaire (IPAQ) criterion.

Results

6650, 5946 and 9389 participants were eligible for cross-sectional analyses, and 4525 participants were included for cohort analysis. The weighted prevalence of PI was 22.25% (95% CI: 20.63–23.95%) in 2011, 20.64% (95% CI: 19.22–22.14%) in 2013 and 19.31% (95% CI: 18.28–20.38%) in 2015. In multivariate analysis, PI was associated with older age, higher education, overweight, obesity and difficulties in daily living, and was negatively associated with working and higher level of expenditure. No material change was detected in results after multiple imputation. In cohort analysis, older age, abundant public facilities, difficulties in daily living were identified as risk factors of incidence PI, while urban areas, college and above education, and working were protective factors.

Conclusions

PI is pandemic in 45 years and older people in China. People with older age, difficulties in daily living and people who are not working are at higher risk. More efforts should be paid in estimating and promoting leisure-time physical activities.
Literature
1.
Kohl HW, Craig CL, Lambert EV, et al. The pandemic of physical inactivity: global action for public health. Lancet. 2012;380(9838):294–305.PubMedCrossRef
2.
Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402–7.PubMedCrossRef
3.
WHO. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010.
4.
Hallal PC, Andersen LB, Bull FC, et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380(9838):247–57.CrossRefPubMed
5.
Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–29.PubMedPubMedCentralCrossRef
6.
7.
8.
Hu G, Pekkarinen H, Hanninen O, et al. Physical activity during leisure and commuting in Tianjin, China. Bull World Health Organ. 2002;80(12):933–8.PubMed
9.
Li X, Cheng M, Zhang H, et al. Prevalence and determinations of physical inactivity among public hospital employees in Shanghai, China: a cross-sectional study. Front Med. 2015;9(1):100–7.PubMedCrossRef
10.
Sun L, Jiang X, Zhao X, et al. Physical activity level and associated factors among civil servants in Xi'an, China. J Sci Med Sport. 2016;19(8):647–53.PubMedCrossRef
11.
Li Y, Wang L, Jiang Y, et al. Risk factors for noncommunicable chronic diseases in women in China: surveillance efforts. Bull World Health Organ. 2013;91(9):650–60.PubMedPubMedCentralCrossRef
12.
Zhao YH, Hu YS, Smith JP, et al. Cohort profile: the China health and retirement longitudinal study (CHARLS). Int J Epidemiol. 2014;43(1):61–8.PubMedCrossRef
13.
Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.PubMedCrossRef
14.
15.
Tomioka K, Iwamoto J, Saeki K, et al. Reliability and validity of the international physical activity questionnaire (IPAQ) in elderly adults: the Fujiwara-kyo study. J Epidemiol. 2011;21(6):459–65.PubMedPubMedCentralCrossRef
16.
Lestari SK, Ng N, Kowal P, et al. Diversity in the Factors Associated with ADL-Related Disability among Older People in Six Middle-Income Countries: A Cross-Country Comparison. Int J Environ Res Public Health. 2019;16(8).
17.
Connolly D, Garvey J, McKee G. Factors associated with ADL/IADL disability in community dwelling older adults in the Irish longitudinal study on ageing (TILDA). Disabil Rehabil. 2017;39(8):809–16.PubMedCrossRef
18.
Consultation W H O E. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.CrossRef
19.
Andrade C. Understanding relative risk, odds ratio, and related terms: as simple as it can get. J Clin Psychiatry. 2015;76(7):e857–61.PubMedCrossRef
20.
White IR, Royston P, Wood AM. Multiple imputation using chained equations: issues and guidance for practice. Stat Med. 2011;30(4):377–99.CrossRefPubMed
21.
Guthold R, Ono T, Strong KL, et al. Worldwide variability in physical inactivity a 51-country survey. Am J Prev Med. 2008;34(6):486–94.PubMedCrossRef
22.
Dumith SC, Hallal PC, Reis RS, et al. Worldwide prevalence of physical inactivity and its association with human development index in 76 countries [J]. Prev Med. 2011;53(1–2):24–8.PubMedCrossRef
23.
Bauman A, Bull F, Chey T, et al. The International Prevalence Study on Physical Activity: results from 20 countries. Int J Behav Nutr Phys Act. 2009;6:21.PubMedPubMedCentralCrossRef
24.
25.
26.
27.
Treiman DJ. The “difference between heaven and earth”: urban–rural disparities in well-being in China. Res Soc Strat Mobil. 2012;30(1):33–47.
28.
Monda KL, Gordon-Larsen P, Stevens J, et al. China's transition: the effect of rapid urbanization on adult occupational physical activity. Soc Sci Med. 2007;64(4):858–70.CrossRefPubMed
29.
Attard SM, Howard AG, Herring AH, et al. Differential associations of urbanicity and income with physical activity in adults in urbanizing China: findings from the population-based China health and nutrition survey 1991-2009. Int J Behav Nutr Phys Act. 2015;12:152.PubMedPubMedCentralCrossRef
30.
Ng SW, Norton EC, Popkin BM. Why have physical activity levels declined among Chinese adults? Findings from the 1991-2006 China health and nutrition surveys. Soc Sci Med. 2009;68(7):1305–14.PubMedPubMedCentralCrossRef
31.
Wilks DC, Besson H, Lindroos AK, et al. Objectively measured physical activity and obesity prevention in children, adolescents and adults: a systematic review of prospective studies. Obes Rev. 2011;12(5):e119–29.PubMedCrossRef
32.
Bauman AE, Reis RS, Sallis JF, et al. Correlates of physical activity: why are some people physically active and others not? Lancet. 2012;380(9838):258–71.CrossRefPubMed
33.
Piirtola M, Kaprio J, Kujala UM, et al. Association between education and future leisure-time physical inactivity: a study of Finnish twins over a 35-year follow-up. BMC Public Health. 2016;16:720.PubMedPubMedCentralCrossRef
34.
Fan M, Yu C, Guo Y, et al. Effect of total, domain-specific, and intensity-specific physical activity on all-cause and cardiovascular mortality among hypertensive adults in China. J Hypertens. 2018;36(4):793–800.PubMedCrossRef
35.
Knuth AG, Hallal PC. Temporal trends in physical activity: a systematic review. J Phys Act Health. 2009;6(5):548–59.PubMedCrossRef
36.
Gu JK, Charles LE, Ma CC, et al. Prevalence and trends of leisure-time physical activity by occupation and industry in U.S. workers: the National Health Interview Survey 2004-2014. Ann Epidemiol. 2016;26(10):685–92.PubMedPubMedCentralCrossRef
37.
Samitz G, Egger M, Zwahlen M. Domains of physical activity and all-cause mortality: systematic review and dose-response meta-analysis of cohort studies. Int J Epidemiol. 2011;40(5):1382–400.PubMedCrossRef
38.
Moore SC, Lee IM, Weiderpass E, et al. Association of Leisure-Time Physical Activity with Risk of 26 types of Cancer in 1.44 million adults. JAMA Intern Med. 2016;176(6):816–25.PubMedPubMedCentralCrossRef
39.
O'Donovan G, Lee IM, Hamer M, et al. Association of "weekend warrior" and other leisure time physical activity patterns with risks for all-cause, cardiovascular disease, and Cancer mortality. JAMA Intern Med. 2017;177(3):335–42.PubMedCrossRef
40.
Sallis JF, Cerin E, Conway TL, et al. Physical activity in relation to urban environments in 14 cities worldwide: a cross-sectional study. Lancet. 2016;387(10034):2207–17.PubMedCrossRef
41.
Sun L, Chang JX, Liu YH, et al. The urban-rural disparities of the elderly labor supply and income in China. Ceis. 2011;2011:15.
42.
Wagner A, Simon C, Evans A, et al. Physical activity patterns in 50-59 year men in France and Northern Ireland. Associations with socio-economic status and health behaviour. Eur J Epidemiol. 2003;18(4):321–9.PubMedCrossRef
43.
Bann D, Chen H, Bonell C, et al. Socioeconomic differences in the benefits of structured physical activity compared with health education on the prevention of major mobility disability in older adults: the LIFE study. J Epidemiol Community Health. 2016;70(9):930–3.PubMedCrossRef
44.
Ani R, Zheng J. Proximity to an exercise facility and physical activity in China. Southeast Asian J Trop Med Public Health. 2014;45(6):1483–91.PubMed
45.
Su M, Tan YY, Liu QM, et al. Association between perceived urban built environment attributes and leisure-time physical activity among adults in Hangzhou, China. Prev Med. 2014;66:60–4.PubMedCrossRef
46.
Morris KS, McAuley E, Motl RW. Self-efficacy and environmental correlates of physical activity among older women and women with multiple sclerosis. Health Educ Res. 2008;23(4):744–52.PubMedCrossRef
47.
Nyunt MS, Shuvo FK, Eng JY, et al. Objective and subjective measures of neighborhood environment (NE): relationships with transportation physical activity among older persons. Int J Behav Nutr Phys Act. 2015;12:108.PubMedPubMedCentralCrossRef
48.
Lee PH, Macfarlane DJ, Lam TH, et al. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011;8:115.PubMedPubMedCentralCrossRef
Metadata
Title
Level of physical activity among middle-aged and older Chinese people: evidence from the China health and retirement longitudinal study
Authors
Xiaowei Li
Wanda Zhang
Weiya Zhang
Ke Tao
Wenli Ni
Kai Wang
Zhanglai Li
Qiang Liu
Jianhao Lin
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2020
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-020-09671-9

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