Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Clinical Studies and Practice

International study of objectively measured physical activity and sedentary time with body mass index and obesity: IPEN adult study

International Journal of Obesity volume 39, pages 199–207 (2015)Cite this article

Subjects

Abstract

Background:

Physical activity (PA) has been consistently implicated in the etiology of obesity, whereas recent evidence on the importance of sedentary time remains inconsistent. Understanding of dose–response associations of PA and sedentary time with overweight and obesity in adults can be improved with large-scale studies using objective measures of PA and sedentary time. The purpose of this study was to examine the strength, direction and shape of dose–response associations of accelerometer-based PA and sedentary time with body mass index (BMI) and weight status in 10 countries, and the moderating effects of study site and gender.

Methods:

Data from the International Physical activity and the Environment Network (IPEN) Adult study were used. IPEN Adult is an observational multi-country cross-sectional study, and 12 sites in 10 countries are included. Participants wore an accelerometer for seven consecutive days, completed a socio-demographic questionnaire and reported height and weight. In total, 5712 adults (18–65 years) were included in the analyses. Generalized additive mixed models, conducted in R, were used to estimate the strength and shape of the associations.

Results:

A curvilinear relationship of accelerometer-based moderate-to-vigorous PA and total counts per minute with BMI and the probability of being overweight/obese was identified. The associations were negative, but weakened at higher levels of moderate-to-vigorous PA (>50 min per day) and higher counts per minute. No associations between sedentary time and weight outcomes were found. Complex site- and gender-specific findings were revealed for BMI, but not for weight status.

Conclusions:

On the basis of these results, the current Institute of Medicine recommendation of 60 min per day of moderate-to-vigorous PA to prevent weight gain in normal-weight adults was supported. No relationship between sedentary time and the weight outcomes was present, calling for further examination. If moderator findings are confirmed, the relationship between PA and BMI may be country- and gender-dependent, which could have important implications for country-specific health guidelines.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Finucane MM, Stevens GA, Cowan MJ, Goodarz D, Lin JK, Paciorek CJ et al. on behalf of the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 2011; 377: 557–567.

    Article  Google Scholar 

  2. Wyatt SB, Winters KP, Dubbert PM . Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Am J Med Sci 2006; 331: 166–174.

    Article  Google Scholar 

  3. World Health Organization. Global recommendations on physical activity for health. WHO press: Geneva, Switzerland, 2010.

  4. Hamilton MT, Healy GN, Dunstan DW, Zderic TW, Owen N . Too little exercise and too much sitting: inactivity physiology and the need for new recommendations on sedentary behavior. Curr Cardiov Risk Rep 2008; 2: 292–298.

    Article  Google Scholar 

  5. Hu F, Li T, Colditz G, Willett W, Manson J . Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003; 289: 1758–1791.

    Article  Google Scholar 

  6. Proper KI, Singh AS, van Mechelen W, Chinapaw MJM . Sedentary behaviors and health outcomes among adults: a systematic review of prospective studies. Am J Prev Med 2011; 40: 174–182.

    Article  Google Scholar 

  7. Thorp AA, Owen N, Neuhaus M, Dunstan DW . Sedentary behaviors and subsequent health outcomes in adults: a systematic review of longitudinal studies, 1996-2011. Am J Prev Med 2011; 41: 207–215.

    Article  Google Scholar 

  8. U.S. Department of Health and Human Services. Physical activity guidelines advisory committee report. 2008. Washington DC: ODPHP publication no U0049. Available from http://www.health.gov/paguidelines/Report/pdf/CommitteeReport.pdf.

  9. Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W, Ekelund U et al. on behalf of the Lancet Physical Activity Series Working Group. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet 2012; 380: 247–257.

    Article  Google Scholar 

  10. Bauman A, Bull F, Chey T, Craig CL, Ainsworth BE, Sallis JF et al. The International Prevalence Study on physical activity: results from 20 countries. Int J Behav Nutr Phys Act 2009; 6: 21.

    Article  Google Scholar 

  11. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE et al. International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003; 35: 1381–1395.

    Article  Google Scholar 

  12. Boon RM, Hamlin MJ, Steel GD, Ross JJ . Validation of the New Zealand Physical Activity Questionnaire (NZPAQ-LF) and the International Physical Activity Questionnaire (IPAQ-LF) with accelerometry. Br J Sports Med 2010; 44: 741–746.

    Article  CAS  Google Scholar 

  13. Hagströmer M, Oja P, Sjöström M . The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr 2006; 9: 755–762.

    Article  Google Scholar 

  14. Kerr J, Sallis JF, Owen N, De Bourdeaudhuij I, Cerin E, Sugiyama T et al. Advancing science and policy through a coordinated international study of physical activity and built environments: IPEN Adult methods. J Phys Act Health 2013; 10: 581–601.

    Article  Google Scholar 

  15. Rhodes RE, Mark RS, Temmel CP . Adult sedentary behavior: a systematic review. Am J Prev Med 2012; 42: e3–e28.

    Article  Google Scholar 

  16. Frank LD, Sallis JF, Saelens BE, Leary L, Cain K, Conway TL et al. The development of a walkability index: application to the Neighborhood Quality of Life Study. Br J Sports Med 2010; 44: 924–933.

    Article  CAS  Google Scholar 

  17. Cerin E, Leslie E, Owen N, Bauman A . An Australian version of the neighborhood environment walkability scale: validity evidence. Meas Phys Educ Exerc Sci 2008; 12: 31–51.

    Article  Google Scholar 

  18. Cain K Accelerometer scoring protocol for the IPEN-adult study. University of California San Diego, CA 2013. Available for download at http://www.ipenproject.org/documents/methods_docs/IPEN_Protocol.pdf.

  19. McAdams MA, Van Dam RM, Hu FB . Comparison of self-reported and measured BMI as correlates of disease markers in US adults. Obesity 2007; 15: 188–196.

    Article  Google Scholar 

  20. Freedson PS, Miller K . Objective monitoring of physical activity using motion sensors and heart rate. Res Q Exerc Sport 2002; 71: S21–S29.

    Article  Google Scholar 

  21. Freedson PS, Lyden K, Kozey-Keadle S, Staudenmayer J . Evaluation of artificial neural network algorithms for predicting METs and activity type from accelerometer data: Validation on an independent sample. J Appl Physiol 2011; 111: 1804–1812.

    Article  Google Scholar 

  22. Welk GJ . Use of accelerometry-based activity monitors to assess physical activity. Physical activity assessments for health-related research. Human Kinetics: Champaign, IL, USA, 2002. 125–141.

    Google Scholar 

  23. Lee KY, Macfarlane DJ, Cerin E . Comparison of three models of actigraph accelerometers during free living and controlled laboratory conditions. Eur J Sport Sci 2013; 13: 332–339.

    Article  Google Scholar 

  24. John D, Tyo B, Bassett DR . Comparison of four Actigraph accelerometers during walking and running. Med Sci Sports Exerc 2010; 42: 368–374.

    Article  Google Scholar 

  25. Vanhelst J, Mikulovic J, Bui-Xuan G, Dieu O, Blondeau T, Fardy P et al. Comparison of two ActiGraph accelerometer generations in the assessment of physical activity in free living conditions. BMC Res Notes 2012; 5: 187.

    Article  Google Scholar 

  26. Tanha T, Tornberg A, Dencker M, Wollmer P . Accelerometer measured daily physical activity and sedentary pursuits – comparison between two models of the Actigraph and the importance of data reduction. BMC Res Notes 2013; 6: 439.

    Article  Google Scholar 

  27. Freedson PS, Melanson E, Sirard J . Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc 1998; 30: 777–781.

    Article  CAS  Google Scholar 

  28. Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR et al. Amount of time spent in sedentary behaviors in the United States, 2003-2004. Am J Epidemiol 2008; 167: 875–881.

    Article  Google Scholar 

  29. Wood SN . Generalized additive models: an introduction with R. Chapman & Hall: Boca Raton, FL, USA, 2006).

    Book  Google Scholar 

  30. Burnham KP, Anderson DR . Model selection and multimodel inference: a practical information-theoretic approach. 2nd edn. Springer: New York, NY, USA, 2002.

    Google Scholar 

  31. Harrell FE . Regression modeling strategies with applications to linear models, logistic regression, and survival analyses. Springer—Verlag: New York, NY, USA, 2001.

    Google Scholar 

  32. Fox J Weisberg S . An R companion to applied regression. 2nd edn Sage: Thousand Oaks CA, USA, 2011).

    Google Scholar 

  33. Warnes GR . gmodels: Various R programming tools for model fitting. R package version 2.15.3 http://CRAN.R-project.org/package=gmodels 2012.

  34. Carstensen B, Plummer M, Laara E, Hills M . Epi: a package for statistical analysis in epidemiology. R package version 1.1.44. URL http://CRAN.R-project.org/package=Epi 2013.

  35. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C 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: 402–407.

    Article  CAS  Google Scholar 

  36. Haskell WL, Min Lee I, Pate RR, Powell KE, Blaire SN, Franklin BA et al. Physical activity and public health: updated recommendations for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39: 1423–1434.

    Article  Google Scholar 

  37. Sattelmair J, Pertman J, Ding EL, Kohl HW, Haskell W, Min Lee I . Dose response between physical activity and risk of coronary heart disease: a meta-analysis. Circulation 2011; 124: 789–795.

    Article  Google Scholar 

  38. Seo D, Li C . Leisure-time physical activity dose-response effects on obesity among US adults: results from the 1999-2006 National Health and Nutrition Examination Survey. J Epidemiol Community Health 2010; 64: 426–431.

    Article  Google Scholar 

  39. Institute of Medicine Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). National Academies Press: Washington, DC, USA, 2002.

  40. Min Lee I, Djoussé L, Sesso HD, Wang L, Buring JE . Physical activity and weight gain prevention. JAMA 2010; 303: 1173–1179.

    Article  Google Scholar 

  41. Haskell WL . Health consequences of physical activity: understanding and challenges regarding dose-response. Med Sci Sports Exerc 1994; 26: 649–660.

    Article  CAS  Google Scholar 

  42. Banks E, Lim L, Seubsman S, Bain C, Sleigh A . Relationship of obesity to physical activity, domestic activities, and sedentary behaviours: cross-sectional findings from a national cohort of over 70,000 Thai adults. BMC Public Health 2011; 11: 762.

    Article  Google Scholar 

  43. Meyer AM, Evenson KR, Couper DJ, Stevens J, Pereria MA, Television Heiss G . physical activity, diet, and body weight status: the ARIC cohort. Int J Behav Nutr Phys Act 2008; 5: 68.

    Article  Google Scholar 

  44. Harnack LJ, Schmitz KH . The role of nutrition and physical activity in the obesity epidemic. Obesity epidemiology: from aetiology to public health. Oxford University Press Inc: New York, NY, USA, 2010, pp 91–104.

    Chapter  Google Scholar 

  45. Carr LJ, Mahar MT . Accuracy of intensity and inclinometer output of three activity monitors for identification of sedentary behavior and light-intensity activity. J Obes 2012; 2012: 460271.

    Article  Google Scholar 

  46. Kozey-Keadle S, Libertine A, Lyden K, Staudenmayer J, Freedson PS . Validation of wearable monitors for assessing sedentary behavior. Med Sci Sports Exerc 2011; 43: 1561–1567.

    Article  Google Scholar 

  47. Buman MP, Hekler EB, Haskell WL, Pruitt L, Conway TL, Caink K et al. Objective light-intensity physical activity associations with rated health in older adults. Am J Epidemiol 2010; 172: 1155–1165.

    Article  Google Scholar 

  48. Carson V, Ridgers ND, Howard BJ, Winkler EA, Healy GN, Owen N et al. Light-intensity physical activity and cardiometabolic biomarkers in US adolescents. PLoS One 2013; 8: e71417.

    Article  CAS  Google Scholar 

  49. Healy GN, Dunstan DW, Salmon J, Cerin E, Shaw JE, Zimmet PZ et al. Breaks in sedentary time: Beneficial associations with metabolic risk. Diabetes Care 2008; 31: 661–666.

    Article  Google Scholar 

  50. Henson J, Yates T, Biddle SJH, Edwardson CL, Khunti K, Wilmot EG et al. Associations of objectively measured sedentary behaviour and physical activity with markers of cardiometabolic health. Diabetologica 2013; 56: 1012–1020.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by IPEN, International Physical Activity and the Environment Network, with funding from NIH Grant R01 CA127296.

Author information

Authors and Affiliations

  1. Research Foundation Flanders, Brussels, Belgium

    D Van Dyck

  2. Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

    D Van Dyck & I De Bourdeaudhuij

  3. Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia

    E Cerin

  4. Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand

    E Hinckson

  5. Research Group of Physical Activity and Quality of Life, School of Health and Biosciences, Pontificia Universidade Catolica do Parana, Curitiba, Brazil

    R S Reis

  6. Department of Physical Education, Universidade Federal do Parana, Curitiba, Brazil

    R S Reis

  7. Centre for Research and Action in Public Health, University of Canberra, ACT, Australia

    R Davey

  8. Department of Public Health, School of Medicine, Universidad de los Andes Carrera, Bogotá, Colombia

    O L Sarmiento

  9. Institute of Active Lifestyle, Faculty of Physical Culture, Palacký Universitsy, Tř. Míru 115, 771 11, Olomouc, Czech Republic

    J Mitas

  10. Department of Sport Sciences and Clinical Biomechanics, Research Unit for Active Living, University of Southern Denmark, Odense, Denmark,

    J Troelsen

  11. Institute of Human Performance, Hong Kong University, Hong Kong

    D MacFarlane

  12. Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, USA

    D Salvo

  13. Department of Health Sciences, Public University of Navarra, Pamplona, Spain

    I Aguinaga-Ontoso

  14. Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia,

    N Owen

  15. School of Population Health, The University of Queensland, Brisbane, Queensland, Australia,

    N Owen

  16. School of Population and Global Health, Melbourne University, Melbourne, Victoria, Australia,

    N Owen

  17. Department of Medicine, Monash University, Melbourne, Victoria, Australia,

    N Owen

  18. Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA

    K L Cain & J F Sallis

Authors
  1. D Van Dyck
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E Cerin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I De Bourdeaudhuij
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E Hinckson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R S Reis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R Davey
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. O L Sarmiento
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J Mitas
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J Troelsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. D MacFarlane
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. D Salvo
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. I Aguinaga-Ontoso
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. N Owen
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. K L Cain
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. J F Sallis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Van Dyck.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dyck, D., Cerin, E., De Bourdeaudhuij, I. et al. International study of objectively measured physical activity and sedentary time with body mass index and obesity: IPEN adult study. Int J Obes 39, 199–207 (2015). https://doi.org/10.1038/ijo.2014.115

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2014.115

This article is cited by

Search

Advanced search

Quick links