Online Exclusive Article

Objectively Assessed Physical Activity Levels in Spanish Cancer Survivors

Ana Ruiz-Casado

Ana Soria Verdugo

María J. Ortega Solano

Itziar Pagola Aldazabal

Carmen Fiuza-Luces

Lidia Brea Alejo

Julio R. Padilla del Hierro

Isabel Palomo

Oscar Aguado-Arroyo

Nuria Garatachea

Héctor Cebolla

Alejandro Lucia

exercise, oncology, accelerometry, cardiorespiratory fitness, adiposity
ONF 2013, 41(1), E12-E20. DOI: 10.1188/14.ONF.E12-E20

Purpose/Objectives: To objectively assess physical activity (PA) levels in a cohort of Spanish cancer survivors.

Design: Descriptive, cross-sectional.

Setting: The Hospital Universitario de Fuenlabrada and two healthcare centers in Madrid, Spain.

Sample: 204 cancer survivors and 115 adults with no history of cancer.

Methods: Participants wore a triaxial accelerometer for seven or more consecutive days to assess PA levels. Body mass index (BMI), indirect indicators of adiposity (waist circumference, waist-to-hip ratio), and cardiorespiratory fitness also were determined.

Main Research Variables: Light, moderate, vigorous, and total PA (sum of the former).

Findings: Most (94%) of the cancer survivors met international recommendations for moderate PA, but very few (3%) fulfilled those (75 minutes or more per week) for vigorous PA. Except for lower total (minute per day, p = 0.048) and vigorous PA levels (p < 0.001 for both minute per day and minute per week) recorded in the cancer survivors group, no between-group differences were detected (p > 0.05). A high percentage of the survivors (33%) were obese (BMI greater than 30 kg/m2), and many also showed poor cardiorespiratory fitness (45% were below the 8 metabolic equivalent threshold).

Conclusions: Although cancer survivors overall met international PA recommendations for a healthy lifestyle, their BMI and cardiorespiratory profiles were not within the healthy range.

Implications for Nursing: Cancer survivors need to be informed about healthy lifestyle habits and should be regularly monitored.

Jump to a section

    References

    Adams, S.A., Matthews, C.E., Ebbeling, C.B., Moore, C.G., Cunningham, J.E., Fulton, J., & Hebert, J.R. (2005). The effect of social desirability and social approval on self-reports of physical activity. American Journal of Epidemiology, 161, 389-398. doi:10.1093/aje/kwi054
    Carnethon, M.R., Gidding, S.S., Nehgme, R., Sidney, S., Jacobs, D.R., Jr., & Liu, K. (2003). Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease risk factors. JAMA, 290, 3092-3100. doi:10.1001/jama.290.23.3092
    Catellier, D.J., Hannan, P.J., Murray, D.M., Addy, C.L., Conway, T.L., Yang, S., & Rice, J.C. (2005). Imputation of missing data when measuring physical activity by accelerometry. Medicine and Science in Sports and Exercise, 37(11, Suppl.), S555-S562.
    Centers for Disease Control and Prevention. (2011). Cancer survivors—United States, 2007. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6009a1.htm
    Church, T.S., Earnest, C.P., Skinner, J.S., & Blair, S.N. (2007). Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight, or obese postmenopausal women with elevated blood pressure: A randomized controlled trial. JAMA, 297, 2081-2091. doi:10.1001/jama.297.19.2081
    Daley, A.J., Bowden, S.J., Rea, D.W., Billingham, L., & Carmicheal, A.R. (2008). What advice are oncologists and surgeons in the United Kingdom giving to breast cancer patients about physical activity? International Journal of Behavioral Nutrition and Physical Activity, 5, 46. doi:10.1186/1479-5868-5-46
    Demark-Wahnefried, W., & Jones, L.W. (2008). Promoting a healthy lifestyle among cancer survivors. Hematology/Oncology Clinics of North America, 22, 319-342, viii. doi:10.1016/j.hoc.2008.01.012
    Freedson, P.S., Melanson, E., & Sirard, J. (1998). Calibration of the Computer Science and Applications, Inc., accelerometer. Medicine and Science in Sports and Exercise, 30, 777-781.
    Gretebeck, R.J., & Montoye, H.J. (1992). Variability of some objective measures of physical activity. Medicine and Science in Sports and Exercise, 24, 1167-1172.
    Gutin, B. (2008). Child obesity can be reduced with vigorous activity rather than restriction of energy intake. Obesity, 16, 2193-2196. doi:10.1038/oby.2008.348
    Hallal, P.C., Andersen, L.B., Bull, F.C., Guthold, R., Haskell, W., & Ekelund, U. (2012). Global physical activity levels: Surveillance progress, pitfalls, and prospects. Lancet, 380, 247-257. doi:10.1016/S0140-6736(12)60646-1
    Horner, M.J., Ries, L.A.G., Krapcho, M., Neyman, N., Aminou, R., Howlader, N., … Edwards, B.K. (2009). Cancer statistics review, 1975-2006. Retrieved from http://seer.cancer.gov/csr/1975_2006
    Jones, L.W., Liang, Y., Pituskin, E.N., Battaglini, C.L., Scott, J.M., Hornsby, W.E., & Haykowsky, M. (2011). Effect of exercise training on peak oxygen consumption in patients with cancer: A meta-analysis. Oncologist, 16, 112-120. doi:10.1634/theoncologist.2010-0197
    Jovanovic, J.L., Hughes, D.C., Baum, G.P., Carmack, C., Greisinger, A.J., & Basen-Engquist, K. (2011). Accelerometry and self-report in sedentary populations. American Journal of Health Behavior, 35, 71-80.
    Kline, G.M., Porcari, J.P., Hintermeister, R., Freedson, P.S., Ward, A., McCarron, R.F., … Rippe, J.M. (1987). Estimation of VO2 max from a one-mile track walk, gender, age, and body weight. Medicine and Science in Sports and Exercise, 19, 253-259.
    Kodama, S., Saito, K., Tanaka, S., Maki, M., Yachi, Y., Asumi, M., … Sone, H. (2009). Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: A meta-analysis. JAMA, 301, 2024-2035. doi:10.1001/jama.2009.681
    Lajous, M., Mozaffarian, D., Mozaffarian, R., Schrag, D., & Adami, H.O. (2011). Lifestyle prescriptions for cancer survivors and their communities. Journal of Internal Medicine, 269, 88-93. doi:10.1111/j.1365-2796.2010.02273.x
    Lee, I.M., Shiroma, E.J., Lobelo, F., Puska, P., Blair, S.N., & Katzmarzyk, P.T. (2012). Effect of physical inactivity on major noncommunicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet, 380, 219-229. doi:10.1016/S0140-6736 (12)61031-9
    Lucia, A., Foster, C., Perez, M., & Arenas, J. (2008). What isn't taught in medical schools: The William Wordsworth lesson. Nature Clinical Practice. Cardiovascular Medicine, 5, 372-374. doi:10.1038/ncpcardio1241
    Lynch, B.M., Dunstan, D.W., Healy, G.N., Winkler, E., Eakin, E., & Owen, N. (2010). Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: Findings from NHANES (2003-2006). Cancer Causes Control, 21, 283-288. doi:10.1007/s10552-009-9460-6
    Lynch, B.M., Dunstan, D.W., Winkler, E., Healy, G.N., Eakin, E., & Owen, N. (2011). Objectively assessed physical activity, sedentary time, and waist circumference among prostate cancer survivors: Findings from the National Health and Nutrition Examination Survey (2003-2006). European Journal of Cancer Care, 20, 514-519. doi:10.1111/j.1365-2354.2010.01205.x
    Matthews, C.E., Hagstromer, M., Pober, D.M., & Bowles, H.R. (2012). Best practices for using physical activity monitors in population-based research. Medicine and Science in Sports and Exercise, 44(1, Suppl. 1), S68-S76. doi:10.1249/MSS.0b013e3182399e5b
    McClellan, R. (2013). Exercise programs for patients with cancer improve physical functioning and quality of life. Journal of Physiotherapy, 59, 57. doi:10.1016/S1836-9553(13)70150-4
    Mishra, S.I., Scherer, R.W., Snyder, C., Geigle, P.M., Berlanstein, D.R., & Topaloglu, O. (2012). Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database of Systematic Reviews, 15, CD008465. doi:10.1002/14651858.CD008465.pub2
    Moore, S.C., Patel, A.V., Matthews, C.E., Berrington de Gonzalez, A., Park, Y., Katki, H.A., … Lee, I.M. (2012). Leisure time physical activity of moderate to vigorous intensity and mortality: A large pooled cohort analysis. PLoS Medicine, 9(11), e1001335. doi:10.1371/journal.pmed.1001335
    National Cancer Institute. (2013). Survivorship-related statistics and graphs. Retrieved from http://dccps.nci.nih.gov/ocs/prevalence/index.html
    Nishida, C., Ko, G.T., & Kumanyika, S. (2010). Body fat distribution and noncommunicable diseases in populations: Overview of the 2008 WHO Expert Consultation on Waist Circumference and Waist-Hip Ratio. European Journal of Clinical Nutrition, 64, 2-5. doi:10.1038/ejcn.2009.139
    Palacios-Cena, D., Alonso-Blanco, C., Jimenez-Garcia, R., Hernandez-Barrera, V., Carrasco-Garrido, P., Pileno-Martinez, E., & Fernandez-de-Las-Penas, C. (2011). Time trends in leisure time physical activity and physical fitness in elderly people: 20 year follow-up of the Spanish Population National Health Survey (1987-2006). BMC Public Health, 11, 799. doi:10.1186/1471-2458-11-799
    Peel, J.B., Sui, X., Matthews, C.E., Adams, S.A., Hebert, J.R., Hardin, J.W., … Blair, S.N. (2009). Cardiorespiratory fitness and digestive cancer mortality: Findings from the aerobics center longitudinal study. Cancer Epidemiology, Biomarkers and Prevention, 18, 1111-1117. doi:10.1158/1055-9965.EPI-08-0846
    Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Z., Verschuren, W.M., … Zannad, F. (2012). European guidelines on cardiovascular disease prevention in clinical practice (Version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on cardiovascular disease prevention in clinical practice (Constituted by Representatives of Nine Societies and by Invited Experts). International Journal of Behavioral Medicine, 19, 403-488. doi:10.1007/s12529-012-9242-5
    Prince, S.A., Adamo, K.B., Hamel, M.E., Hardt, J., Gorber, S.C., & Tremblay, M. (2008). A comparison of direct versus self-report measures for assessing physical activity in adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 5, 56. doi:10.1186/1479-5868-5-56
    Rock, C.L., Doyle, C., Demark-Wahnefried, W., Meyerhardt, J., Courneya, K.S., Schwartz, A.L., … Gansler, T. (2012). Nutrition and physical activity guidelines for cancer survivors. CA: A Cancer Journal for Clinicians, 62, 243-274. doi:10.3322/caac.21142
    Rodriguez-Romo, G., Cordente, C.A., Mayorga, J.I., Garrido-Munoz, M., Macias, R., Lucia, A., & Ruiz, J.R. (2011). [Influence of sociodemographic correlates on the adherence to physical activity recommendations in adults aged from 15 to 74 years]. Revista Española de Salud Pública, 85, 351-362. doi:10.1590/S1135-57272011000400004
    Santos-Lozano, A., Marin, P.J., Torres-Luque, G., Ruiz, J.R., Lucia, A., & Garatachea, N. (2012). Technical variability of the GT3X accelerometer. Medical Engineering and Physics, 34, 787-790.
    Schmitz, K.H., Courneya, K.S., Matthews, C., Demark-Wahnefried, W., Galvao, D.A., Pinto, B.M., … Schwartz, A.L. (2010). American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Medicine and Science in Sports and Exercise, 42, 1409-1426. doi:10.1249/MSS.0b013e3181e0c112
    Shaw, K., Gennat, H., O'Rourke, P., & Del Mar, C. (2006). Exercise for overweight or obesity. Cochrane Database of Systematic Reviews, 4, CD003817. doi:10.1002/14651858.CD003817.pub3
    Siegel, R., De Santis, C., Virgo, K., Stein, K., Mariotto, A., Smith, T., … Ward, E. (2012). Cancer treatment and survivorship statistics 2012. CA: A Cancer Journal for Clinicians, 62, 220-241.
    Smith, W.A., Nolan, V.G., Robison, L.L., Hudson, M.M., & Ness, K.K. (2011). Physical activity among cancer survivors and those with no history of cancer—A report from the National Health and Nutrition Examination Survey 2003-2006. American Journal of Translational Research, 3, 342-350.
    Stewart, A., Marfell-Jones, M., Olds, T., & de Ridder, H. (2011). International standards for anthropometric assessment. Lower Hutt, New Zealand: ISAK.
    Sui, X., LaMonte, M.J., Laditka, J.N., Hardin, J.W., Chase, N., Hooker, S.P., & Blair, S.N. (2007). Cardiorespiratory fitness and adiposity as mortality predictors in older adults. JAMA, 298, 2507-2516. doi:10.1001/jama.298.21.2507
    Troiano, R.P., Berrigan, D., Dodd, K.W., Masse, L.C., Tilert, T., & McDowell, M. (2008). Physical activity in the United States measured by accelerometer. Medicine and Science in Sports and Exercise, 40, 181-188. doi:10.1249/mss.0b013e31815a51b3
    Trost, S.G., McIver, K.L., & Pate, R.R. (2005). Conducting accelerometer-based activity assessments in field-based research. Medicine and Science in Sports and Exercise, 37(11, Suppl.), S531-S543.
    Tucker, J.M., Welk, G.J., & Beyler, N.K. (2011). Physical activity in United States: Adult compliance with the Physical Activity Guidelines for Americans. American Journal of Preventive Medicine, 40, 454-461. doi:10.1016/j.amepre.2010.12.016
    U.S. Department of Health and Human Services. (2008). Physical activity guidelines advisory committee report, 2008. Washington, DC: Author.
    Vandenbroucke, J.P., von Elm, E., Altman, D.G., Gotzsche, P.C., Mulrow, C.D., Pocock, S.J., … Egger, M. (2007). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration. PLoS Medicine, 4(10), e297. doi:10.1371/journal.pmed.0040297
    von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., Gotzsche, P.C., & Vandenbroucke, J.P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Annals of Internal Medicine, 147, 573-577.
    Welk, G.J. (Ed.). (2002). Physical activity assessments for health-related research. Chicago, IL: Human Kinetics.
    World Health Organization. (2010). Global recommendations on physical activity for health. Geneva, Switzerland: Author.