Recently, new physical activity (PA) guidelines were adopted in the Netherlands consisting of two components: (1) addressing duration of moderate and vigorous PA, (2) bone and muscle strengthening activities. The aim of this study is to retrospectively assess the long-term trend in fulfilling the criteria of the new PA guidelines and to gain insight into which activities contribute to changes over time. Data were available for 2001–2018 of a nationally representative sample of approximately 7000 Dutch citizens aged 12 years and over using the Short Questionnaire to Assess Health-enhancing physical activity (SQUASH). Multiple logistic regression analysis was performed by age, sex, and level of education. Overall, a positive trend was found from 39.9% adherence in 2001 to 46.0% in 2018. Adherence levels among adolescents decreased and increased among adults and seniors. Intermediate and higher educated groups showed positive trends over time whereas a stable trend was observed among lower educated. Activities contributing most to changes over time were sports, leisure time walking, and strenuous occupational activities. In the period 2001–2018, though an increasing trend was found, less than half of the population was sufficiently active. Special effort is necessary to reach adolescents, seniors, and lower educated groups in PA promotion programs.
Background This systematic review aims to describe the relation between physical inactivity and healthcare costs, by taking into account healthcare costs of physical-inactivity-related diseases (common practice), including physical-activity-related injuries (new) and costs in life-years gained due to avoiding diseases (new), whenever available. Moreover, the association between physical inactivity and healthcare costs may both be negatively and positively impacted by increased physical activity. Methods A systematic review was conducted, including records reporting on physical (in)activity in relation to healthcare costs for a general population. Studies were required to report sufficient information to calculate the percentage of total healthcare costs potentially attributable to physical inactivity. Results Of the 264 records identified, 25 were included in this review. Included studies showed substantial variation in the assessment methods of physical activity and in type of costs included. Overall, studies showed that physical inactivity is related to higher healthcare costs. Only one study included costs of healthcare resources used in prolonged life when physical-inactivity-related diseases were averted, showing net higher healthcare costs. No study included healthcare costs for physical-activity-related injuries. Conclusions Physical inactivity is associated with higher healthcare costs in the general population in the short-term. However, in the long-term aversion of diseases related with physical inactivity may increase longevity and, as a consequence, healthcare costs in life-years gained. Future studies should use a broad definition of costs, including costs in life-years gained and costs related to physical-activity-related injuries.
Patients treated for vulvar carcinoma may experience losses in mobility and physical activity. In this study, we assess the prevalence and severity of mobility problems using patient-reported outcomes of three questionnaires: EQ-5D-5L to estimate QoL and perceived health; SQUASH to estimate habitual physical activity; and a problem-specific questionnaire on bicycling. Patients treated for vulvar carcinoma between 2018 and 2021 were recruited, and 84 (62.7%) responded. The mean age was 68 ± 12 years (mean ± standard deviation). Self-reported QoL and perceived health were 0.832 ± 0.224 and 75.6 ± 20.0, respectively. Dutch physical activity guidelines were met by 34.2% of participants. Compared to baseline values, the times spent walking, bicycling, and participating in sports were all reduced. During bicycling, patients experienced moderate or severe pain in the skin of the vulva (24.5%), pain in the sit bones (23.2%), chafing (25.5%), or itching (8.9%). Overall, 40.3% experienced moderate or severe bicycling problems or could not bicycle, 34.9% felt that their vulva impeded bicycling, and 57.1% wished to make more or longer bicycling journeys. To conclude, vulvar carcinoma and its treatment reduce self-reported health, mobility, and physical activity. This motivates us to investigate ways to reduce discomfort during physical activities, and help women regain their mobility and self-reliance.
Background The Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH) is a widely used questionnaire, and used for monitoring prevalence rates of physical activity(PA) in the Netherlands. To provide a standardized protocol for data processing and analysis of the SQUASH, an analysis guide was published in 2004. However, since then, the compendium of Metabolic Equivalent (MET) values of PA has been updated, and new PA guidelines have been developed. The new PA guidelines differ from the old ones in terms of the appropriate amount of active time (150 minutes/week versus 5 days/week 30 minutes), decrease in cut-off point for moderate intensity (adults 18-54 years of age) and adding a bone- and muscle strengthening component. Therefore, the protocol for data processing and analysis of the SQUASH needs to be updated. In this study, results from the old and new protocol demonstrate the differences in adherence rates between the two sets of guidelines in the Netherlands for the adult population. Methods Data of a nationally representative sample of 6942 participants aged 18 years and older were used to calculate adherence to the old and the new PA guidelines by using the original and the updated protocol. In the new protocol, the MET-values of the activities including sports were adjusted according to the 2011 Compendium. Moderate intense activity was defined as ≥ 3.0 MET irrespective of age and the bone and muscle strengthening component was added. Results Adherence to the old Dutch PA guidelines is 48.1% among adults aged 18-54 years, and 74.4% among adults 55 years and older. For the new PA guidelines the adherence is 48.4% and 38.1% respectively. The large difference for adults 55 years and older is due to changes in the cut-off values for moderate-to-vigorous intensity PA and the addition of bone and muscle strengthening exercises. Conclusions The updated protocol for data processing and analysis of the SQUASH describes the steps to calculate the new PA guidelines in a structured way and gives researchers the opportunity to work with the data from the SQUASH in a uniform way. The SPSS syntax for data processing is available at: www.sportenbewegenincijfers.nl/methoden.
Background Sedentary time (sitting) has been associated with adverse cardio-metabolic consequences. The general recommendation is to interrupt long periods of sitting. In order to successfully develop interventions and policies to decrease sedentary behaviour, high-risk groups as well as the context of sitting should be identified. The aim of this study was to investigate sedentary behaviour among (subgroups of) the Dutch population and to identify in which domains most sedentary time was spent. Methods Data from the 2017 Dutch national Health Interview Survey was used, which includes a nationally representative sample of 8,441 Dutch citizens aged 4 years and older. Sedentary time on an average day was assessed using an adjusted version of the Marshall questionnaire. Sitting domains were defined as: 1) traveling, 2) at work, 3) at school or studying 4) watching television, 5) using a computer/smartphone at home, and 6) otherwise. Total sedentary time was analysed stratified by age, sex and level of education with ANOVA and Bonferroni correction. Results On average the Dutch population accumulates 9,0 hours/day of sedentary time. Overall, participants accumulated most sedentary time while watching television (2.2 hours/day) followed by sitting at work and other activities (both 1.7 hour/day). Significant differences (p > 0.001) were found by sex, age group and level of education. Men reported slightly more sedentary hours than women (9.2 vs. 8.8 hours/day). With respect to age groups, adolescents (12-17 years old) reported the highest, whereas children (4-11 years old) reported the lowest sedentary hours (10.1 vs. 7.3 hours/day). Finally, sedentary hours were high for higher educated people (9.7 vs. 8.2 hours/day in lower educated people). Adolescents accumulated most sedentary time at school or during studying (4.0 hours/day), higher educated people accumulated most sedentary time at work (3.4 hours/day). Conclusions Our study showed that in general Dutch people spend a lot of time sedentarily, especially adolescents and higher educated people. Most sedentary times was spent while watching television, at school or during studying, and at work. Therefore interventions aiming to decrease sedentary behaviour in the home environment, the occupational as well as the educational setting are of importance to implement.
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