Graduate Thesis Or Dissertation
 

Identifying Threshold Values of Accelerometer-Determined Moderate-to-Vigorous Physical Activity that Correspond to Self-Reported Compliance to the 2008 Physical Activity Guidelines for Americans : National Health and Nutrition Examination Survey 2003-2006

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  • Current public health guidelines for physical activity (PA) were primarily formulated using evidence collected from a series of prospective cohort epidemiological investigations that measured self-reported PA. In light of this observation, and the known discordance between self-reported and objectively-monitored PA, it remains common for researchers to assess compliance to current PA guidelines (≥ 150 minutes/week of an equivalent combination of moderate- and vigorous-intensity PA [MV2PA]) using objective-monitoring methods such as accelerometer-determined PA. However, investigations seeking to calibrate accelerometer-determined PA against self-reported compliance to current PA guidelines are scant within the extant literature. Calibration of objective-monitoring methods, such as accelerometer-determined PA, may prove fruitful in mitigating the discordance between self-reported and accelerometer-determined PA, while also providing compliance estimates for PA that better reflect a population’s associated health risks. Therefore, the purpose of this study was to identify optimal accelerometer-determined thresholds of MV2PA that correspond to 150 minutes/week of self-reported MV2PA outlined in the current 2008 Physical Activity Guidelines for Americans (PAGA). This study was a secondary analysis of 4,784 adults (18-64 years) from the 2003-2006 NHANES who provided ≥ 4 valid days of accelerometer data. Receiver operating characteristic (ROC) curves were used to identify accelerometer-determined thresholds of weekly MV2PA corresponding to self-reported compliance to the 2008 PAGA. MV2PA in modified 10-minute bouts and total MV2PA were significant predictors of self-reported compliance to the 2008 PAGA (both p < 0.001). Optimal thresholds of accelerometer-determined MV2PA predicting self-reported compliance to the 2008 PAGA were 13.00 ± 1.69 minutes/week in modified 10-minute bouts and 122.30 ± 4.62 minutes/week in total (no bout requirement). However, levels of sensitivity and specificity associated with ROC curve analyses were low (all < 70%). Construct validity analyses revealed that self-reported compliance to the 2008 PAGA was only favorably associated with one cardiometabolic biomarker (glycated hemoglobin, p = 0.003). Conversely, compliance to the 2008 PAGA assessed using the newly identified accelerometer-determined MV2PA threshold in modified 10-minute bouts (≥ 13.0 minutes/week of MV2PA) was favorably associated with 5 biomarkers (glycated hemoglobin, high-density lipoprotein [HDL], systolic blood pressure [SBP], waist circumference, and body mass index [BMI]; all p < 0.05) and 2 chronic diseases (hypertension and obesity; all p < 0.01). Similarly, compliance to the 2008 PAGA assessed via total accelerometer-determined MV2PA (≥ 122.3 minutes/week of MV2PA; no bout requirement) was favorably associated with 6 biomarkers (glycated hemoglobin, fasting plasma glucose, triglycerides, SBP, waist circumference, and BMI; all p < 0.05) and 4 chronic diseases (hypertension, obesity, impaired fasting glucose, and diabetes mellitus; all p < 0.05). However, follow-up analyses using different activity counts/minute cut-points produced a wide range of optimal thresholds for MV2PA in 10-minute bouts (0.03 to 58.8 minutes/week) and in total (22.5 to 166.7 minutes/week). Although accelerometer-determined MV2PA was significantly related to self-reported compliance to the 2008 PAGA, the strength of this relationship was weak. Absolute estimates of weekly accelerometer-determined MV2PA corresponding to self-reported compliance to the 2008 PAGA were significantly less than the 150 minutes/week minimum criteria. Construct validity analyses indicated that compliance to the 2008 PAGA, as assessed using the newly identified accelerometer-determined MV2PA thresholds, was more strongly related to various anthropometric and cardiometabolic constructs than self-reported compliance. Future epidemiological and clinical research is needed to aid the development of PA guidelines informed by accelerometer-determined estimates of PA.
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