• Journal of Nutrition and Health
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• v.54 no.6
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• pp.573-583
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• 2021

Energy requirement is defined as energy expenditure in an energy equilibrium state. The doubly labeled water (DLW) method is considered the gold standard for measuring total energy expenditure (TEE). In 2002, the Institute of Medicine (IOM) of the National Academies established dietary reference intakes (DRIs) for Americans and Canadians, and the equations for estimated energy requirement (EER) were developed by using pooled data from studies that had applied the DLW method. Since 2005, these equations have been used for establishing EER in the DRI for Koreans. These equations based on age group include the physical activity (PA) coefficient determined by the PA level (PAL; sedentary, low active, active and very active) as well as body weight and height. The PAL values of Koreans calculated using the DLW method and PA diaries were determined to fall in the low active category (1.40~1.59). Therefore, the PA coefficient corresponding to 'low active' was applied to the EER equations. In recent years, with increasing number of people regularly engaging in various physical activities in Korea, EER is now separately presented for people with 'active' and 'very active' PALs. In the future, like the United States and Japan, Korea needs to expand the DLW research for developing EER predictive equations for Koreans. In addition, standardized guidelines should be prepared to accurately evaluate the PAL using the physical activity diary and the new PA classification table for Koreans.

• Journal of Preventive Medicine and Public Health
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• v.52 no.2
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• pp.101-108
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• 2019

Objectives: To objectively determine and compare the physical activity (PA) levels of adults newly diagnosed with type 2 diabetes (T2D) and adults without T2D in Vietnam using an accelerometer. Methods: A total of 120 participants with newly diagnosed T2D and 120 adults without T2D were recruited from a large hospital in Hanoi, the capital city of Vietnam. All participants wore an ActiGraph GT3X accelerometer for at least 5 days, including 1 weekend day. Freedson cut-off points were used to estimate different intensities of PA. In addition, comparisons between groups were made with respect to achieving the World Health Organization (WHO) and International Diabetes Federation (IDF) recommended PA guidelines. Results: Men with T2D had significantly lower levels of PA than men without T2D. The respective multivariable-adjusted mean values of daily step count, daily light-intensity, moderate-intensity, and moderate-to-vigorous-intensity PA were approximately 14%, 19%, and 22% lower in the men with T2D than in their non-T2D counterparts. However, women with T2D accumulated a greater number of steps per day than women without T2D. Only 59.2% of the adults with T2D met the minimum recommended level of PA (WHO and IDF), compared to 74.2% of adults without T2D (p<0.05). After adjusting for potential confounders, participants with T2D experienced 50.0% significantly lower odds of achieving PA recommendations. Conclusions: Vietnamese men with T2D were less physically active than those without T2D, and adults with T2D were less likely to meet PA guidelines. The results suggest a need for integrating PA into the self-management of this chronic condition.

• The Korean Journal of Community Living Science
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• v.20 no.3
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• pp.413-421
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• 2009

The purpose of this study was to analyze the patterns and the interrelationships for meeting guidelines of three health behaviors including physical activity(PA), sedentary behavior(SB), and dietary behavior(DB) for Korean adolescents using 2007 KYRBS(Korea Youth Risk Behavior Survey) data. A cross-sectional design was used to assess 73392 middle-high school students. PA(moderate physical activity${\geqq}$5times/week, or vigorous ${\geqq}$3times/week), SB(watching TV, computer, DVD, video, etc. < 3 hr/day), and DB(servings of fruits ${\geqq}$1 times/day, or vegetables ${\geqq}$ 3 times/day) were categorized into two levels (meeting guidelines or not). Chi-squared tests were conducted to compare the prevalence of students not meeting these three health behaviors between boys and girls, and logistic linear regression was used to determine the interrelationships of three health behaviors. Students meeting guidelines for PA, SB, and DB were 31.0%(boys 42.6%, girls 18.0%), 74.7%(boys 75.4%, girls 74.0%), and 38.5%(boys 38.6%, girls 38.4%), respectively. In addition, there were significant differences between both genders for PA and SB (PA; $x^2(1)$=35175.11, p<.0001, SB; $x^2(1)$=19.44, p<.0001). Only 10.9% of students met all three guidelines and 12.4% did not meet all three. Pattern that simultaneously did not meet PA and DB were high in both boys(27.1%) and girls(37.2%). Students who did not meet DB were at greater risk of not meeting PA(Boys; OR 1.49, 95% CI 1.43 to 1.55, Girls; OR 1.42, 95% CI 1.34 to 1.50), and not meeting SB(Boys; OR 1.41, 95% CI 1.34 to 1.48, Girls; OR 1.36, 95% CI 1.29 to 1.43) compared with students who met DB. The findings of this study supported further evidence for the need of a multiple behavior approach considering gender and interrelationships among three behaviors.

• Journal of Korean Academy of Nursing
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• v.48 no.6
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• pp.692-707
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• 2018

Purpose: We aimed to examine the effects of an integrated physical activity (PA) program developed for physically inactive workers on the theoretical basis of the PRECEDE-PROCEED model. Methods: Participants were 268 workers in three departments of L manufacturing unit in South Korea. The three departments were randomly allocated into integration (n=86) (INT), education (n=94) (ED), and control (n=88) (CT) groups. The INT group received self-regulation, support, and policy-environmental strategies of a 12-week integrated PA program, the ED group received self-regulation strategies only, and the CT group did not receive any strategies. After 12 weeks, process evaluation was conducted by using the measures of self-regulation (autonomous vs. controlled regulation), autonomy support, and resource availability; impact evaluation by using PA measures of sitting time, PA expenditure, and compliance; and outcome evaluation by using the measures of cardiometabolic/musculoskeletal health and presenteeism. Results: Among process measures, autonomous regulation did not differ by group, but significantly decreased in the CT group (p=.006). Among impact measures, PA compliance significantly increased in the INT group compared to the CT group (p=.003). Among outcome measures, the changes in cardiometabolic/musculoskeletal health and presenteeism did not differ by group; however, systolic blood pressure (p=.012) and a presenteeism variable (p=.041) significantly decreased only in the INT group. Conclusion: The integrated PA program may have a significant effect on increases in PA compliance and significant tendencies toward improvements in a part of cardiometabolic health and presenteeism for physically inactive workers. Therefore, occupational health nurses may modify and use it as a workplace PA program.

• Safety and Health at Work
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• v.14 no.3
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• pp.340-346
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• 2023

Background: Truck driving is a highly sedentary occupation that places workers at risk for chronic health conditions, such as obesity and high blood pressure. The primary purpose of this study was to objectively describe truck drivers' typical physical activity (PA) patterns. Methods: We used ~7-10-day baseline PA actigraphy data samples from drivers in the Safety & Health Involvement For Truckers (SHIFT) study (n = 394). Driver PA patterns (e.g., average number of ≥10 minute Freedson bouts per week, time in bouts, and common days/times for PA) were summarized with descriptive analyses. We also compared objective accelerometer data to self-reports. Results: Drivers' weekly PA averaged 14.4 minutes (SD = 37.0), and most PA occurred between 5-6 pm on Tuesdays and Wednesdays. Drivers overestimated self-reported weekly exercise by over 60 min/week compared to accelerometer data. Conclusion: Our results suggest that objective PA assessment may be warranted over self-report when possible, and timing may be key in future PA intervention work with truck drivers.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.351-360
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• 2012

Background: Identification of reliable predictors of leisure time physical activity (LTPA) will enable healthcare providers to intervene and change the patterns of LTPA in the population to improve community health. Objectives: The objectives of this study were to determine prevalence and pattern of LTPA among adult Saudis aged 18-65 years, and to define the socio-demographic determinants that correlate with LTPA in Al-Hassa, Saudi Arabia. Subjects and Methods: A cross-sectional study of 2176 adult Saudis attending urban and rural primary health care centers were selected using a multistage proportionate sampling method. Participants were personally interviewed to gather information regarding socio-demographics, physical activity pattern using the Global Physical Activity Questionnaire (GPAQ). Physical activity (PA) in each domain was expressed in metabolic equivalents (METs). Results: The median total METs minutes/week for LTPA for both genders was 256, higher for men (636 METs minutes/week) compared to women (249METs minutes/week). Overall, only 19.8% of the total PA was derived from LTPA. Of the sampled population 50.0% reported doing no leisure activity. Using the cut off of 600 METs-minutes/day or 150 minutes of moderate intensity over 5 or more days/week, only 21.0% of the included sample were considered as being sufficiently active and 10.4% were in the high active category with beneficial health effects. Multivariate regression analysis showed that male, younger age (<35 years), absence of chronic disease conditions and moderate level of total PA were significant predictors for being active in the LTPA domain. Conclusion: The prevalence and intensity of LTPA among the included sample demonstrated low levels. Nearly 80% of the included sample population did not achieve the recommended LTPA level with beneficial health effects. Female gender, urban residence and associated chronic diseases correlated with a low LTPA.

• Nutrition Research and Practice
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• v.13 no.5
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• pp.415-424
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• 2019

BACKGROUND/OBJECTIVES: Existing evidence on lifestyle modification programs for weight loss is limited by the high attrition rate of such programs. Identifying predictors of adherence to a lifestyle modification program could result in program improvement. However, little is known about behavior-specific adherence and its psychological predictors. This study aimed to examine the psychological predictors of adherence after one-month participation in a community-based lifestyle modification program among Chinese overweight and obese adults in Hong Kong. SUBJECTS/METHODS: A total of 205 Chinese overweight and obese adults aged $38.9{\pm}10.5years$ completed the study. Data were collected at baseline and after one month using self-reported questionnaires, which assessed knowledge (self-developed scale), motivation (Treatment Self-Regulation Questionnaire), stage of change (Stage of Exercise Scale) and self-efficacy (Self-Rated Abilities for Health Practices Scale). At one month, a 4-day dietary recall and the International Physical Activity Questionnaire-Short Form were used to assess dietary and physical activity (PA) adherence. Food and PA diaries were examined to indicate self-monitoring. Program attendance was tracked between baseline and one-month follow-up. RESULTS: After one month, participants reported high dietary adherence, attendance, and adherence to self-monitoring but low PA adherence. Multiple regression analyses suggested that diet self-efficacy (baseline) and nutrition knowledge (one-month change) were independent predictors of dietary adherence score at one month, whereas autonomous PA motivation (baseline) and PA self-efficacy (both baseline and one-month change) were independent predictors of PA adherence score at one month. No significant psychological predictor was identified for attendance or self-monitoring. CONCLUSIONS: The results suggest that the effect of psychological factors on adherence differs between diet and PA adherence outcomes. To promote adherence, practitioners should assess self-efficacy, knowledge, and motivation at the beginning of a weight-loss program and explore behavior-specific strategies to improve knowledge and self-efficacy. The results of this study have direct implications for program improvements.

• Journal of Sasang Constitutional Medicine
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• v.34 no.3
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• pp.41-49
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• 2022

Background Abdominal obesity, a major public health concern, is related to many health problems. In addition, it is influenced by individual characteristics. We investigated sleep quality and physical activity (PA) as risk factors for abdominal obesity, according to the Sasang constitutional medicine. Methods In this cross-sectional study, we analyzed data from 5,221 community-based participants. Sleep quality and PA were measured using structured questionnaires, and abdominal obesity was classified according to waist circumference. Sasang constitution (SC) was classified as Taeeumin (TE), Soeumin (SE), or Soyangin (SY) type, using an established SC questionnaire. Chi-square test and logistic regression analysis were performed to access the association of sleep quality and PA with abdominal obesity in individuals stratified according to the SC types. Results The percentage of poor sleep quality and inactive PA was the highest in the SE type, and the higher prevalence of abdominal obesity was found in the TE type. After adjusting for variables, inactive PA was associated with abdominal obesity in the TE type (OR=1.694, 95% CI=1.42-2.021), and in the SE type, abdominal obesity was associated with poor sleep quality (OR=1.688, 95% CI=1.091-2.611) and low PA (OR=2.127, 95% CI=1.163-3.89). Moreover, the combination of these two factors were also significantly associated with abdominal obesity in the TE and SE types. Conclusion Abdominal obesity was associated with sleep quality and PA, and these results were different in each SC type. Taking various associated lifestyles and individual characteristics in consideration may contribute to better management of abdominal obesity in clinical practice.

• Korean Journal of Exercise Nutrition
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• v.25 no.4
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• pp.1-9
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• 2021

[Purpose] This study analyzed data from the 7^th Korean National Health and Nutrition Examination Survey (2016-2018) to compare the differences in energy intake and physical activity (PA) levels in middle-aged Korean men aged 40-59 years according to household type and the presence of metabolic syndrome (MetS). [Methods] Data from 2,266 young adults (aged >39 years and <60 years) were obtained from the KNHANES. We analyzed the differences in energy intake and PA levels according to household type and MetS. The presence or absence of MetS was determined by measuring waist circumference, blood pressure, fasting blood glucose, triglyceride, and HDL-C levels. [Results] Regarding total nutritional intake, no relationship with MetS was observed regardless of household type (interaction between MetS and household type: p = 0.875). No differences in total PA were observed between multiple- and single-person households (interaction between MetS and household type: p = 0.122). The relationship between MetS and MetS components according to nutritional intake showed that participants with a higher energy intake had a 27% lower prevalence of low high-density lipoprotein cholesterol (HDL-C) (p < 0.05) and a 36% higher prevalence of high blood pressure (p < 0.01). The relationship between MetS and MetS components according to the PA level showed significantly reduced prevalence of MetS by approximately 39%, 35%, and 43% (p < 0.01, 0.01, and 0.001) in subjects who were somewhat active, active, and very active, respectively, compared to inactivity. [Conclusion] Middle-aged men showed no difference in nutritional intake and PA between multiple- and single-person households. However, the risk of MetS was significantly higher in participants with approximately 1.5 times the energy intake compared to the group with the lowest energy intake. Moreover, higher levels of PA had a marked positive effect on the risk factors and prevalence of MetS. Therefore, we suggest that reducing the total energy intake and increasing total PA are important for preventing MetS in middle-aged men regardless of household type.

• Journal of Nutrition and Health
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• v.45 no.6
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• pp.511-521
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• 2012

The purposes of this study were to assess the physical activity level (PAL) and the total daily energy expenditure (TEE) as well as to evaluate the validity of prediction equation for the estimated energy requirement (EER) in normal weight and overweight or obese children and adolescents. The subjects comprised of 100 healthy Korean students aged between 7-18. The anthropometric data was collected. PAL was calculated from the physical activity diary by the 24-hour recall method, and the resting metabolic rate (RMR) was measured by an open-circuit indirect calorimetry using a ventilated hood system. Daily energy expenditure was PAL multiplied by RMR. EER was calculated by using the prediction equation published in KDRIs. There was no significant difference in the means of age and height between the 46 obese subjects and 54 nonobese subjects. The weight and BMI of the obese group (60.2 kg, $25.3kg/m^2$) were significantly higher than those of the nonobese group (42.4 kg, $18.4kg/m^2$). However, PAL was not significantly different between the two groups (nonobese 1.45, obese 1.46). TEE of the obese group (2,212 kcal/day) was significantly higher than that of the nonobese group (1,774 kcal/day). EER (individual PA) and EER (light PA) were significantly higher than TEE (p < 0,001); however, EER (sedentary PA) was not significantly different with TEE in the two groups. These results showed that the levels of physical activity were the same as the sedentary activity both in the nonobese and obese Korean students; moreover, the predictive equation for EER published in KDRI overestimated the TEE of Korean children and adolescents. Therefore, in further research, a new predictive equation for EER should be developed for Korean children and adolescents through the doubly labeled water method.