The physical activity paradox: six reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does

Holtermann, Andreas; Krause, Niklas; Beek, Allard J. van der; Straker, Leon

doi:10.1136/bjsports-2017-097965

Cited by 445 publications

(487 citation statements)

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“…Since these jobs mainly characterise white collars, the residual confounding of social class should be acknowledged, although we adjusted for the educational level. On the other hand, performing heavy physical working tasks and engaging in high levels of sport activities during leisure time may lead to premature exhaustion and fatigue, and generate an overloading of the cardiovascular system, which over years with insufficient recovery can lead to CVD 29. Our online supplementary material findings on workers meeting recommended SpPA levels and with intense daily commuting PA strengthen our confidence to the main results, and provide further support to the overloading hypothesis.…”

Section: Discussionsupporting

confidence: 71%

Differing associations for sport versus occupational physical activity and cardiovascular risk

Roncaioli

Veronesi

Holtermann

et al. 2018

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Section: Discussionsupporting

confidence: 71%

Differing associations for sport versus occupational physical activity and cardiovascular risk

Roncaioli

Veronesi

Holtermann

et al. 2018

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“…Moreover, high occupational physical activity has been associated with an increased risk of cardiovascular disease [97] and all-cause mortality, especially among employees with low physical fitness levels [95,96]. These contrasting health effects have been termed the physical activity health paradox [94,98], highlighting the importance of a good balance between physical fitness and physical work demands [96]. Encouraging an active lifestyle in lower educated working young adults could be beneficial for this balance.…”

Section: Discussionmentioning

confidence: 99%

Effect and Process Evaluation of a Smartphone App to Promote an Active Lifestyle in Lower Educated Working Young Adults: Cluster Randomized Controlled Trial

Simons

Bourdeaudhuij

Clarys

et al. 2018

JMIR Mhealth Uhealth

143

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BackgroundMobile technologies have great potential to promote an active lifestyle in lower educated working young adults, an underresearched target group at a high risk of low activity levels.ObjectiveThe objective of our study was to examine the effect and process evaluation of the newly developed evidence- and theory-based smartphone app “Active Coach” on the objectively measured total daily physical activity; self-reported, context-specific physical activity; and self-reported psychosocial variables among lower educated working young adults.MethodsWe recruited 130 lower educated working young adults in this 2-group cluster randomized controlled trial and assessed outcomes at baseline, posttest (baseline+9 weeks), and follow-up (posttest+3 months). Intervention participants (n=60) used the Active Coach app (for 9 weeks) combined with a Fitbit activity tracker. Personal goals, practical tips, and educational facts were provided to encourage physical activity. The control group received print-based generic physical activity information. Both groups wore accelerometers for objective measurement of physical activity, and individual interviews were conducted to assess the psychosocial variables and context-specific physical activity. Furthermore, intervention participants were asked process evaluation questions and generalized linear mixed models and descriptive statistics were applied.ResultsNo significant intervention effects were found for objectively measured physical activity, self-reported physical activity, and self-reported psychosocial variables (all P>.05). Intervention participants evaluated the Active Coach app and the combined use with the Fitbit wearable as self-explanatory (36/51, 70.6%), user friendly (40/51, 78.4%), and interesting (34/51, 66.7%). Throughout the intervention, we observed a decrease in the frequency of viewing graphical displays in the app (P<.001); reading the tips, facts, and goals (P<.05); and wearing the Fitbit wearable (P<.001). Few intervention participants found the tips and facts motivating (10/41, 24.4%), used them to be physically active (8/41, 19.6%), and thought they were tailored to their lifestyle (7/41, 17.1%).ConclusionsThe lack of significant intervention effects might be due to low continuous user engagement. Advice or feedback that was not perceived as adequately tailored and the difficulty to compete with many popular commercial apps on young people’s smartphones may be responsible for a decrease in the engagement. A stand-alone app does not seem sufficient to promote an active lifestyle among lower educated working young adults; therefore, multicomponent interventions (using both technological and human support), as well as context-specific sensing to provide tailored advice, might be needed in this population.Trial RegistrationClinicalTrials.gov NCT02948803; https://clinicaltrials.gov/ct2/show/results/NCT02948803 (Archived by WebCite at http://www.webcitation.org/71OPFwaoA)

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“…New evidence, however, suggests a contrast between the health effects of leisure time and occupational PA,11 12 suggesting a PA paradox 13. Specifically, while beneficial health outcomes have been associated with high level leisure time PA, detrimental health consequences have been documented for high level occupational PA, regarding cardiovascular disorders,14–17 sickness absence12 and mortality 18–21.…”

Section: Introductionmentioning

confidence: 99%

Do highly physically active workers die early? A systematic review with meta-analysis of data from 193 696 participants

Huysmans²,

et al. 2018

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The physical activity paradox: six reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does

Cited by 445 publications

References 8 publications

Differing associations for sport versus occupational physical activity and cardiovascular risk

Differing associations for sport versus occupational physical activity and cardiovascular risk

Effect and Process Evaluation of a Smartphone App to Promote an Active Lifestyle in Lower Educated Working Young Adults: Cluster Randomized Controlled Trial

Do highly physically active workers die early? A systematic review with meta-analysis of data from 193 696 participants

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