Research article
Domestic Physical Activity in Relationship to Multiple CVD Risk Factors

https://doi.org/10.1016/j.amepre.2006.12.020Get rights and content

Background

Public health recommendations emphasize regular participation in moderate intensity physical activity (at least 5 days per week, 30 minutes or more per day), including domestic activities (e.g., heavy housework). The contribution of domestic activities in improving cardiovascular disease risk remains unclear. This cross-sectional study aimed at determining the independent associations of domestic activity and other activity types with multiple cardiovascular disease (CVD) risk factors (resting pulse rate, obesity, total cholesterol, high-density lipoprotein cholesterol, blood pressure, C-reactive protein).

Methods

The sample comprised of 14,836 adults (ages 16 years and over) living in households in England in 2003. Interviews assessed participation in at least moderate intensity physical activity (domestic activity, walking, and sports), and nurses measured blood pressure and took blood samples. Analyses were done in 2006.

Results

A total of 24.2% of men and 19.8% of women met the activity recommendations, dropping to a total of 17.6% and 13.0% when domestic activity was excluded. With the exception of systolic blood pressure in women, domestic activity was not related to a favorable profile of any other CVD risk factors. There was a trend for lower body mass index and waist circumference and higher high-density lipoprotein cholesterol with increased participation in walking. Sports participation was related to a favorable profile for all risk factors excluding systolic blood pressure in men and cholesterol and C-reactive protein in women. The odds of being obese (body mass index more than 30 kg/m2) were lower with increased participation in walking and sports.

Conclusions

Despite its high prevalence, domestic physical activity was not associated with improvements in CVD risk factors. These results suggest that physical activity recommendations may need to focus on physical activities other than those performed in and around the household.

Introduction

A physically active lifestyle is protective against chronic disease, most notably against cardiovascular disease (CVD) and obesity.1 A number of CVD-related risk factors and biomarkers, such as blood pressure, obesity, resting pulse rate, C-reactive protein, cholesterol, and high-density lipoprotein (HDL) cholesterol, respond favorably to increased levels of physical activity and exercise.1, 2 The English Chief Medical Officer’s3 2004 report on physical activity concluded that all adults should accumulate 30 minutes or more of moderate to vigorous intensity physical activity on at least 5 days a week, and made repeated references to participation in domestic activity (e.g., gardening, do it yourself [DIY], housework) as a means of acquiring the required amounts of physical activity. This is in line with less recent primary care4 and public health5, 6 recommendations that encouraged engagement in domestic activity to achieve health benefits.

Although the evidence on the benefits of moderate-intensity activity is robust,3 it is less clear what the specific contribution of domestic activity is. Some studies suggest that low- to moderate-intensity leisure activity (including domestic) may be associated with decreased overall7, 8, 9 and CVD10 mortality, but others have found that only moderate or vigorous-intensity activity has an effect,11, 12 or that domestic activity specifically does not associate with risk factors.13 It is common for domestic activity to be grouped with other leisure-time and lifestyle activities (such as walking or cycling), preventing examination of its independent association with various health outcomes. Domestic physical activity, such as vacuuming, digging, and cutting grass, differs from other recommended modes of physical activity, such as walking, cycling, and swimming. The latter types of aerobic activity are characterized by the use of large muscle groups employed in a rhythmic or dynamic nature.14 Domestic physical activity mainly utilizes smaller upper body muscles and is more intermittent and less rhythmic. Also, domestic physical activity may not be intense enough to produce improvements in cardiovascular fitness, which may be required to reduce the risk of disease.

The aim of this study was to examine the contribution of domestic physical activity to the overall prevalence of physical activity and to assess its independent associations with obesity and a number of key CVD risk factors in a large, nationally representative sample of adults living in England.

Section snippets

Methods

The Health Survey for England (HSfE)15 is a continuous annual survey that draws a nationally representative sample of the general population living in households. The sample was drawn using multistage stratified probability sampling. This analysis included data from adults aged 16 and over collected during 2003. Data were collected in two household visits. During the first visit, interviewers collected self-reported data and measured weight and height. In the second visit nurses measured blood

Results

Sixty-six percent of eligible adults completed the physical activity interview (n=14,824) and 51% saw a nurse (n=11,408). Height, weight, and waist measurements were obtained by 62% (n=13,769), 60% (13,388), and 49% (n =11,038) of eligible adults, respectively. Blood samples were collected by 38% of them (n=8552). Of those who completed the physical activity interview, 344 men and 474 women were excluded on the grounds of suspected limited mobility (reporting limiting long-standing illness and

Discussion

In a large, nationally representative, cross-sectional sample of adults living in England, the prevalence of physical activity at recommended levels is greatly altered by the inclusion/exclusion of heavy domestic physical activity, confirming previous studies among Australia adults17 and elderly British women.13 In the current study, the overall prevalence of recommended physical activity was reduced by approximately seven percentage points when domestic physical activity is excluded,

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