|Year : 2013 | Volume
| Issue : 1 | Page : 17-21
Does adequate physical activity among medical health care professionals exist?
Sami A Al Nassar1, Wassem Hajjar1, Ghadeer Al Shaikh2, Arthur Isnani3, Nojud Alhejin1, Amna Baljoun1, Ahlam Almaawi1
1 Department of Surgery, Division of Thoracic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
2 Department of Obstetrics and Gynecology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
3 Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
|Date of Web Publication||28-May-2013|
Sami A Al Nassar
Division of Thoracic Surgery, Department of Surgery (37), College of Medicine, King Saud University, P.O. Box 7805, Riyadh 11427
Source of Support: None, Conflict of Interest: None
Rationale: To determine the amount of physical activity (PA) among our staff and if it meets the daily-recommended minimum PA set by the American Heart Association. Materials and Methods: A questionnaire developed by the World Health Organization (WHO) to measure and assess the PA was distributed to hospital staff. The questionnaire has 16 items of three domains (activity at work, travel, and recreation) which were coded to measure the total physical activity (TPA) of each individual per day. Domains were calculated and analyses were done. Results: Of 134 participants, 81 (60.4%) were males and 53 (39.6%) were females. There were 48 (35.8%) students, 44 (32.8%) residents, and 42 (31.3%) consultants. Mean BMI was 26.4 ± 5.9. Males had significantly higher BMI than females and were spending significantly more time for vigorous recreational activities than females. Males were significantly more overweight to obese than females. Residents and consultants were more overweight to obese than medical students. The overweight to obese individuals spend less than 3000 minutes per week on activities. Overall, there were 64 (47.8%) who did not meet the AHA physical activity guidelines and have low TPA. An insignificant majority (n = 70, 52.2%) of our respondents have moderate to high TPA. Conclusion: Almost half of our respondents do not meet the AHA required PA thus there is still a need to encourage and facilitate the increase in PA among our employees in our institution through information campaigns, proper support for physical fitness programs and provision of adequate fitness facilities.
Keywords: Hospital staff, physical activity, recreation, travel, work
|How to cite this article:|
Al Nassar SA, Hajjar W, Al Shaikh G, Isnani A, Alhejin N, Baljoun A, Almaawi A. Does adequate physical activity among medical health care professionals exist?. Saudi J Sports Med 2013;13:17-21
|How to cite this URL:|
Al Nassar SA, Hajjar W, Al Shaikh G, Isnani A, Alhejin N, Baljoun A, Almaawi A. Does adequate physical activity among medical health care professionals exist?. Saudi J Sports Med [serial online] 2013 [cited 2022 Aug 13];13:17-21. Available from: https://www.sjosm.org/text.asp?2013/13/1/17/112212
| Introduction|| |
Physical activity (PA) is very important for the maintenance of health and well-being of every individual. It is beneficial to many health outcomes such as coronary heart disease, stroke, high blood pressure, type 2 diabetes, metabolic syndrome, colon and breast cancer, obesity, depression and in lowering the overall risk of premature death. ,, Walking is a practical, accessible and cheap form of PA through which people can develop and maintain their health. 
Taking small increment steps helps reduce the risk of chronic diseases related to sedentary or low activity lifestyles.  Experts also agreed that accumulating at least 10,000 daily steps represents a minimal public health goal and that 3000-4000 of these steps should be achieved through bouts of brisk walking (3-4 mph), sustained for 10 minutes or more. Studies proved that brisk walking as little as 45-150 minutes per week significantly lowers the risks mentioned above, thus reinforces the original 1995 recommendation for ≥30 minutes per day of moderate-intensity activity on most days. ,
To promote PA, national agencies like the American College of Sports Medicine (ACSM), American Heart Association (AHA), and the Center for Disease Control and Prevention (CDC) have issued in 1995 and updated in 2008, a minimum recommended PA. The guideline states that all individuals should minimally accumulate at least 30 minutes a day of moderate intensity activity (such as brisk walking) five days a week or 20 minutes a day of vigorous cardio workout three days a week. In addition, it was also recommended to have an eight to 12 repetitions of a 10 strength-training exercise twice a week. ,
Physical inactivity remains a pressing public health issue. Modern technologies and economic incentives tend to discourage activity by eliminating simple daily activities that promotes sedentary lifestyles. There are individuals who misinterpret or do not accept the original recommendation, more so, some people continue to believe that only vigorous intensity activity will improve health while others believe that light activities done daily are sufficient to maintain and promote ones health. During the time after the recommendation was issued, the CDC Behavioral Risk Surveillance System indicates a decline in the prevalence of leisure time physical inactivity in both genders. ,,, However, there remains a broad range of evidence to underscore concern that many adults are still not active enough. Data from the year 2005 indicates that less than half of the adults met the recommended PA and men are more likely to meet the recommendation than women, while younger people are more active than the older people and the prevalence declines as the age advances. ,,, There are data also depicts the level of education has a factor in meeting the recommended PA. People with college degree tend to meet the recommendation than the less education people. ,,,
This study aimed to determine if our participants/individuals meet the minimum amount of PA as recommend in the guidelines of ACSM, AHA, and CDC. , The results of this study would provide a significant data that will justify and substantiate evidences for the need to prioritize implementation of health related policies and guidelines in the work environment of our institution, as well as provide facilities that will promote health consciousness and provision of building facilities that will promote a healthy environment for the workforce of our institution.
| Materials and Methods|| |
Healthy students and employees aged 18 years old to 65 years old of the College of Medicine, King Saud University, Riyadh, Saudi Arabia were invited to participate in the study conducted from March until May 2011. Participants who have cardiac, metabolic, endocrine, immunologic, and other chronic conditions or functional limitations that affect movement ability or physical fitness were excluded from the study.
Participants were asked to fill out a survey questionnaire adopted from the Global Physical Activity Questionnaire (GPAQ) developed by the World Health Organization (WHO) for PA surveillance in countries around the world. The survey checklist corresponded to the daily physical activities of the participant during their working hours and contained the following parameters: department of the employee, position or work, age, gender, height and weight, educational attainment, and co-morbidities. The height and weight was used to calculate the Body Mass Index (BMI), and thereby categorize each participant as underweight (BMI <20), normal (BMI of 20-25), overweight (BMI of 25.1 - 30), and obese (if BMI is >30). The educational attainment is an integral part of the research survey to establish the significance of level of education in the compliance of the recommended daily PA as well as the interrelationship of the type of work or position of the participant.
The survey also collected information of PA in three settings/domains namely; TPA at work, TPA spent on travel to and from places and TPA spent on recreational activities as well as the participants' sedentary behaviors.
TPA was computed using the equation:
TPA = [(P2 * P3 * 8) + (P5 * P6 * 4) + (P8 * P9 * 4) + (P11 * P12 * 8) + (P14 * P15* 4)]
P2, is the number of days spent for vigorous activity at work in mean days/week
P3, is the amount of time spent for vigorous activity at work in mean minutes/day
P5, is the number of days spent for moderate-intensity activity at work in mean days/week
P6, is the amount of time spent for moderate-intensity activity at work in mean minutes/day
P8, is the number of days spent for travel in mean days/week
P9, is the amount of time spent for travel in mean minutes/day
P11, is the number of days spent for vigorous recreation activities in mean days/week
P12, is the amount of time spent for vigorous recreation activities in mean minutes/week
P14, is the number of days spent for moderate-intensity recreation activities in mean days/week
P15, is the amount of time spent for moderate-intensity recreation activities in mean minutes/day
Participants were categorized according to their level of PA based on the physical activity cut-off value recommended by the AHA [Table 1].
Data was collected and entered using Microsoft Excel 2007 and analyzed using Predictive Analytical Software version 18.1 (PASW, IBM, Chicago, Illinois, USA). Data was presented as mean ± standard deviation or as percentages. Independent t-test was performed to determine the significance between two continuous variables. P values <0.05 were considered statistically significant.
| Results|| |
One-hundred thirty four participants consented to join the study, 81 (60.4%) males, and 53 (39.6%) females. There were 48 (35.8%) students, 44 (32.8%) residents, and 42 (31.3%) consultants. Mean BMI was 26.4 ± 5.9. Mean physical activities (vigorous and moderate-intensity) afforded at work, travel and recreation are summarized in [Table 1].
Males had significantly higher BMI than females (28.2 ± 6.2 vs. 23.6 ± 4.1, p < 0.0001). Moreover, males spent a mean of 1.5 days for vigorous recreational activities significantly more than women who spend a mean of 0.4 days (p < 0.0001). Males also spend a mean of 37.3 minutes per day for moderate-intensity recreational activities, significantly more than the females who spend a mean of 16.2 minutes/day for moderate-intensity recreational activities (p = 0.007). There was no significant differences in time and amount spent for travel, the time spent for sedentary activities and the TPA between gender (p=0.721, p = 0.242 and p = 0.299, respectively) [Table 1].
[Table 2] shows the amount of physical activities incurred in the three domains according to BMI categories. There were 14 (10.4%) underweight participants, 47 (35.1%) normal BMI, 48 (35.8%) overweight and 25 (18.7%) were obese. Based on the BMI, the significant majority (40 out of 48, 83.3%) of those who were overweight were males (p < 0.0001). Furthermore, 80% of those who were obese were also males (p < 0.0001). Residents and consultants tended to be more overweight to obese than medical students. Underweight and Normal weight participants spend a mean of more than 3000 minutes/week of PA relatively more than the overweight to obese individuals, who spend less than 3000 minutes/week. (p > 0.05) The underweight and normal individuals significantly spend more time on recreational sports activities compared to the overweight and obese individuals (p < 0.0001) [Table 2].
Medical students spend significantly more time for vigorous activities at work compared to residents and consultants (3.8 ± 15.9 minutes/day vs. 19.0 ± 58.2 minutes/day, p = 0.024), whereas residents and consultants significantly spend more time on moderate-intensity activities at work than medical students do (65.2 ± 117.1 minutes/day vs. 28.8 ± 70.3 minutes/day, p=0.026). Medical students spend more time on sedentary activities significantly more than residents and consultants (567.9 ± 263.2 minutes/day vs. 401.5 ± 240.5 minutes/day, p < 0.0001).
No significant differences in other parameters were noted between medical students and residents/consultants [Table 3]. Medical residents significantly spend more time on PA compared to consultants (5036.4 ± 7704.6 minutes/week vs. 1959.7 ± 1965.7 minutes/week, p = 0.021) [Table 3]. Male medical students significantly spend more days on vigorous recreational activities compared to female medical students (2.6 ± 2.3 days/week vs. 0.4 ± 1.2 days/week, p < 0.0001). No significant differences in physical activities spent by residents and consultants according to gender. Overall, there were 64 (47.8%) who have low TPA. An insignificant majority (n = 70, 52.2%) of our respondents have moderate to high TPA. Among the 64 participants who had low TPA, 36 (56.3%) were males and 26 (40.6%) were residents, 18 (28.1%) were consultants and 20 (31.3%) were medical students. Of the 33 participants who had moderate TPA, 18 (54.5%) were males and 14 (42.4%) were medical students. Of those 37 participants who had high TPA, 27 (73.0%) were males and 14 (37.8%) were medical students, 13 (35.1%) were residents and 10 (27.0%) were consultants.
| Discussion|| |
Our study showed that almost half of our participants (47.8%) have low TPA. This means that almost half of our participants do not meet the required PA recommended by the AHA and the CDC of at least 30 minutes a day of moderate intensity activity (such as brisk walking) five days a week or 20 minutes a day of vigorous cardio workout three days a week. , It was noted in our findings that medical students meet the required TPA more than their resident and consultant counterparts do. In other words, those who did not meet the required TPA were residents and consultants. This could be due to more non-vigorous activities spent by residents and consultants at work compared to medical students. More so, residents and consultants spend most of their time reading and careful consideration pertaining to clinical duties in diagnosis and management of their patients. Should there be sufficient free time that could be spent by residents and consultants for moderate to vigorous PA, interest for PA is overwhelmed by the need to sleep and rest from mental exhaustion. Some of the other barriers that were reported in the literature were lack of time, increased labor demands for administrative personnel, and limited funding. 
There is good evidence in the literature showing that the physicians' own PA practice influences their clinical attitudes and counseling practice towards PA, which is another important reason to promote PA among physicians. 
There are many ways to reduce this high percentage of employees with low TPA. First, through adequate information through campaigns and materials such as information booklets and posters to promote healthy lifestyles. This would emphasize the fact that an increase in PA above the recommended minimum amount provides even greater health benefits. The inclusion of muscle strengthening activities and endurance training promote development and maintenance of metabolically active lean muscle mass, which enhances glucose metabolism. Second, to encourage staff to engage in physical activities through provision of on-site health facilities and equipments that will be readily accessible to all. Provision of showers, change room facilities, and lockers for those who wish to engage in fitness activities after work hours will improve the PA levels of the employees. In addition, most of all, administrative support for sports and physical activities conducted by the administration and the sports officials within the institution will greatly help. A third option, once the onsite facilities are available, would be to start workplace intervention to promote PA. Such interventions were reported to be very successful. 
In conclusion, there is still a need to facilitate an increase in PA among our employees so that most of them will meet the required PA set by the AHA through information campaigns, proper support for physical fitness programs and provision of adequate fitness facilities.
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[Table 1], [Table 2], [Table 3]