PHYSICAL CULTURE AND SPORT. STUDIES AND RESEARCH DOI: 10.2478/pcssr-2013-0019 Comparative Leisure Physical Activity: A Comparison Between Polish and European Population Authors’ contribution: A) conception and design of the study B) acquisition of data C) analysis and interpretation of data D) manuscript preparation E) obtaining funding Elżbieta Biernat1 A-D, Monika Piątkowska2 A-D 1 2 Warsaw School of Economics, Poland Josef Pilsudski University of Physical Education in Warsaw, Poland ABSTRACT KEYWORDS Introduction and objective: In Poland, there are only a few studies that refer to the whole society’s participation in sport and recreation and that are based an the international questionnaire thus allowing for comparative analysis with other European reports. The aim of the study was to determine the association between leisure physical activity and socio-demographic variables. Methods: A survey based on CAPI was carried out in Poland from October to November 2012. A random sample of Polish adults (N=1,633) was interviewed using the IPAQ-long form. The data were analyzed using standard statistical procedures. Results: More than 21% of Polish subjects did not undertake any physical activity in their leisure time. Of those who were physically active, over 70% engaged in vigorous physical activity; only one in four respondents performed moderate physical activity or walking. The average leisure physical activity of the Poles was 1,916.9 ± 2,621 MET-min/week. A comparison of the current results and European research findings demonstrated that the median physical activity for the Polish population (MET-min/week) was similar to the median values for Czech subjects and Norwegian males and nearly three times higher than Croats. Conclusions: Insufficient participation in the conscious process of caring for one’s health is a common occurrence among adults living in the EU. In order to encourage the Polish population’s participation in physical activities, it is necessary to raise their awareness of the need of well-balanced, regular exercise. Furthermore, this study suggests that caution is warranted before using the CAPI technique to provide the IPAQ-long form survey. physical activity, leisure, comparative study, Poland, European population Introduction Research institutions around the world are increasingly engaged in a cross-sectional research on physical activity (European Commission, 2004, 2010; Physical Activity…, 1996; Sidney et al., 1991) and Poland is no exception (Biernat, 2011; Drygas et al., 2005; Polish population…, 2003; Piątkowska, 2012). However, the majority of investigations and analyses conducted by research bodies in Poland (such as academic institutions, the Central Statistical Office, or the Public Opinion Research Centre) have either 2013 • VOLUME LIX 33 PHYSICAL CULTURE AND SPORT. STUDIES AND RESEARCH evaluated the frequency and duration of a physical activity by using varied, often non-comparable, methods or have defined an active life style differently. The key aspects of these analyses were the type of activity undertaken in leisure time, the percentage of participation in various activities, the duration of a particular activity, and the frequency of occurrence of a specific activity in a set behavior of a group or an individual (Toczek-Werner & Sołtysik, 1997). The data were often collected and analyzed as they existed at the time of assessment by using small samples that varied in terms of participants’ age, gender, and employment status. As an answer to the social need for a detailed verification of the existing research findings, there was a call for a broader, more representative set of results. This issue was addressed by raising the idea and the current concept of leisure physical activities diagnosis by means of a Polish version of the Last 7 Days Physical Activity Recall (L7DPAR), which was officially approved by an international IPAQ committee (Biernat et al., 2007; Gajewski & Biernat, 2010). This analysis, along with the socio-demographic factors gender, age, education, occupation, income, and the size of the place of residence, would allow for creating a complex profile of the investigated population, which in turn would become a valuable reflection of the lifestyle(s) of the Polish population. It is expected that the current investigation will add to the understanding of the differences and similarities between Polish citizens’ leisure physical activity and that of other European citizens (both measured with the same tools). Material and methods The surveys were carried out between 10 October 2012 and 14 November 20121 via ComputerAssisted Telephone Interviews (CATI). Qualified and supervised surveyors conducted the interviews. They delivered the questions in a way that was equally easy for all respondents to comprehend. Leisure physical activity was estimated by the Polish long version of International Physical Activity Questionnaire (IPAQ) (Biernat, 2013). The sample consisted of 2,004 Polish people aged 15 years or older. They were selected through the stratified-quota sampling method. The demographic variables of age, sex, education, and place of residence were stratified The quotas, which were established proportionally, were based on the data made accessible to the researchers by Poland’s Central Statistical Office. Furthermore, in order to increase the representativeness of the sample, a data weighting procedure of the variables listed above was used. The quotas were proportionally assessed based on the data provided by the Central Statistical Office. The analysis excluded 234 participants who were over the age of 69 years, as the IPAQ methodology recommends using the questionnaires for the population in the age range of 15-69 years. Of the remaining sample (n=1,770), 132 subjects who reported physical activity exceeding 16 hours per day were excluded from the analysis (Guidelines…, 2005). The characteristics of the respondents can be found in Table 1. Data analysis was accomplished using statistical software IBM SPSS 21.0. Descriptive statistics was used to present the basic data in the study including the mean, median (me), extreme values (max, min), and standard deviation (SD). Inferential statistics was applied in order to reveal statistically significant differences between groups. It included the t-test and the chi-squared test. The significance level was p=0.05. Results The data analysis shows that over 21% of Polish subjects did not undertake any physical activity (PA) in their leisure time (see Table 2). The lowest physical activity was observed for subjects with secondary education (23.3%); farmers, gardeners, foresters and fishermen (30%); and those with average gross income (per capita in household) of 2,000-2,999 zł per month (26.6%). 1 Data collection excluded All Saints' Day (a national holiday in Poland) due to the increased physical activity frequently caused by visits to cemeteries. 34 2013 • VOLUME LIX PHYSICAL CULTURE AND SPORT. STUDIES AND RESEARCH Table 1. Socio-demographic characteristics of Polish respondents aged 15-69 years Variables Sex Male Female Age 15-19 years 20-24 years 25-29 years 30-39 years 40-49 years 50-59 years 60-69 years Education Primary Secondary Higher Place of residence Village City up to 20,000 inhabitants City with 21,000-50,000 inhabitants City with 51,000-100,000 inhabitants City with 101,000-200,000 inhabitants City with 201,000-500,000 inhabitants City over 500,000 inhabitants Average monthly gross income (per capita in household)* <1,000 zł 1,000-1,999 zł 2,000- 2,999 zł 3,000-3,999 zł 4,000-4,999 zł 5,000-5,999 zł ≥6,000 zł N=1,633 n % 801 49.1 832 50.9 88 206 200 322 295 293 229 5.4 12.6 12.2 19.7 18.1 17.9 14.0 431 911 291 26.4 55.8 17.8 451 222 343 245 125 122 125 27.6 13.6 21.0 15.0 7.7 7.5 7.7 185 437 363 219 107 57 81 11.3 26.8 22.2 13.4 6.6 3.5 5.0 * The percentages for average monthly gross income (per capita in household) do not total 100% due to possible data deficiencies and lack of responses. Source: own study. Of those who were physically active, over 70% engaged in a vigorous physical activity (leading to a highly increased heart rate and breathing). Only one in four respondents performed a moderate physical activity (24.4%) or walking (25.5%). In general, vigorous physical activity, which was declared more often than moderate physical activity or walking, underlay the leisure physical activity amongst Polish males (69.8%) and females (70.7%). Interestingly, this mostly affected respondents having a primary education (70.9%), those employed by the armed forces (75%), and those who were unemployed (73.2%). However, it should be mentioned that the differences in this respect were not statistically significant when gender, age, place of residence, gross income, and occupation were taken into consideration. Walking (whether related to work, involved with shopping, part of getting to work, or leisure walking) was declared by subjects aged 25-39 years (27.6%). In contrast, subjects aged 15-24 years rarely declared walking as their leisure physical activity (22.8%). There were industrial laborers and craftsmen on the one side of the spectrum, of which only 18.5% chose to walk in their leisure time. On the other side were CEOs, administration managers and officials (33.3%), employees of the armed forces (33.3%), and professional athletes (33.3%). They declared this particular activity more often. However, these differences were not statistically significant. Interestingly, the results show that Polish respondents with primary education declared taking up walking as their physical activity more often than those with higher or secondary education (31.5%, 28.1%, and 21.8%, respectively). These differences were found to be significant (χ2=15.7, p<0.001). 2013 • VOLUME LIX 35 PHYSICAL CULTURE AND SPORT. STUDIES AND RESEARCH Table 2. The fraction of Polish population aged 15-69 years (n=1633) declaring participation in leisure physical activity Variables Vigorous PA Leisure PA Moderate PA Walking No PA Sex Male 69.8 26.4 25.2 21.7 Female 70.7 22.4 25.7 21.2 Age 15-24 years 71.7 24.5 22.8 22.2 25-39 years 68.9 25.1 27.6 23.2 40-54 years 72.3 25.2 23.1 18.2 55-69 years 68.7 22.4 27.3 22.1 Education Primary 70.9 27.2 31.5b 20.1 Secondary 70.6 23.1 21.8 22.3 Higher 68.2 24.1 28.1 20.6 Place of residence Village 70.8 23.3 24.2 21.4 City up to 20,000 inhabitants 68.9 25.0 23.6 23.9 City with 21,000-50,000 inhabitants 71.7 23.6 23.7 20.8 City with 51,000-100,000 inhabitants 68.7 26.6 24.7 21.6 City with 101,000-200,000 inhabitants 72.0 25.6 35.2 17.6 City with 201,000-500,000 inhabitants 66.9 23.0 23.1 24.2 City over 500,000 inhabitants 71.0 24.8 32.3 20.3 Occupation CEOs, officials, and administrative managers 71.7 28.3 33.3 18.3 Professionals and freelancers 71.3 26.3 30.9 17.7 Technicians and other middle-level staff 66.2 23.0 26.9 28.8 Office clerks 69.7 27.4 23.7 19.7 Personal care and sales assistants 71.3 24.0 26.8 20.7 Farmers, gardeners, foresters, and fishermen 60.0 14.3 24.2 30.0 Industrial workers and craftsmen 72.2 24.2 18.5 21.6 Heavy equipment operators and fitters 71.1 28.1 27.3 19.0 Support staff (seasonal farmers, cleaners, 67.6 21.1 25.0 25.2 security guards) Armed forces employees 75.0 30.2 33.3 16.7 Professional athletes 50.0 33.3 33.3 16.7 Unemployed 73.2 22.7 22.4 20.6 Average monthly gross income (per capita in household) <1,000 zł 67.9 20.5 23.5 23.1 1,000-1,999 zł 72.5 21.8 22.8 19.5 2,000- 2,999 zł 65.2 24.9 25.2 26.6 3,000-3,999 zł 73.6 23.7 30.1 18.5 4,000-4,999 zł 72.9 35.2 29.8 17.3 5,000-5,999 zł 68.4 24.6 17.5 26.3 ≥6,000 zł 75.0 38.3c 34.6 15.0 24.4 25.5 21.5 Total 70.2a Statistically significant differences were found for: a vigorous physical activity vs moderate physical activity and walking (p<0.05); b primary education vs secondary education (p<0.001); c average monthly gross income ≥6,000 zł vs all remaining income ranges(p<0.01). Source: own study. Moderate physical activity (leading to a slight increase in breathing and a higher heart rate) was declared significantly more often (χ2=19.1, p<0.01) by those on monthly gross income ≥6,000 zł (38.3%). The average leisure moderate physical activity among Polish respondents (MET-min/week) was 223 ± 652.9 36 2013 • VOLUME LIX PHYSICAL CULTURE AND SPORT. STUDIES AND RESEARCH and, as with with walking (128.7±352.4), was relatively lower than the average vigorous physical activity (1,571.3±2,394.1) (Table 3). Table 3. Means, standard deviations (SD), and medians of Polish population’s leisure physical activity (METmin/week) Leisure PA (MET-min./week) PA Male Mean±SD Female Median Mean±SD Total Median Mean±SD Median Vigorous 1,474.2±2,281.4 720.0 1,665.2±2,496.1 960.0 1,571.3±2,394.1 800.0 Moderate 240.1±701.2 0 206.5±602.7 0 223.0±652.9 0 Walking 124.4±355.0 0 132.8±350.0 0 128.7±352.4 0 Source: own study. The average leisure physical activity (MET-min/week) was 1,916.9 ± 2,621, with a median of 1,017 (see Table 4). The comparison of current results and European research findings demonstrated that the median physical activity (MET-min/week) for the Polish population was similar to the median of Czech subjects (990 for males and 1,081 for females) (Sigmund et al., 2009) and Norwegian males (Graff-Iversen et al., 2007) and nearly three times higher than Croats over 15 years of age (360) (Jurakić et al., 2009). Table 4. Means, standard deviations (SD), and medians of Europeans’ leisure physical activity MET-min/week Variables Weekly leisure PA Mean (±SD) Median Poland 2012 (n=1,633; aged 15-69) Male 1,816.6 (2528.6) 960.0 Female 2,013.5 (2705.1) 1,065.0 Total 1,916.9 (2621.0) 1,017.0 Greece 2004 (n=300; aged 20-50) 20-29 years 216.4 (240.6) Male 30-39 years 74.1 (148.1) 40-50 years 113.0 (137.0) 20-29 years 228.0 (257.6) Female 30-39 years 132.0 (126.2) 40-50 years 136.2 (153.6) Norway 2000 (n=2,274; 31-67 years old) ≥12 years of education 1,230 Male <12 years of education 891 ≥12 years of education 1,389 Female <12 years of education 1,024 Croatia 2007 (n=1,032; >15 years old) Male 360 Female 360 Total 360 Czech Republic 2004-2005 (n=3,377) Male 990 Female 1,081 Sweden 2002-2005 (n=704; 18-65 years old) Female 714 Finland 2002-2005 (n=865; 18-65 years old) Female 792 Source: own study based on Μακαβέλου et al., 2005; Graff-Iversen et al., 2007; Jurakić et al., 2009; Sigmund et al., 2009; Södergren et al., 2010. 2013 • VOLUME LIX 37 PHYSICAL CULTURE AND SPORT. STUDIES AND RESEARCH Similarly, the average leisure physical activity of Polish respondents (MET-min/week) aged 20-50 years was 13 times higher than Greeks (Μακαβέλου et al., 2005). The median of all physical activities undertaken by Polish females (MET-min/week) was lower (1,065) than the median of educated Norwegian females (over 12 years of education, 1,389) (Graff-Iversen et al., 2007) but much higher than Swedish females (714) or Finns (792) (Södergren et al., 2010). A similar pattern was observed for males: the median for Polish males was 960, whereas Norwegians with more than 12 years of education had a median of 1,230 and those with less than 12 years of education 891 (Graff-Iversen et al., 2007). Discussion Increasing the amount of physical activity undertaken by European citizens is challenging for the public health sector across the EU. Promoting a healthy lifestyle requires effective strategies that encourage participation in various forms of physical activity. Furthermore, there is a need for continuous monitoring and analysis of this phenomenon. The current investigation regarding the Polish population shows that close attention should be given to specific occupational groups (i.e., farmers, gardeners, foresters, and fishermen) that show a very low level of leisure physical activity (30%). Polish respondents with gross income in the range of 2,000-2,999 zł and those educated to the secondary level show a similar percentage of physical activity (26.6% and 22.3%, respectively). This is consistent with the fact that leisure physical activity is rarely undertaken by those who do physical work (Salmon et al., 2000; Marquez et al., 2010) or those educated to the lower level (Jones et al., 1998) and with lower income (Burton & Turrel, 2000). Given that the lack of physical activity (sedentary lifestyle) is one of the main factors putting people at a higher risk for developing cardiovascular disease and other chronic disorders, it is necessary to educate the most inactive population groups by stressing the importance of active, healthy lifestyles. These groups should be made aware of the need for physical activity in their leisure time as well as the intensity levels at which these activities should be performed. The intensity of a physical activity affects physiological outcome of that activity and is crucial for health and safety. It is suggested to undertake a moderate physical activity (≥150min/week) (Drygas & Jegier, 2009) with the possibility of replacing it with a vigorous activity (≥75min/week) or a combination of a moderate and vigorous activity (WHO, 2010). It should be pointed out that among Polish respondents who declared leisure physical activity, over 70% stated that they were engaged in a vigorous physical activity; only one in four declared moderate physical activity (24.4%) or walking (25.5%). Additionally, no significant differences were found in this respect when the age of subjects was taken into consideration. This might be due to limited knowledge of the training methods of the subjects or that the findings were affected by issues with the IPAQ’s use in Poland (for example, misunderstanding the term “intensity”). It supports the statement put forward by the authors of Polish version of IPAQ: the practice of respondents completing the surveys (and CATI) independently may result in errors (such as overestimation of energy expenditure) (Biernat et al., 2008). As current findings show, a relatively high percentage (nearly 80%) of active Polish population is striking when compared with British (43.85%, aged 35.3±10.4 years) or Dutch (48.5%, aged 32.7±10.9 years) (Rosenberg et al., 2008). This is even more shocking, considering that British and Dutch are perceived as very active nations. Perhaps these highly positive results are biased towards young people (the age range of Polish subjects was 15-69 years of age). It would be incorrect to assume that such a high proportion of active Polish people is due to misunderstanding the survey’s questions. However, research shows that the average and median leisure physical activity of Polish respondents (MET-min/week) is comparable with the results of other European citizens. The median value (METmin/week) for Polish males and females (960 and 1,065, respectively), for instance, were nearly the same as Czech males and females (990 and 1,081, respectively) and only slightly lower than the medians of 38 2013 • VOLUME LIX PHYSICAL CULTURE AND SPORT. STUDIES AND RESEARCH Norwegians educated to a degree level (1,230 for males and 1,389 for females with over 12 years of education and 891 for males and 1,024 for females with less than 12 years of education) (Graff-Iversen et al., 2007). It is not surprising that the Polish population is characterized by lower levels of leisure physical activity than the Scandinavian population. According to Martinez-Gonzalez et al. (2001), northern Europeans are considered to be much more physically active than those people living in southern Europe. In light of these findings, it should not come as a surprise that the average leisure physical activity (MET-min/week) of Polish citizens (1,916.9±2,621) is much higher than Greeks aged 20-50 years (Μακαβέλου et al., 2005). Similarly, the median in Poland is 1,017, which is higher than the median of Croats above 15 years of age (360) (Jurakić et al., 2009). However, it is puzzling that the median leisure physical activity for Polish females (MET-min/week) is higher than Swedish (714) or Finns (792) (Södergren et al., 2010). This may be a result of the majority of Polish women (70.7%) declaring vigorous leisure physical activity, which in turn may have influenced the overall energy expenditure score. The detailed analysis of individual types of physical activity shows that the average leisure walking MET-min/week for Polish respondents is much lower (128.7±352.4, of which the average for males was 124.4±355 and females 132.8±350) than Czech respondents (1,727.5, of which the average for males was 1,692 and females 1,763) (Sigmund et al., 2009). The Polish respondents’ median equals zero, meaning that at least half of the subjects walk no more than 10 minutes in general, whereas Swedish people aged 20-65 years walk 60 minutes per day (198 MET-min/week) (Sundquist et al., 2011) and Norwegian men (depending on the level of education): 2,520 (12 years of education or more) and 3,323 MET-min/week (less than 12 years of education) (Graff-Iversen et al., 2007). Depending on level of education, the median walking for Norwegian women (MET-min/week) was 3,450 and 3,561, respectively. The Polish respondents’ average moderate leisure physical activity (MET-min/week) is close to that of Belgians aged 20-65 years (Van Dyck et al., 2011). It is 223±652.9 for the Polish population and 36.1±95.9 minutes per day for a Belgian group (144.4 MET-min/week). When considering Europe’s younger population, there is a difference between south and north of the continent: Polish respondents aged 25-39 years undertake more physical activities of moderate intensity (196.4±509.3 MET-min/week) compared to Portuguese of the same age (31±84 MET-min/day, which gives 124 MET-min/week) but less when compared with the same age group in Belgium (64±132 MET-min/day, which gives roughly 256 METmin/week) (De Bourdeaudhuij et al., 2005). The largest discrepancy was observed in vigorous physical activity: the average value for Polish subjects was 1,571.3±2,394.1 MET-min/week (1,474.2±2,281.4 for males and 1,665.2±2,496.1 for females), whereas Belgians showed an average of 58.1±123.6 (464.8 MET-min/week) (Van Dyck et al., 2011). Conclusions 1. Insufficient participation in the conscious process of caring for one’s own health is a common occurrence amongst adults living in the EU. Sadly, this problem particularly challenges individuals who work physically, have lower levels of education, and a lower gross income. In Poland, these are mainly farmers, gardeners, foresters, and fishermen. Additionally, this group consists of people with monthly gross income of 2,000-2,999 zł and those educated to a secondary school level. 2. In order to encourage the Polish population to participate in physical activities, it is necessary to raise their awareness of a need of well-balanced, regular exercise. Knowledge of the intensity levels of undertaken physical activity should be an integral part of our healthy lifestyle. 3. The outcome of the current study shows that using CATI (Computer-Assisted Telephone Interview) is not error free. Exclusion of 132 participants who declared over 16 hours of physical activity per day is one of the difficulties encountered when using this questionnaire. As telephone surveys in Poland are neither particularly popular yet nor widely used, there are issues with delivering a questionnaire this way. First, the respondents are easily disheartened because the interview process is fairly long. Second, they often lack a full understanding of the content of the questionnaire, which may lead to 2013 • VOLUME LIX 39 PHYSICAL CULTURE AND SPORT. STUDIES AND RESEARCH overestimations or underestimations. 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Retrieved 22.12.2012 from www.ess.nsd.uib.no WHO (2010) Global Recommendations on Physical activity http://whqlibdoc.who.int/publications/2010/ 9789241599979_eng.pdf AUTHOR’S ADDRESS: 2013 • VOLUME LIX for Health. Retrieved 22.12.2012 from Elżbieta Biernat SGH, CWFiS Al. Niepodległości 162 02-554 Warszawa Poland Email: elzbieta.biernat@sgh.waw.pl 41