title: Validity of a short questionnaire to assess physical activity in 10 European countries.
abstract: To accurately examine associations of physical activity (PA) with disease outcomes, a valid method of assessing free-living activity is required. We examined the validity of a brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC). PA energy expenditure (PAEE) and time spent in moderate and vigorous physical activity (MVPA) was measured in 1,941 healthy individuals from 10 European countries using individually-calibrated combined heart-rate and movement sensing. Participants also completed the short EPIC-PAQ, which refers to past year's activity. Pearson (r) and Spearman (σ) correlation coefficients were calculated for each country, and random effects meta-analysis was used to calculate the combined correlation across countries to estimate the validity of two previously- and one newly-derived ordered, categorical PA indices ("Cambridge index", "total PA index", and "recreational index") that categorized individuals as inactive, moderately inactive, moderately active, or active. The strongest associations with PAEE and MVPA were observed for the Cambridge index (r = 0.33 and r = 0.25, respectively). No significant heterogeneity by country was observed for this index (I(2) = 36.3%, P = 0.12; I(2) = 0.0%, P = 0.85), whereas heterogeneity was suggested for other indices (I(2) > 48%, P < 0.05, I(2) > 47%, P < 0.05). PAEE increased linearly across self-reported PA categories (P for trend <0.001), with an average difference of approximately 460 kJ/d for men and 365 kJ/d for women, between categories of the Cambridge index. The EPIC-PAQ is suitable for categorizing European men and women into four distinct categories of overall physical activity. The difference in PAEE between categories may be useful when estimating effect sizes from observational research.
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authors.lastname: Wendel-Vos
authors.forename: Annemieke
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authors.lastname: Spijkerman
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authors.lastname: Benjaminsen-Borch
authors.forename: Elisavet
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authors.lastname: Valanou
authors.forename: Blandine
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authors.lastname: de Lauzon Guillain
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Stephen
authors.initials: S
authors.lastname: Sharp
authors.forename: Nicola
authors.initials: N
authors.lastname: Kerrison
authors.forename: Claudia
authors.initials: C
authors.lastname: Langenberg
authors.forename: Larraitz
authors.initials: L
authors.lastname: Arriola
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Carlos
authors.initials: C
authors.lastname: Gonzales
authors.forename: Sara
authors.initials: S
authors.lastname: Grioni
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Timothy
authors.initials: T
authors.lastname: Key
authors.forename: Kay Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Anne
authors.initials: A
authors.lastname: May
authors.forename: Peter
authors.initials: P
authors.lastname: Nilsson
authors.forename: Teresa
authors.initials: T
authors.lastname: Norat
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Jose
authors.initials: J
authors.lastname: Ramón Quirós
authors.forename: Fulvio
authors.initials: F
authors.lastname: Ricceri
authors.forename: Maria-Jose
authors.initials: MJ
authors.lastname: Sanchez
authors.forename: Nadia
authors.initials: N
authors.lastname: Slimani
authors.forename: Anne
authors.initials: A
authors.lastname: Tjonneland
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Edith
authors.initials: E
authors.lastname: Feskins
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
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mesh_terms: D004734:Energy Metabolism; D005060:Europe; D015444:Exercise; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011998:Recreation; D057566:Self Report; D011795:Surveys and Questionnaires
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