title: The forgotten guidelines: cross-sectional analysis of participation in muscle strengthening and balance & co-ordination activities by adults and older adults in Scotland.
abstract: In 2011, the UK physical activity guidelines were updated to include recommendations for muscle strengthening and balance & coordination (at least two sessions of relevant activities per week). However, monitoring and policy efforts remain focussed on aerobic activity. This study aimed to assess differences by gender and age in the a) prevalence of muscle strengthening and balance & co-ordination guidelines, and b) participation in guideline-specific activities.
  
  
  
  The sample for the muscle strengthening analyses was 10,488 adult (16-64 years) and 3857 older adult (≥65 years) 2012-2014 Scottish Health Survey respondents. The balance & co-ordination analyses used only the older adult responses. Differences by gender and (where possible) age in guideline prevalence and activity participation were assessed using logistic regression and t-tests.
  
  
  
  Thirty-one percent of men and 24 % of women met the muscle strengthening guideline, approximately half that of published figures for aerobic physical activity. Nineteen percent of older men and 12 % of older women met the balance & co-ordination guidelines. The oldest age groups were less likely to meet both guidelines compared to the youngest age groups. Differences by gender were only evident for muscle strengthening: more men met the guidelines than women in all age groups, with the largest difference amongst 16-24 year olds (55 % men compared with 40 % women). Participation in relevant activities differed by gender for both guidelines. 'Workout at gym' was the most popular activity to improve muscle strength for men (18 % participated), while swimming was for women (15 % participated). Golf was the most popular activity to improve balance & co-ordination for older men (11 % participated) and aerobics was for older women (6 % participated). Participation decreased in most muscle strengthening activities for both men and women. One exception was golf, where participation levels were as high amongst older men as in younger age groups, although overall levels were low (3 % of all men).
  
  
  
  Physical activity policy should aim to increase prevalence of these 'forgotten' guidelines, particularly amongst young women (for muscle strengthening) and older age groups (both guidelines). Gender and age participation differences should be considered when designing population-level interventions.
authors: Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, St Leonard's Land, The University of Edinburgh, Holyrood Road, Edinburgh, EH8 8AQ, UK. tessa.strain@ed.ac.uk.
authors: Tessa
authors: 0000-0002-7086-1047
authors: T
authors: Strain
authors: Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, St Leonard's Land, The University of Edinburgh, Holyrood Road, Edinburgh, EH8 8AQ, UK.
authors: Claire
authors: C
authors: Fitzsimons
authors: Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, St Leonard's Land, The University of Edinburgh, Holyrood Road, Edinburgh, EH8 8AQ, UK.
authors: Paul
authors: P
authors: Kelly
authors: Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, St Leonard's Land, The University of Edinburgh, Holyrood Road, Edinburgh, EH8 8AQ, UK.
authors: Nanette
authors: N
authors: Mutrie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012606:Scotland; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Balance; Co-ordination; Guidelines; Muscle strengthening; Physical activity; Public health surveillance