EXERCISE

Definition

To gauge levels of exercise and to measure against the Guidelines, the 2014-15 NHS collected the following data in relation to leisure-time exercise, in line with Active Australia:

• Walking for fitness, recreation or sport for at least 10 minutes continuously
• Walking for at least 10 minutes continuously to get from place to place
• Moderate intensity exercise (apart from walking)
• Vigorous intensity exercise

The 2014-15 NHS collected these questions using the concept of 'exercise',

Walking was defined as requiring a 10 minute minimum threshold per session, and aimed to include continuous walking, excluding activities such as walking around a shopping centre as people tend to frequently pause while shopping.

Walking for transport and walking for fitness, recreation or sport was collected separately.

Moderate intensity exercise was defined as activities that caused a moderate increase in the heart rate or breathing of the respondent (e.g. gentle swimming, social tennis, golf).

Vigorous intensity exercise was defined as activities that caused a large increase in the respondent's heart rate or breathing (e.g. jogging, cycling, aerobics, competitive tennis).

Moderate and vigorous exercise excluded previously identified walking as well as household chores, gardening or yard work.

2014-15 NHS respondents were also asked about strength and toning activities and activities during their usual work day.

Population

Information was obtained for persons aged 15 years and over in the 2014-15 NHS.

Methodology

Information about exercise was published in the National Health Survey: First Results, 2014-15 based on a sample of 15,396 people aged 15 years and over and was used in cross-tabulations for the Health Service Usage and Health related Actions, Australia, 2014-15.

Whether Met Current Guidelines (Released in 2014)

Data on exercise was collected to provide national estimates in order to report against Australia's Physical Activity and Sedentary Behaviour Guidelines for particular age groups.

As the guidelines have changed since the 2011-12 NHS, the 2014-15 NHS collected data which allows reporting against both the former and current guidelines. Details regarding the former guidelines can be found in the 4363.0.55.001 - Australian Health Survey: Users' Guide, 2011-13.

Australia’s Physical Activity & Sedentary Behaviour Guidelines for Young People (13 -17 years)

The current Australia's Physical Activity & Sedentary Behaviour Guidelines for Young People (13-17 years) recommend:

• For health benefits, young people aged 13–17 years should accumulate at least 60 minutes of moderate to vigorous intensity physical activity every day.
• Young peoples’ physical activity should include a variety of aerobic activities, including some vigorous intensity activity.
• On at least three days per week, young people should engage in activities that strengthen muscle and bone.
• To achieve additional health benefits, young people should engage in more activity – up to several hours per day.

Australia's Physical Activity & Sedentary Behaviour Guidelines for Adults (18-64 years)

The current Australia’s Physical Activity & Sedentary Behaviour Guidelines for Adults (18-64 years) recommend:

• Be active on most, preferably all, days every week.
• Accumulate 150 to 300 minutes (2 ½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1 ¼ to 2 ½ hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.
• Do muscle strengthening activities on at least 2 days each week.

Physical Activity Recommendations for Older Australians (65 years and older)

There are five physical activity recommendations for older Australians:

1. Older people should do some form of physical activity, no matter what their age, weight, health problems or abilities.
2. Older people should be active every day in as many ways as possible, doing a range of physical activities that incorporate fitness, strength, balance and flexibility.
3. Older people should accumulate at least 30 minutes of moderate intensity physical activity on most, preferably all, days.
4. Older people who have stopped physical activity, or who are starting a new physical activity, should start at a level that is easily manageable and gradually build up the recommended amount, type and frequency of activity.
5. Older people who continue to enjoy a lifetime of vigorous physical activity should carry on doing so in a manner suited to their capability into later life, provided recommended safety procedures and guidelines are adhered to.

Derivation of the physical activity items

Respondents were asked a series of questions about the exercise they undertook in the last week (as outlined above).

For each of the domains of exercise, respondents were asked:

• The number of sessions they had done of that activity in the last week
• The total amount of time spent (hours and minutes) doing that activity in the last week.

From this information the following items were derived:

Data item		Population	Calculation
Whether exercise last week met 150 minutes recommended guidelines (previous guidelines)		Persons 18 years and over	Walking for transport + Walking for fitness + Moderate + Vigorous time
Exercise last week met 150 minutes and 5 sessions recommended guidelines (prev guideline)		Persons 18 years and over	Walking for transport + Walking for fitness + Moderate + Vigorous time and session
Whether participated in sufficient activity1 in last week (duration only)		Persons 18 years and over	Walking for transport + Walking for fitness + Moderate + Vigorous time Vigorous time is multiplied by two. Output categories: Sufficiently active for health = 150 minutes or more Insufficiently active = 1-149 minutes Inactive = 0 minutes
Whether participated in sufficient activity1 in last week (duration and session)		Persons 18 years and over	Walking for transport + Walking for fitness + Moderate + Vigorous time Vigorous time is multiplied by two. Number of sessions for Walking for transport + Walking for fitness + Moderate + Vigorous Output categories: Sufficiently active for health = 150 minutes or more and at least 5 sessions Insufficiently active = 1-149 minutes or 150 minutes or more but less than 5 sessions Inactive = 0 minutes
Level of exercise2 undertaken for fitness, recreation or sport in last week (time- series)		Persons 15 years and over	Duration of exercise (mins) x Intensity factor (walking for fitness = 3.5, moderate = 5, vigorous = 7.5)3 Output categories: Sedentary: Scores less than 50 (includes no exercise) Low: Scores of 50 to less than 800 Moderate: Scores of 800 to 1,600, or more than 1,600 but with less than 1 hour vigorous exercise High: Scores more than 1,600 and with 1 hour or more of vigorous exercise
Level of exercise2 undertaken for fitness, recreation, sport or walking for transport in last week		Persons 15 years and over	Duration of exercise (mins) x Intensity factor (walking for fitness = 3.5, walking for transport = 3.5, moderate = 5, vigorous = 7.5)3 Output categories: Sedentary: Scores less than 50 (includes no exercise) Low: Scores of 50 to less than 800 Moderate: Scores of 800 to 1,600, or more than 1,600 but with less than 1 hour vigorous exercise High: Scores more than 1,600 and with 1 hour or more of vigorous exercise

¹ The ‘Whether participated in sufficient activity’ items are calculated as set out in the Active Australia instructions. These items are similar to the calculations for the ‘Whether met guidelines’ items, with the exception that Vigorous time is multiplied by two.
² The ‘Level of exercise’ items were created with the aim of producing a descriptor of relative overall exercise level, and to indicate the quality of the activities undertaken in terms of maintaining heart, lung and muscle fitness. Intensity, or Metabolic Equivalent of Task (MET), is a measure of the energy expenditure required to carry out the exercise, expressed as a multiple of the resting metabolic rate (RMR). This item has historically been used in NHS output. As a result, this item was produced as two versions, to allow time-series to be produced which excludes walking for transport in the calculation. Note that for these two items, NHS also includes data for 15 to 17 year olds.
³ As the NHS does not collect details of the types of activities undertaken, an intensity value was estimated for each of the three domains of exercise identified in the survey, as shown in the above formula.
Days exercised for at least 30 minutes/60 minutes

In the 2014-15 NHS, respondents were also asked on how many days they exercised in the last week, and of those, on how many they exercised for at least 30 minutes per day. These questions were asked in order to measure against the 5 days and 30 minutes recommendation that is used in physical activity campaigns. Respondents aged 15 to 17 years were also asked, of those days, on how many they exercised for at least 60 minutes. This was a new question included in the 2014-15 NHS in order to address this aspect of the guidelines for those aged 15 to 17 years.

Strength and toning

Respondents were then asked whether they had done any strength or toning activities in the last week, and if so, the number of days they had done strength and toning activities. Muscle strength and toning activity can help maintain bone strength and reduce the risk of osteopenia or osteoporosis. These were new questions included in the 2014-15 NHS in order to address this aspect of the guidelines.

These activities were defined as being designed to increase muscle strength or tone, such as lifting weights, resistance training, pull-ups, push-ups, or sit-ups. These sessions were meant to be undertaken with the specific intention of strength and toning, and not include incidental activity, such as carrying or lifting wood for a wood fire or heavy grocery bags. Responses to these questions could include activities for which they had already reported, such as part of training sessions that were considered to meet moderate/vigorous intensity.

Typical work day

Employed respondents were then asked which of the following best describes what they do on a typical work day:

• Mostly sitting
• Mostly standing
• Mostly walking
• Mostly heavy labour or physically demanding work

Data items

The questionnaire, data items and related output categories for this topic are available in pdf/Excel spreadsheet format from the Downloads page of this product.

Interpretation

Points to be considered when interpreting data relating to exercise (walking, moderate, vigorous activity):

• The information is 'as reported' by respondents and reflects the respondent's perception of the activity undertaken, the intensity of their participation, their level of fitness, etc. As a result, data should be interpreted with particular care.
• The intended purpose of the exercise questions (regarding walking, moderate and vigorous activity) is meant to be focused on leisure-time, in-line with Active Australia instructions. However, as the wording of the questions do not specifically exclude work based activity, it is possible that some respondents included this time.
• Although the moderate and vigorous exercise questions excluded household chores, gardening and yardwork, it is possible that some of these activities were included in responses.
• The application of intensity definitions reflected the respondent's perception of moderate or vigorous exercise or walking, and the purpose of that activity. Responses may have varied according to the type of activity performed, the intensity with which it was performed, the level of fitness of the participant, and their general health and other characteristics (e.g. age). For example, some respondents may consider jogging to be moderate exercise while others may consider it vigorous.
• Walking for transport is a difficult concept to measure and define in a way which is meaningful to both respondents and users of the data. The data from this topic should therefore be used with caution.
• In this survey, walking for fitness, recreation or sport and walking for transport are conceptually separate activities, and occasions should be recorded as of either type, not both. Respondents may, however, have reported the same occasions of walking in both sections, as, for example, they may have chosen to walk to work for the exercise rather than take the bus, but recorded this activity time as both walking for exercise and walking for transport.
• The exercise domains were split to aid recall and to provide finer detail. This also provides opportunities for respondents to report activities more than once, although this is discouraged through exclusion statements in the questions.
• Strength and toning questions were asked about activity that was deliberately intended to increase muscle strength and tone. However, some respondents may have reported activities where muscle strengthening and toning was incidental to the types of activities they were thinking of when answering this question e.g. digging soil while working in the garden.
• Strength and toning session information may also form part of responses to the moderate/vigorous exercise. As such, due to the duplication of responses, the data cannot be combined with the other exercise data to contribute further to exercise measurements unless this duplication is considered appropriate.
• There were varying levels of child participation in answering the questions, depending on age, parental permission and presence of the child. The accuracy of reports for activities occurring when the parent was not present (for example, activities during the school day) may therefore vary.

Comparability with 2011-12 NHS and 2011-13 AHS Core

The majority of the 2014-15 NHS data on exercise and sedentary behaviours were collected using the same methodology and questions used in the 2011-12 NHS , and therefore 2014-15 and 2011-12 NHS results are considered directly comparable. The following should be noted:

• Strength and toning questions asked in the 2014-15 NHS were not asked in the 2011-12 NHS.
• The 2014-15 NHS collected an additional question for those aged 15-17 years regarding the number of days in the last week that they exercised for at least 60 minutes in order to allow reporting against the new guidelines. This question was not asked in the 2011-12 NHS.
• Over recent years there has been an increasing focus by governments and media on health and lifestyle issues around obesity and exercise. While such attention is likely to influence the levels of activity in the community, it may also have an impact on reporting behaviour; for example, creating a tendency to report what is perceived to be a desirable level of activity rather than actual activity. This should be considered when interpreting changes between results from 014-15, 2011-12, 2007-08 and 2004-05 surveys.

Information about adult exercise (for persons 18 years and over) was collected in both the 2011-12 NHS and the 2011-12 NNPAS surveys (i.e. the 2011-13 AHS Core). For comparison of exercise with 2014-15 NHS, the 2011-12 NHS file should be used.