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Publication, Part of

Health Survey for England, 2021 part 2

Official statistics, National statistics, Survey

National Statistics

Physical Activity Technical Appendix

The evolution of physical activity questions for adults used in the HSE series was described in detail in the HSE 2012 report (Scholes and Mindell, 2013).


Activity types, frequency, duration, and intensity

Details about four main types of physical activity were included in the questionnaire. 

Occupational activities

Occupational activities include activities done while employed or self-employed, including voluntary and unpaid work, other than home activities. 

Participants who did any paid or unpaid work in the last four weeks were asked ‘Which of these did you do whilst working?’ 

  • Sitting down or standing up
  • Walking at work (e.g. door to door sales, hospital nurse work)
  • Climbing stairs or ladders
  • Lifting, carrying or moving heavy loads. 

For each activity that they did, they were asked how long they usually spent doing it on an average work day. 

Participants who reported that they did some climbing of stairs or ladders, or lifting, carrying or moving heavy loads were asked whether they did that activity every working day, or only on some days. Those who did not do an activity every working day were asked on how many days in the last four weeks they had done it. 

Participants were also asked ‘Thinking about your job in general would you say that you are…very physically active; fairly physically active; not very physically active; not at all physically active?’ Physical activity while at work was included in the calculation of aerobic activity levels only for those participants who reported being very physically active in their job.

The questions asked about activities over the last four weeks to ensure that occasional activities were adequately covered. Weekly averages were calculated over the four-week period. So, for instance, someone who had done an activity twice a week on average might have done it twice every week, or on four days over two weeks, or some other pattern.

Work-based activities were assumed to be of moderate intensity.

Home activity

Participants were provided with a list of examples of light housework first and then heavy housework. For each, they were asked if they had done any of the listed activities. For heavy housework only (not light activities), the number of days in the past four weeks and the average length of time spent doing each activity was recorded. 

Similar sequences of questions were asked for manual work, gardening and DIY.

Examples of heavy housework, manual work, gardening and DIY were classified as ‘moderate’.

The listed activities are included in the Survey Documentation

Walking

Participants were asked ‘During the past four weeks, on how many days did you do a walk of at least 10 minutes?’ 

Walking intensity was assessed by asking participants to rate their usual walking pace (slow, average, fairly brisk or fast). Walking at a fairly brisk or fast pace was considered to be moderate intensity physical activity. 

Because walking at a slow or average pace can also represent moderate intensity physical activity in some older people, an additional question asked participants aged 65 and over whether the effort of walking for 10 minutes or more was usually enough to make them ‘breathe faster, feel warmer or sweat’.

Sports and exercise

Participants were shown a list of ten activities and asked: ‘Can you tell me on how many separate days you did [name of specific sport and exercise activity] for at least 10 minutes at a time during the past four weeks?’. They could also list up to six other sports or exercise activities. For each activity they reported, they were asked for the amount of time they usually spent doing that activity and the intensity was assessed by asking participants whether the activity had made them ‘out of breath or sweaty’.


Intensity level assigned to sports and exercise

Sports and exercises were grouped into light, moderate or vigorous intensity categories based on the MET (metabolic equivalent) intensity. MET is a unit used to estimate the intensity of physical activity. It is based on the amount of oxygen consumed during physical activity. The baseline energy used by the body at rest in one minute is defined as 1 MET. Thus an activity with a MET value of 1.5 uses 50% more energy than baseline energy expenditure. MET levels can be linked to specific activities in various settings. Moderate physical activity (MPA) includes activities with estimated intensity levels of 3-6 METs; vigorous physical activities (VPA) are those with estimated intensity levels of 6 METs or higher.  

Vigorous: 

a) All occurrences of a number of activities (classified as being 7.5-12 METs) including: climbing, hockey, martial arts, running/jogging, squash. 

b) The following activities (5.5-7 METs) were coded as vigorous intensity if they had made the participant ‘out of breath or sweaty’, but were otherwise coded as moderate intensity: aerobics, badminton, boxing, cycling, football, hillwalking, rugby, skiing, swimming, tennis, workout at a gym (e.g. exercise bike, weight training). 

Moderate: 

a) See ‘vigorous’ category (b). 

b) All occasions of a large number of activities (3.5-5 METs) including: canoeing, cricket, fell walking, golf, horse riding, tai chi, table tennis. 

c) The following sports/exercise activities were coded as moderate intensity if they had made the participant ‘out of breath or sweaty’, but were otherwise coded as light intensity: dancing, exercise (press-ups, sit-ups etc.). 

Light: 

a) See ‘moderate’ category (c). 

b) All occasions of a large number of activities (1.5-3 METs) including: bowls, fishing, pilates, snooker, yoga.


Muscle-strengthening activities

Muscle-strengthening activities were identified in this report as follows: 

  • Working out at a gym, aerobics, or exercises such as press-ups or sit-ups (which were included in the list of sports and exercise activities specifically asked about) or reported additional activities such as golf and volleyball were included as muscle-strengthening activities if participants reported that the effort of that activity was usually enough to make their muscles feel some tension, shake or feel warm. 
  • Sports and exercise such as canoeing or climbing (not provided in the initial list of 10 activities but reported as additional activities) were always included as muscle-strengthening activities (regardless of responses to the follow-up question). 
  • Some pursuits such as cycling, swimming, squash and football were included in the initial list of sports and exercise activities were always included as muscle-strengthening, possibly leading to some overestimate of the proportion of adults meeting the muscle-strengthening guideline. 

The following activities were always included as muscle-strengthening activities: canoeing, climbing, field athletics, horse riding, kayaking, rowing, sailing, skiing or snowboarding, Tai-chi, water skiing, wind surfing. 

The following activities were included as muscle-strengthening activities for participants who reported that the effort of that activity was usually enough to make their muscles feel some tension, shake or feel warm: aqua aerobics or aquafit, aerobics, basketball, body boarding, bowls, exercise (press-ups, sit-ups etc), cricket, curling, golf, hillwalking, hockey, ice skating, martial arts other than tai chi, netball, pilates, rambling, surfing, tenpin bowling, volleyball, workout at a gym (e.g. exercise bike, weight training), yoga. 

For some activities the question about whether the effort of that activity was usually enough to make their muscles feel some tension, shake or feel warm was not asked: badminton, cycling, dancing, football, rugby, running or jogging, squash, swimming, tennis. These activities were always included as muscle-strengthening, possibly leading to some overestimate of the proportion of adults meeting the muscle-strengthening guideline. 


Balance improving exercises

The following activities were included as activities that improve balance: aerobics, aqua aerobics/aquafit, badminton, basketball, body boarding, bowls, canoeing, climbing, cricket, curling, cycling, dancing, field athletics, football, golf, hillwalking, hockey, horse riding, ice skating, kayaking, workout at a gym, martial arts, netball, pilates, rambling, rugby, running or jogging, sailing, skiing or snowboarding, squash, surfing, table tennis, Tai-chi, tennis, tenpin bowling, volleyball, wind surfing, yoga, water-skiing. Exercise (press-ups, sit-ups etc) was included as balance-improving for participants who reported that the exercises involved standing up and moving about.


Last edited: 16 May 2023 9:31 am