What they say and what they do: comparing physical activity across the USA, England and the Netherlands

Physical activity (PA) is important for maintaining health, but there are fundamental unanswered questions on how best it should be measured.

We measured PA in the Netherlands (n=748), the USA (n=540) and England (n=254), both by a 7 day wrist-worn accelerometer and by self-reports. The self-reports included a global self-report on PA and a report on the frequency of vigorous, moderate and mild activity.

The self-reported data showed only minor differences across countries and across groups within countries (such as different age groups or working vs non-working respondents). The accelerometer data, however, showed large differences; the Dutch and English appeared to be much more physically active than Americans h (For instance, among respondents aged 50 years or older 38% of Americans are in the lowest activity quintile of the Dutch distribution). In addition, accelerometer data showed a sharp decline of PA with age, while no such pattern was observed in self-reports. The differences between objective measures and self-reports occurred for both types of self-reports.

It is clear that self-reports and objective measures tell vastly different stories, suggesting that across countries people use different response scales when answering questions about how physically active they are.