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Background: Socio-cultural differences for country-specific activities are rarely addressed in physical activity questionnaires. We examined the reliability and validity of the Indian Migration Study Physical Activity Questionnaire (IMS-PAQ) in urban and rural groups in India., Methods: A sub-sample of IMS participants (n = 479) was used to examine short term (≤ 1 month [n = 158]) and long term (> 1 month [n = 321]) IMS-PAQ reliability for levels of total, sedentary, light and moderate/vigorous activity (MVPA) intensity using intraclass correlation (ICC) and kappa coefficients (k). Criterion validity (n = 157) was examined by comparing the IMS-PAQ to a uniaxial accelerometer (ACC) worn ≥ 4 days, via Spearman's rank correlations (ρ) and k, using Bland-Altman plots to check for systematic bias. Construct validity (n = 7,000) was established using linear regression, comparing IMS-PAQ against theoretical constructs associated with physical activity (PA): BMI [kg/m2], percent body fat and pulse rate., Results: IMS-PAQ reliability ranged from ICC 0.42-0.88 and k = 0.37-0.61 (≤ 1 month) and ICC 0.26 to 0.62; kappa 0.17 to 0.45 (> 1 month). Criterion validity was ρ = 0.18-0.48; k = 0.08-0.34. Light activity was underestimated and MVPA consistently and substantially overestimated for the IMS-PAQ vs. the accelerometer. Criterion validity was moderate for total activity and MVPA. Reliability and validity were comparable for urban and rural participants but lower in women than men. Increasing time spent in total activity or MVPA, and decreasing time in sedentary activity were associated with decreasing BMI, percent body fat and pulse rate, thereby demonstrating construct validity., Conclusion: IMS-PAQ reliability and validity is similar to comparable self-reported instruments. It is an appropriate tool for ranking PA of individuals in India. Some refinements may be required for sedentary populations and women in India.

Background: Physical exercise has been inversely associated with coronary heart disease (CHD) risk in Western populations; however, the association has not been examined in India where physical inactivity levels in urban areas are now comparable with the West., Methods: We conducted a hospital-based case-control study and collected data from 350 cases of acute myocardial infarction and 700 controls matched on age, gender, and hospital in New Delhi and Bangalore. We used conditional logistic regression to control for the matching and other risk factors., Results: Of the controls, 48% participated in some form of leisure-time exercise compared with 38% of cases. In age- and sex-adjusted analyses, people in the highest level of leisure-time exercise (>145 metabolic equivalents [MET]-minutes per day, equivalent to 36 minutes of brisk walking per day) had a relative risk of 0.45 (95% CI: 0.31, 0.66) compared with non-exercisers. Multivariate adjustment for other risk factors did not substantially alter the association. We observed a positive association between non-work sedentary activity and CHD risk; people with >3.6 hours per day of sedentary activity (for example, television viewing) had an elevated risk of 1.88 (95% CI: 1.09, 3.20) compared with <70 minutes per day in multivariate analysis., Conclusion: Leisure-time exercise, including as much as 35-40 minutes per day of brisk walking, was protective for CHD risk and sedentary lifestyles were positively associated with risk of CHD. Given limited resources for care of CHD in India and the important role of physical exercise in disease risk in urban India, improvements in physical activity should be promoted.

The aim of this study was to describe the detailed physical activity profiles of educated, employed, urban Indians and to ascertain their knowledge about the benefits of exercise, their concept of 'ideal' exercise, and the constraints in achieving it. To this end, 401 subjects (193 males, 208 females) between the ages of 25 and 58 years were studied. Women were significantly more active than men (p < 0.05), largely due to enhanced household activity (p < 0.05), which was not offset by the higher leisure time-related exercise of males (p < 0.05). Over 50 percent of subjects were aware of the benefits of exercise in preventing heart disease. The subjects' perceptions of 'ideal' exercise, based on exercise programmes they had drawn up for themselves, were adequate in terms of frequency and duration, but inadequate in intensity, when compared with the current recommendations for exercise in primary prevention of coronary heart disease. Lack of time (men 53.4%, women 68.3%) and lack of motivation (men 26.4%, women 28.4%) were the most-often cited reasons for being unable to achieve 'ideal' exercise goals. The data provides an important framework for understanding physical activity profiles of urban, educated and employed Indians on the basis of which behavioural strategies can be formulated to enhance physical activity and reduce cardiovascular risk.

A single page physical activity questionnaire was designed for use in epidemiological studies. The questionnaire estimates 24 h energy expenditure as well as components of occupation and discretionary leisure time activities. Estimates of physical activity were highly repeatable, when the questionnaire was re-administered within a 4 wk period (e.g., r = 0.86, P < 0.01 for 24 h energy expenditure). Relative validity was assessed by comparing energy intake (using repeated 24 h dietary recalls) and expenditure (using the physical activity questionnaire) over the same period. A correlate of r = 0.33, P < 0.05 between the two measures compared well with reports from literature. The discriminatory power of the questionnaire was assessed by comparing the physical activity patterns of young (18-30 yr) and older (> 60 yr), free living healthy subjects. The questionnaire provides a tool for the assessment of physical activity patterns of urban middle class Indians, which despite its importance has been inadequately studied so far.

Objective: To validate questionnaire-based physical activity level (PAL) against accelerometry and a 24 h physical activity diary (24 h AD) as reference methods (Protocol 2), after validating these reference methods against the heart rate- oxygen consumption (HRVO2) method (Protocol 1). Design: Cross-sectional study. Setting: Two villages in Andhra Pradesh state and Bangalore city, South India. Subjects: Ninety-four participants (fifty males, forty-four females) for Protocol 2; thirteen males for Protocol 1. Results: In Protocol 2, mean PAL derived from the questionnaire (1·72 (SD 0·20)) was comparable to that from the 24 h AD (1·78 (SD 0·20)) but significantly higher than the mean PAL derived from accelerometry (1·36 (SD 0·20); P<0·001). Mean bias of PAL from the questionnaire was larger against the accelerometer (0·36) than against the 24 h AD (20·06), but with large limits of agreement against both. Correlations of PAL from the questionnaire with that of the accelerometer (r=0·28; P=0·01) and the 24 h AD (r50·30; P=0·006) were modest. In Protocol 1, mean PAL from the 24 h AD (1·65 (SD 0·18)) was comparable, while that from the accelerometer (1·51 (SD 0·23)) was significantly lower (P<0·001), than mean PAL obtained from the HRVO2 method (1·69 (SD 0·21)). Conclusions: The questionnaire showed acceptable validity with the reference methods in a group with a wide range of physical activity levels. The accelerometer underestimated PAL in comparison with the HRVO2 method. [ABSTRACT FROM AUTHOR]