Understanding health inequalities is essential for improving social justice. Intersectionality refers to a theoretical framework for studying the intersection of multiple social categorizations that create unique experiences and related social inequalities. Currently, the majority of the intersectional studies in the physical activity field have a qualitative design; thus, there is a need for quantitative intersectional studies. This commentary aims to explore primary obstacles impeding intersectional quantitative research and provide recommendations for overcoming these obstacles in physical activity research. In the commentary, we discuss that the lack of accessibility of large-scale and diverse data sets, and suboptimal social categorizations and intersectionality-related questions may contribute to the scarcity of intersectional quantitative research in the field. To facilitate intersectional quantitative analyses, we advocate for making large-scale data sets accessible for intersectional secondary analyses, diverse sampling, standardizing questions and categories related to intersectionality, promoting inclusive research designs and methods, and using the appropriate questions and social categorization that reflect the distinct experiences of each subgroup. By addressing these challenges, researchers may gain new insights into health disparities, making physical activity research more inclusive and contributing to more equitable health outcomes.
Physical activity (PA) decreases from childhood to adolescence, with girls being less active than boys. The timing of these differences remains unknown. Using accelerometer data from three cross-sectional studies in Norway and Belgium (n = 2507, age = 3-17years), we assessed sex differences in sedentary behaviour (SB) and PA levels (light, moderate, vigorous) throughout the day and across the full spectrum of activity intensity distribution on weekdays and weekend days, using linear regression and functional data analyses. Across all age groups (preschoolers (3-5y), children (6-10y), adolescents (11-17y)), girls were less active than boys, particularly on weekdays (e.g., vigorous PA (> 1111 counts/15s) difference:-16.9 min/day (95% Confidence interval:-19.3,-14.4; p-value < 0.001) in children). It was the case throughout the day, particularly during school hours (8h30-15h29) in all age groups. Analysis of the full spectrum of activity intensity distribution (0 to 3000 counts) added to these findings that on weekend days, girls spent less time in zero-count SB than boys (difference=-21.0 min/day (-28.7,-13.4; p-value < 0.001) in children), but higher (17.3 min/day (13.2,21.4; p-value < 0.001)) in the “other SB”, 1-180 counts/15s. The sex differences in PA during school hours suggest the need for targeted interventions promoting activities engaging girls. Additionally, the time spent in zero-count, particularly evident in boys on weekend days, deserves further investigation.
Importance Chronic low back pain (LBP) is a prevalent and costly condition, and regular physical activity may reduce its risk. Walking is a common and accessible form of physical activity, but its association with the risk of chronic LBP is unclear.
Objective To examine whether accelerometer-derived daily walking volume and walking intensity are associated with the risk of chronic LBP.
Design, Setting, and Participants This prospective population-based cohort study used data from the Trøndelag Health (HUNT) Study in Norway, with a baseline in 2017 to 2019 and follow-up in 2021 to 2023. The study included individuals without chronic LBP at baseline and with at least 1 valid day of device-measured walking.
Exposure Daily walking volume (minutes per day) and walking intensity, expressed as metabolic equivalent of task (MET) per minute.
Main Outcomes and Measures The primary outcome was self-reported chronic LBP at follow-up, defined as pain lasting 3 months or longer in the past 12 months. Poisson regression was used to estimate adjusted risk ratios (RRs) with 95% CIs of chronic LBP according to daily walking volume and mean walking intensity.
Results A total of 11 194 participants aged 20 years or older (mean [SD] age, 55.3 [15.1] years; 6564 women [58.6%]) were included in the analysis. At follow-up (mean [SD] follow-up time, 4.2 [0.3] years), 1659 participants (14.8%) reported chronic LBP. Continuous measures of both walking volume and walking intensity were inversely associated with the risk of chronic LBP using restricted cubic splines models. Compared with participants walking less than 78 minutes per day, those walking 78 to 100 minutes per day had an RR for chronic LBP of 0.87 (95% CI, 0.77-0.98), those walking 101 to 124 minutes per day had an RR of 0.77 (95% CI, 0.68-0.87), and those walking 125 minutes or more per day had an RR of 0.76 (95% CI, 0.67-0.87). Compared with a mean walking intensity of less than 3.00 MET per minute, participants with walking intensity of 3.00 to 3.11 MET per minute had an RR for chronic LBP of 0.85 (95% CI, 0.75-0.96), those with walking intensity of 3.12 to 3.26 MET per minute had an RR of 0.82 (95% CI, 0.72-0.93), and those with walking intensity greater than or equal to 3.27 MET per minute had an RR of 0.82 (95% CI, 0.72-0.93). After mutual adjustment, the association remained largely similar for walking volume but was attenuated for walking intensity.
Conclusions and Relevance In this cohort study, daily walking volume and walking intensity were inversely associated with the risk of chronic LBP. The findings suggest that walking volume may have a more pronounced benefit than walking intensity.