Physical activity domains

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Click below for an introduction to the different domains of physical activity:


Leisure time physical activity

Leisure time physical activity includes any form of activity undertaken during leisure (non-work) time, such as exercise. Leisure time physical activity only accounts for an estimated 5-10% of total energy expenditure [27, 28], but it has been the predominant focus of epidemiological research [29, 30]. There is a particular public health interest in leisure time physical activity due to the assumption that individuals have greater autonomy over their activity levels during leisure time and such activities may improve cardiorespiratory fitness [31].

Prospective studies have found that greater levels of participation in leisure time physical activity is associated with a longer lifespan [32-34] and a lower prevalence of chronic diseases including cardiovascular disease, type-2 diabetes and multiple cancers [14, 35-38]. Further, evidence suggests that even relatively low levels of participation in leisure time physical activity may have substantial health benefits. For example, one study estimates that engaging in the equivalent of 75 minutes of brisk walking per week could increase life expectancy by 1.8 years in those aged over 40 years old, compared with no activity [33]. Engaging in more regular moderate-to-high intensity activity can improve cardiorespiratory fitness, which may have additional, independent benefits for cardiovascular health [39-41]. Cultural and socioeconomic factors may also affect leisure time physical activity. For example, leisure time physical activity has been reported to increase with age after retirement in China, but not in other countries such as Australia [42]. People with higher levels of socioeconomic position tend to report higher levels of leisure time physical activity than those with lower socioeconomic position [43].

 


Occupational activity

Occupational activity refers to any activity related to employment and may—depending on the job role—contribute substantial fractions of daily activity [27]. Early epidemiological studies examining links with health outcomes focussed on occupational activity [13], but attention shifted away following societal changes, such as increasing automation in the workplace. Recently, there has been a renewed interest in occupational activity on the back of growing concerns about sedentary behaviour, particularly in the workplace [44].

Most physical activity guidelines focus on promoting physical activity regardless of the domain, but the relationship between occupational activity and health is contentious. Certain aspects of occupational activity may not be conducive to health benefits as it can be of an insufficient intensity, over long durations without sufficient recovery periods, and involve heavy lifting or improper posture [45]. Some longitudinal studies have found that moderate-to-high levels of occupational activity have a weak association with increased cardiovascular risk [36] or increased risk of long-term sickness from work [46]. Such results could however be attributable to confounding by common causes of both highly active occupations and ill health [47, 48]. However, most studies find a dose-response relationship between all physical activity and positive health outcomes irrespective of activity domain [18, 34, 49]. Prospective studies have mostly found that high versus low occupational activity is associated with a lower risk of chronic disease, including type 2 diabetes, cardiovascular disease, cancers and all-cause mortality [14, 34, 35, 50]. While the impact of high occupational activity levels on health are unclear, there are growing concerns about the health impact of sedentary behaviour [51]. There has been a well-documented rise in sedentary behaviour in the workplace of developed nations [51]. In the UK for example, those in office-based jobs spend between 65-75% of their working hours sitting down [52, 53]. Research underlying the health concerns with sedentary behaviour are discussed below.

 


Active travel

Active travel generally refers to physical activity-based travel that is not for the purpose of leisure, such as cycling or walking to work. Engagement in active travel appears to have declined in recent years [54]. Data from Understanding Society suggest that 15% of participants who were currently employed and travelled for work engage in active travel to work from 2009 to 2011 [55].

Active travel is increasingly promoted as a potential method of increasing total physical activity [27], with several reported links to health outcomes [56]. Prospective studies suggest that active travel could reduce the risk of type 2 diabetes, cardiovascular disease, hypertension, and all-cause mortality [57, 58]. While there may be some additional risks associated with active travel, such as air pollution exposure [59], these are likely to be outweighed by the health benefits [56]. However, this is a relatively new area of research and as such there remains uncertainty in the links between active travel and health outcomes.

 


Domestic activity

Domestic activities, such as cleaning and gardening, also contribute towards total physical activity levels, and women and older adults spend a greater proportion of time in domestic activities [60]. Promoting engagement in physically demanding domestic activities are another potential method of increasing total physical activity levels in the population. One cross-sectional study in the UK estimates that domestic activity accounts for 35.6% of all daily moderate-to-vigorous physical activity [60]. However, similar to occupational activity, it is unclear whether domestic activity is associated with increased health. There is some evidence for links between higher domestic activity and reduced premature cardiovascular disease and all-cause premature mortality risk [61, 62], yet some studies report null findings [63]. A meta-analysis of prospective studies found that physical activity of daily living was associated with a lower risk of all-cause mortality [34]. However, this definition of daily living does include domestic activities as well as others such as active travel.

 


Sedentary behaviours

Early work by Morris et al. (1953) and the series of studies that followed it were important for highlighting the prominent role of physical activity in preventing poor health. Much of this attention has been attributed to the promotion of moderate-to-vigorous physical activity, but the rise of interest in sedentary behaviour is a relatively new area in public health. There is evidence from prospective studies to suggest that sedentary behaviour is associated with a range of adverse health outcomes, including an increased risk of cardiovascular disease, type-2 diabetes and all-cause mortality [17, 44, 64, 65]. Concerns about sedentary behaviour stem from its pervasiveness in modern lifestyles. Sedentary behaviours that include prolonged periods in a sitting, reclining or lying posture now make up a large proportion of daily life for many people, such as watching television or using a computer [66]. Such behaviours are major contributors to the rise in sedentary behaviour [67, 68] and are spread across several activity domains, including leisure time and occupational activity [44, 69]. Worryingly, some evidence suggests that the adverse health impact of sedentary behaviour may be independent of total physical activity levels or time spent in moderate-to-vigorous activity [64, 65, 70]. There is also a strong social gradient in sedentary behaviour, with a higher prevalence amongst socioeconomically disadvantaged groups [71].

In a global action plan to tackle non-communicable diseases, member states of the World Health Organisation (WHO) agreed to seek to reduce sedentary behaviour by 10% between 2013 and 2025 [72]. Despite this agreement, a 2018 report including 1.9 million participants from 168 countries suggest that sedentary behaviour has been stable between 2001 and 2016 at around 28.5% [73].

 


Learn more about the individual studies covered by this guide and their measurement of physical activity:

Explore the measures by physical activity domain and their cross-study comparability:

Further information:


This page is part of the CLOSER resource: ‘Physical activity across age and study: a guide to data in six CLOSER studies’.