The document summarizes an epidemiological study on physical fitness, physical activity, and health in Flanders. The study was conducted by researchers from three universities in Flanders and was supported by government funding between 2001-2006. It involved collecting data through computerized questionnaires from over 6,000 youths on their physical activity levels, and conducting physical fitness and health tests on over 5,000 adults. The study aimed to assess current physical activity and fitness levels, examine associations with health, and inform the development of intervention strategies. Key results showed boys were more active than girls, activity declined with age, and socioeconomic status was related to activity levels and health outcomes.

1. Epidemiological study of physical fitness
and physical activity in Flanders
Renaat Philippaerts1,
William Duquet (†)2, Johan Lefevre3
1Department of Movement and Sports Sciences,
Ghent University
2Faculty of Physical Education and Physiotherapy, VUBrussel
3Department of Biomedical Kinesiology, KULeuven

2. Welcome in Gent
3th most historical city in the world
(National Geographic, 2008)
1.Wachau (Austria)
2.Ontario (Canada)
3.Gent (Belgium)

6. 1. Policy Research Centre in Flanders
2. Frame of reference
3. Computerised questionnaires
4. Results
5. Time & Money: some facts
Renaat Philippaerts
Department of Movement and Sports Sciences

7. 1. Policy Research Centers
12 Policy Research Centers
- according to the policy domains:
- Sport, physical activity and health,
- Culture,
- Tourism and leisure
- Transportation,
- Gender and equality,
- Education, ...
- provide evidence-based knowledge to
policy makers, ministers, …

8. 1. Policy Research Centers
- Periods of 5 years:
- 2001-2006, 2007-2011, …
- Consortium between universities,
colleges, administrations and
scientific institutions
- Budget over 5 years for each center
- 4.000.000 – 5.000.000 €

9. Policy Research Center for Sport, Physical Activity and Health
(SPAH)
supported by the Flemish Government
(2001-2006: 4.214.200 euro)

10. 1. Policy Research Centers
Theme I: Current status of physical activity, fitness
and health in Flanders
Theme II: Associations between physical activity,
fitness and health
Theme III: Development of intervention strategies for
specific target groups (school, obese, internet
use, elderly, …)
Theme IV: prevalence of injuries due to physical
activity and sports

11. 2. Frame of reference
Consensus model of Bouchard & Shephard, 1994

12. 2. Frame of reference
Theme I: Current status of physical activity, fitness and
health in Flanders
“Correct assessment of physical activity (PA)
behavior and energy expenditure (EE)
related to physical activity is essential to
study the effects of physical activity on
fitness and potential health benefits”

13. 3. Computerised questionnaire
How to quantify physical activity?
Physical activity is a complex concept,
determined by different indicators:
– Frequency
– Duration
– Intensity
→ different methods

14. 3. Computerised questionnaire
Activity energy expediture
‣ Different activities contribute to AEE
‧ PA during occupation
‧ PA during leisure time – sport activities
‧ Home and household activities
‧ Transportation
‧ Personal care
Renaat Philippaerts
Department of Movement and Sports Sciences

15. 3. Computerised questionnaire
Criterion methods
Objective methods
- Heart rate monitoring (HRM)
- Activity monitors (pedometers and
accelerometers) (AM)
- Combination of HRM and AM

16. 3. Computerised questionnaire
Criterion methods
Objective methods
Subjective methods
- Survey techniques (questionnaires)
- Self-reported
- Paper and pencil
- Electronic surveys
- Interviewer-assisted

17. 3. Computerised questionnaire
Advantages paper-pencil Q:
1. The only method feasible for a large
number of people
2. Inexpensive
3. Specific activities can be identified
together with frequency and
duration (intensity?)

18. 3. Computerised questionnaire
Advantages paper-pencil Q:
4. Q does not influence the subject’s
activities
5. Using energy tables: conversion to
AEE/ADMR
6. Usable over a wide range of age
7. Good reliability

19. 3. Computerised questionnaire
Limitations paper-pencil Q:
1. Recall their activities accurately?
- overstimation
- underestimation
2. Questions are not clear
3. Instrument is age and group specific
4. Time consuming: encoding,
analyzing

20. 3. Computerised questionnaire
Limitations paper-pencil Q:
5. “human errors”
6. Difficult to assess validity

21. 3. Computerised questionnaire
Tecumseh/Minnesota
Five City/7 day recall
Baecke
Godin-Shephard
Framingham
Lipid Research Clinic
Baecke Modification
Zutphen Q
?
Yale PA Q
PASE
Amsterdam Growth Study Q
…
IPAQ

22. 3. Computerised questionnaire
Computerised questionnaires
Computer delivered questionnaires
…
What?
Why?

23. 3. Computerised questionnaire
Advantages:
1. administration to a large number of
people simultaneously
2. subjects cannot omit questions (no
missing data)
3. software can skip superfluous
questions
4. subjects report more honestly
undesirable behavior

24. 3. Computerised questionnaire
Advantages:
5. avoiding all sources of coding errors
6. reducing hours of data entry: less
expensive
7. explanation of difficult words or
questions by film clips
…and all advantages of P-P Q

25. 3. Computerised questionnaire
Limitations:
1. development of software (need of
technicians)
2. development can be expensive
3. dependent on hardware, server, …

26. 3. Computerised questionnaire
Children-adolescents
- McMurray RG et al., 1998, Med Sci Sports
Exerc 30: 1238-1245.
- Ridley K et al., 2001, Pediat Exerc Sci 13: 35-46.
- Philippaerts RM et al., 2006, Int J Sports Med 27:
131-136.
Adults
- Vandelanotte C et al., 2005, Journal for Physical
Activity and Health 2 (1): 63-75.
- Matton L et al., 2007, Res Quarterly Exerc Sport 78 (4): 293-
306.

32. BACKOFFICE

33. 3. Computerised questionnaire
The concept of the FPACQ
- similar to IPAQ
- specific sub-components
- indication of intensity
- calculation of EE by using METs
- one single administrator
Renaat Philippaerts
Department of Movement and Sports Sciences

34. 3. Computerised questionnaire
The concept of the FPACQ
- all data are directly saved and
encoded
- additional variables are directly
calculated by the software
- immediate feedback is possible
Renaat Philippaerts
Department of Movement and Sports Sciences

35. 3. Computerised questionnaire
From FPACQ to IPACQ ??
- translation to other languages
- pilot studies: reliability and validity in
international context
renaat.philippaerts@UGent.be
johan.lefevre@faber.kuleuven.be
Renaat Philippaerts
Department of Movement and Sports Sciences

36. 4. Results
2001: Subjects (12-18 yrs)
N %
Girls 3738 61.1
Boys 2379 38.9
Total 6117 100
Representative sample according to the different
educational systems (free, state, official)
This study was supported by the Flemisch Agency for the promotion of Sport BLOSO

37. 4. Results
2002-2004: Adults
46 communities (ad random)
28840 subjects (age 18-75) (ad random)
22830 with known telephone number
18453 reached
5170 participated
5170/18453 = 28%

38. 4. Results

39. Boys 12-18 years

40. Girls 12-18 years
Dansen 26,0
Zwemmen 18,1
Fitness 17,0
Fietssporten 15,1
Paardensport 10,6
Tennis 10,5
Atletiek 9,1
Turnen 7,6
Volleybal 5,9
Basketbal 5,5
0 10 20 30 40 50
Percentage

41. Results: boys
Inactivity: TV and computer games
hrs/wk 29
Age: ns
27 SES: L >< H
25 Age x SES: ns
23 low
21 middle
high
19
17
15
12 13 14 15 16 17 18 age (yr)

42. Results: girls
Inactivity: TV and computer games
hrs/wk 27
Age: **
25 SES: L,M >< H
Age x SES: ns
23
low
21
middle
19 high
17
15
12 13 14 15 16 17 18 age (yr)

43. Results: boys
Passive transport (car, bus, train, …)
hrs/wk 6
Age: **
5 SES: ns
Age x SES: ns
4
low
3
middle
2 high
1
0
12 13 14 15 16 17 18 age (yr)

44. Results: girls
Passive transport (car, bus, train, …)
hrs/wk 6
Age: **
5 SES: L >< H
Age x SES: ns
4
low
3
middle
2 high
1
0
12 13 14 15 16 17 18 age (yr)

45. Results: boys
Sport participation leisure time: no difference
Active transport: no difference
Total activity: no difference
Frequency moderate activities: no difference
Frequency heavy activities: no difference

46. Results: girls
Leisure time sport participation
hrs/wk 6
Age: ns
5 SES: L >< M >< H
Age x SES: *
4
low
3
middle
2 high
1
0
12 13 14 15 16 17 18 age (yr)

47. Results: girls
Total activity
(sports + active transport + school sports + PE)
hrs/wk 16
Age: **
14 SES: L >< M >< H
Age x SES: ns
12
low
middle
10
high
8
6
12 13 14 15 16 17 18 age (yr)

48. Results: girls
Frequency moderate activities
days/wk 3
Age: **
SES: L,M >< H
Age x SES: **
2
low
middle
1 high
0
12 13 14 15 16 17 18 age (yr)

49. Results: girls
Frequency heavy activities
n/wk 3
Age: **
SES: L,M >< H
Age x SES: *
2
low
middle
1 high
0
12 13 14 15 16 17 18 age (yr)

50. 4. Results
In Flanders:
Boys are more physically active than girls
Girls are more prone to sedentary behavior
Physical activity declines with age in youth

51. Prevalence over Overweight
25 > BMI <30

52. Prevalence of Obesitas
BMI > 30

53. Health-related sport activity for age and gender
• > 1.5 h/week
%
• > 3.5 MET’s (intensity)
• according PA guidelines

54. Prevalence of sport inactivity
(no sport activity at all)
%

55. 4. Results
Sedentary behaviour

56. Prevalence of sedentarity
PAL < 1.55 (kcal/kg/h or MET)
%

57. Prevalence of Hypertension
SP > 140 mmHg or DP > 90 mmHg
%

58. Profiel M ANNEN 45-49 jaar
P10 P25 P50 P75 P90
170.0 172.0 176.0 180.0 186.0
G estalte
(cm )
70.0 73.0 80.0 89.0 109.0
G ew icht
(kg)
22.2 23.9 25.5 28.5 31.6
BM I
(kg/m 2)
15.2 19.1 23.0 26.6 30.5
Vetpercentage
(% )
8.0 14.0 21.0 27.0 32.0
Lenigheid
Zittend reiken (cm )
35.0 42.0 49.0 56.0 62.0
Statische kracht
Handknijpkracht (kg)
521.0 557.5 612.4 685.5 703.8
W andeltest (m )
116.0 120.7 130.0 140.0 150.0
Systolische bloeddruk
(m m Hg)
73.3 78.7 82.0 90.0 95.3
Diastolische bloeddruk
(m m Hg)
3.9 4.3 4.9 5.4 6.0
Longinhoud
(l)
164.0 186.0 209.0 236.0 265.0
Totaal cholesterol
(m g/100m l)
0.0 0.0 0.0 3.0 8.0
Uren sport
(u/w eek)
4.5 9.0 16.0 21.0 28.0
Kijkindex
(u/w eek)

59. Recommendations to the policy
%

60. 5. Time & Money: some facts
Budget epidemiological study
2.000.000 € (2001-2006)
Subjects
• PA: 6117 boys and girls: in a 3-month period
• PA & PF & Health test battery: 5170 men and women: during ca. 50
weeks (about 100 subjects per week)

61. 5. Time & Money: some facts
Staff:
• 3 promotors
• 1 director (on pay roll)
• 1 administrator (on pay roll)
• 1 test manager (on pay roll)
• 3 PhD students (on pay roll)
• Call center (1 year: 12 students) (on pay roll)
• 4 physicians (free lance),
• 2 nurses (free lance)
• 8 part-time administrators and test leaders (on pay roll)
• ca. 25 master students

62. Thank you !