Validity and relative validity of alternative methods to assess physical activity in epidemiologic studies: Findings from the Men's Lifestyle Validation Study

Authors: PERNAR, CLAIRE - Harvard University; CHOMISTEK, ANDREA - Indiana University; BARNETT, JUNAIDAH - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; IVEY, KERRY - Harvard University; AL-SHAAR, LAILA - Harvard University; ROBERTS, SUSAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; ROOD, JENNIFER - Louisiana State University; FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; BLOCK, JASON - Harvard University; LI, RUIFENG - Harvard University; WILLETT, WALTER - Harvard University; PARMIGIANI, GIOVANNI - Dana-Farber Cancer Institute; GIOVANNUCCI, EDWARD - Harvard University; MUCCI, LORELEI - Harvard University; RIMM, ERIC - Harvard University

Submitted to: American Journal of Epidemiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/9/2021
Publication Date: 3/15/2022
Citation: Pernar, C.H., Chomistek, A.K., Barnett, J.B., Ivey, K., Al-Shaar, L., Roberts, S., Rood, J., Fielding, R.A., Block, J., Li, R., Willett, W.C., Parmigiani, G., Giovannucci, E.L., Mucci, L.A., Rimm, E.B. 2022. Validity and relative validity of alternative methods to assess physical activity in epidemiologic studies: Findings from the Men's Lifestyle Validation Study. American Journal of Epidemiology. https://doi.org/10.1093/aje/kwac051.
DOI: https://doi.org/10.1093/aje/kwac051

Interpretive Summary: Questionnaires for determining physical activity are widely used, but their validity has not been assessed with statistical rigor. This study examined the ability of different physical activity questionnaires and activity monitors for assessment of free-living physical activity in men, using the doubly labeled water method as a gold-standard reference. The results demonstrate validity of both the Paffenbarger physical activity questionnaire and accelerometer activity monitor for use in epidemiological studies that require a questionnaire method for assessment of physical activity.

Technical Abstract: In the Men's Lifestyle Validation Study, we examined the validity and relative validity of a physical activity questionnaire (PAQ), web-based 24-hour recalls (ACT24) and accelerometers by multiple comparison methods. Over one year, 609 men completed two PAQs, two 7-day accelerometer measures, one doubly-labeled water (DLW)-physical activity level (PAL) measure (repeated, n=100), four ACT24s and resting pulse rate. A subset (n=197) completed dual energy X-ray absorptiometry (DXA)(repeated, n=99). The method of triads was used to estimate correlations with true activity using DLW-PAL, accelerometer, and PAQ or ACT24 as alternative comparison measures. Estimated correlations (95% confidence intervals) of the PAQ with true activity were 0.60 (0.52, 0.68) for total activity, 0.69 (0.61, 0.71) for moderate to vigorous physical activity (MVPA), and 0.76 (0.62, 0.93) for vigorous activity. Corresponding correlations for total activity were 0.53 (0.45, 0.63) for the average of four ACT24s and 0.68 (0.61, 0.75) for accelerometer. Total activity and MVPA measured by PAQ, ACT24, and accelerometer were significantly all correlated with body fat and resting pulse rate, which are physiological indicators of physical activity. Using a combination of comparison methods, we found the PAQ to have good validity for assessing physical activity, especially MVPA, in epidemiologic studies.