Multivariate statistical analysis to identify social, demographic, and clinical determinants of physical activity in the general Greek population: ATTICA epidemiological study (2002-2022)

ABSTRACT

Introduction: Recent studies emphasize that even moderate-intensity physical activity is vital for maintaining health and promoting longevity. However, the increasing prevalence of sedentary lifestyles has led to a significant global decline in physical activity levels.1-3. Additionally, there is a gap in epidemiological knowledge regarding the factors that influence the maintenance of an active lifestyle.

Objective:  Evaluation of the determining factors that influence the physical activity levels of men and women in the general Greek population, overa20-year period (2002-2022).

Method: In this study, data were utilized from 1,293 men (aged 46±14 years) and 1,292 women (aged 46±15 years), who participated in the ATTICA epidemiological study and had reliable information regarding their physical activity levels. Physical activity levels were first assessed at the participants' enrollment in the study (2001-2002) and followed by three more evaluations (2006, 2012, and 2022), using the validated International Physical Activity Questionnaire (IPAQ). Four trajectories of physical activity were detected among the participants: consistently active (engaging in light/moderate exercise at least once per week), consistently inactive, and those who transitioned either from active to inactive or from inactive to active.

Results: During the 20-year follow-up period, 45% of men and 53% of women were classified as physically inactive, 13% of men and 9% of women transitioned from physically active to inactive, 24% of men and 23% of women transitioned to active, and 18% of men and 15% of women remained physically active (p<0.001). According to the multivariable model of the study, a man, with an average age of 45 years, of medium socioeconomic status, without clinical risk factors, and with moderate adherence to the Mediterranean diet, has a 33% probability of remaining physically active throughout the 20-year follow-up period, while a corresponding woman has a 25% probability of remaining physically active over the entire follow-up period.

Conclusions: The results of the study highlight the social factors as a key determinant of physical activity, shaping it as a way of life. This underscores the importance of targeted interventions, which should be tailored to the socioeconomic characteristics of the population.

Keywords: physical activity, determinants, ATTICA study