Increases in physical activity may affect quality of life differently in men and women: the PACE project
Obesity is associated with impaired quality of life (QoL), but less is known about physical activity. We investigated how decreases in body mass index (BMI) and increases in activity affect obesity-specific QoL and potential gender differences in associations.
In a large worksite randomized trial of a multilevel intervention on diet and physical activity behaviors, we conducted a cohort analysis at two years of follow-up. Self-reported activity and Obesity and Weight Loss Quality of Life (OWLQOL) were analyzed for individual-level associations using linear mixed models accounting for random worksite effects.
Gender modified the BMI–OWLQOL relationship, so analyses were conducted for males and females separately. Adjusting for demographic confounders, baseline OWLQOL, and several worksite-level variables including intervention arm, a 1.9 unit decrease in BMI (the interquartile range) was associated with an OWLQOL increase of 1.7 (95 % CI: 1.2, 2.2) in males and 3.6 (95 % CI: 3.2, 4.0) in females. Similarly, a 23 unit increase in physical activity score was associated with an OWLQOL increase of 0.9 (95 % CI: 0.5, 1.4) in males and 1.6 (95 % CI: 1.0, 2.3) in females. Physical activity associations were attenuated when adjusting for change in BMI, but remained significant for women (mean BMI 27.8 kg/m2).
This is the first study to demonstrate that increasing physical activity may improve obesity-specific QoL to a greater extent in women, particularly among overweight women, independent of BMI. Results may inform the design of interventions tailored to women targeting well-being through messages of increasing physical activity.
KeywordsBody mass index Physical activity Quality of life Weight loss Women
The authors wish to acknowledge the employees at the worksites who took the time to complete the baseline survey, follow-up survey, and physical measurements for the PACE study. Their voluntary participation made our investigation possible. The research reported here was supported by the National Heart, Lung, and Blood Institute R01 HL79491 and by the NCI Biobehavioral Cancer Prevention and Control Training Program (R25CA092408). The study sponsors played no role in any of the following: study design, the collection, analysis, and interpretation of data; the writing of the report; nor the decision to submit the paper for publication.
Conflict of interest
The authors declare that there is no conflict of interest.
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