Physical inactivity in adults (Indicator 7)
Updated
The indicator describes the following: The proportion of adults who are insufficiently physically active, defined as fewer than 150 minutes of moderate to vigorous intensity activity per week
This indicator is part of target (3): 15 per cent reduction of insufficient physical activity.
The indicator is based on data collected using accelerometers from samples drawn from all Norwegian counties and describes the proportion who do not meet the minimum recommendation for physical activity.
Results
In the latest version of the guidelines for physical activity from the WHO (2020) and the Norwegian Directorate of Health (2022), the requirement that physical activity must be accumulated in bouts of at least 10 minutes has been removed. This highlights the need for objective measurements of physical activity in population surveys that can capture minute to minute changes in physical activity. It also means that the proportion of adults who are insufficiently physically active must be estimated differently compared to before.
Based on accelerometer data collected in 2021 and 2022, this new method of calculation suggests that about 25% of adults are physically inactive. This is based on data from the third Norwegian National Physical Activity Survey, NNPAS3 (Figure 1).
New estimates based on accelerometer data collected in the two previous NNPAS studies in 2008/09 (NNPAS1) and 2014/15 NNPAS2) indicate a slight decrease in the proportion of adults who are insufficiently physically active. However, it is noted that changes between 2014/15 and 2021/22 are uncertain (Figure 1).
![Figure 1: Proportion (%) of adults (20-85 years) in Norway who are categorized as insufficiently physically active (i.e. who do not meet the minimum recommendation for physical activity [>150 minutes/week of moderate-intensity physical activity]) in 2008/09, 2014/15 and in 2021/22 based on accelerometer data collected in the NNPAS studies.](/contentassets/7f0470d76f934f3bb410ac5a9f436372/2023-en-fys-aktivitet-fig-1.jpg "Figure 1: Proportion (%) of adults (20-85 years) in Norway who are categorized as insufficiently physically active (i.e. who do not meet the minimum recommendation for physical activity [>150 minutes/week of moderate-intensity physical activity]) in 2008/09, 2014/15 and in 2021/22 based on accelerometer data collected in the NNPAS studies. The data from 2008/09 and 2014/15 have been reanalysed based on the new physical activity physical activity guidelines. The figures are not standardized for age. Source: the Norwegian National Physical Activity Survey (NNPAS1, NNPAS2 and NNPAS3)")
| Women | |||||
|
|
20-34 years |
35-49 years |
50-64 years |
≥65 years |
All ages |
|
2008/09 |
30.4 |
32.8 |
29.8 |
52.3 |
36.2 |
|
2014/15 |
27.6 |
24.8 |
27.8 |
44.1 |
31.1 |
|
2021/22 |
22.1 |
21.8 |
26.5 |
38.4 |
27.2 |
|
Men |
|||||
|
2008/09 |
26.4 |
22.8 |
30.2 |
45.7 |
31.2 |
|
2014/15 |
20.3 |
17.8 |
21.3 |
44.5 |
26.0 |
|
2021/22 |
18.5 |
20.1 |
24.3 |
34.5 |
24.3 |
|
Total |
|||||
|
2008/09 |
28.2 |
27.6 |
29.9 |
49 |
33.8 |
|
2014/15 |
23.8 |
21.3 |
24.4 |
44.3 |
28.4 |
|
2021/22 |
20.1 |
21.0 |
25.3 |
36.4 |
25.8 |
Data sources
The data source for this indicator is the Norwegian National Physical Activity Survey (NNPAS).
Below is a description of the NNPAS studies and the definitions used.
Data source: The NNPAS Studies
The Norwegian National Physical Activity Survey (NNPAS).
Description
Physical activity among adults (20-85 years) in Norway has been assessed in representative samples in 2008/09 (NNPAS1, N=3464; 32% participation), in 2014/15 (NNPAS2, N= 3173; 29% participation) and in 2021/22 (NNPAS3, N=3006; 31% participation). The surveys have assessed physical activity using accelerometers worn at the hip by the participants for one week. The NNPAS studies have been conducted by the Norwegian School of Sport Sciences in collaboration with the Norwegian Directorate of Health (NNPAS1 and NNPAS2) and the Norwegian Public Health Institute (NNPAS3). (NNPAS3).
Effect measure
- The proportion not meeting the physical activity recommendations by device-based measurement using accelerometers, among adults aged 20-85, as a percentage
The participants in the study were categorised as meeting the recommendations for physical activity as assessed by accelerometers, if they satisfied the following criteria:
- 150 minutes/week* of moderate-intensity physical activity, operationalized as an average of at least 21.4 minutes of moderate-intensity physical activity per day, or
- 75 minutes/week* of high-intensity physical activity, operationalized as an average of at least 10.7 minutes of high-intensity physical activity per day, or
- a combination of physical activity of moderate and high intensity which in total corresponds to 150 minutes/week** of physical activity of moderate intensity
*It is recommended that all adults should be in physical activity of moderate intensity 150-300 minutes/week / in physical activity of high intensity for 75-150 minutes/week. To calculate the proportion that satisfies the minimum recommendation, >150 and >75 minutes/week are used
**One minute of hard-intensity physical activity counts as two minutes of moderate-intensity physical activity in the calculation
In the figures and tables, we show the proportion who did not meet these recommendations for physical activity. The data are not age-standardized.
Interpretation and sources of error
Measurement of physical activity by self-report may be prone to misclassification bias due to over-reporting. Device measured physical activity using accelerometers is independent from an active response by participants and provides valid and reliable estimates of physical activity. A key weakness of accelerometers is that some activities are not captured (e.g. cycling). However, because the latest physical activity guidelines are operationalized as "every minute counts", it is prerequisite that the prevalence of physical inactivity is assessed using accelerometers.
Based on the revised physical activity guidelines from the WHO and the Norwegian Directorate of Health, there are several considerations that can be included when estimating the proportion of the adult population that does not meet the minimum recommendation for physical activity. Firstly, it is not straight forward to categorize individuals as either active or inactive because intervals of minutes are recommended (150-300 minutes/week of moderate-intensity physical activity / 75-150 minutes/week of high-intensity physical activity). If the highest number in these intervals are used in the estimates, the proportion that satisfies the recommendations is reduced from around 75% to around 40%. Second, the guidelines state that people who spend more than 8 hours per day sedentary should engage in at least 300 minutes of moderate-intensity physical activity or 150 minutes of vigorous-intensity physical activity during a week (or a combination). In the NNPAS3 survey, this applied to 80% of the sample. Among these, only 30% satisfied this recommendation. Thirdly, the recommendations state adults should also do muscle-strengthening activities at moderate or greater intensity that involve all major muscle groups on 2 or more days a week. It is not possible based on accelerometer data to say anything about the proportion that satisfy this part of the recommendations.
Datakvalitet
Device-based measures of physical activity using accelerometers provides high quality data. Self-reported data appears to produce substantially higher prevalence data, likely due to over-reporting. To make an international comparison, self-reported data are currently the only type of data available since very few countries have nationally representative data on physical activity measured by a device-based method.
The proportion of individuals who took part in NNPAS 1 and NNPAS2 is low: around 30 per cent of those invited participated. A low participation rate leads to greater uncertainty as to whether the results are representative for the entire population of Norway.
National adaptation to global indicators
WHO’s definition of the indicator
Indicator 7. Age-standardised prevalence of physically active persons aged 18+ years (defined as less than 150 minutes of moderate-intensity activity per week, or equivalent).
National adaptation
WHO’s indicator is based on self-reporting. We present both measurement data based on device measured physical activity using accelerometers and data based on self-report (International Physical Activity Questionnaire).
The data shown are representative of the age distribution in the Norwegian National Physical Activity Survey (NNPAS1 and NNPAS2). The data are not age-standardised.