INDICATORS

Notes: Exclusive versus partial breastfeeding. The WHO recommends exclusive breastfeeding
for the first six months of life, and subsequent breastfeeding with appropriate complementary
foods while breastfeeding continues for up to two years of age or beyond. Eurodiet-project:
The average population goal is around 6 months, but for individuals exclusive breastfeeding
should continue for at least four months and breastfeeding should be the principal source of
milk for the infant until one year of age.
Comparisons among countries are not easy; the definitions, questions, recall period and
methods of data collection are different, not all countries gather regular data on breastfeeding
and few has data on trends.
52. PHYSICAL ACTIVITY
Definition: This indicator is referring to the concept of “health-enhancing physical
activity”. It is covering a whole range of physical activities including leisure time physical
activities, exercises, sport, occupational activities, commuting and daily tasks. Physical
activity is defined as any bodily movement produced by skeletal muscle that results in energy
expenditure.
Calculation:
1) EHIS instrument (deriving from the IPAQ) to measure the proportion of population
performing moderate and vigorous physical activity (days and/or hours per week), derived
from questions PE.1.–6: During the past 7 days, a) days and time devoted to vigorous
physical activities. b) days and time devoted to moderate physical activities c) days and time
spent walking. Precise operationalisation to be formulated.
2) The Health Behaviour of School Children Survey (HBSC, 2001/2002) includes some
questions for children aged 11–13–15: % of children reporting 60 minutes or more of
physical activity of at least moderate intensity on 5 or more days a week, carried out at school
and/or in free-time, a) during both the previous week and b) a typical week, derived from
questions:
Over the past 7 days, on how many days were you physically active for a total of at least 60
minutes per day? Over a typical or usual week, on how many days are you physically active
for a total of at least 60 minutes per day? The response categories for both were: 0 days, 1
day, 2 days, … 7 days.
Notes: Population health surveys allow verifying if the respondents have effectively
performed any type of physical activity. Intensity as well as frequency of the effort is
taken into account. This can be done either through direct measurements (pedometer,
accelerometer) or rather based on the self-declaration of the individuals
Possible operational measures of physical activity level and pattern include: a) The total
amount of activity expressed either as activity energy expenditure (kcal, Joules, MET mins,
etc) or physical activity level (PAL); b) Time (mins/day or week) spent at health enhancing
physical activity level (i.e. activity at moderate and vigorous intensity levels); c) Time (mins/
day or week) spent sitting; d) Proportion of the population reaching the threshold level for
health enhancing physical activity.
European Physical Activity Surveillance System, EUPASS -project stresses 4 key dimensions
of physical activity: type, frequency, duration and intensity of activity. The International
Physical Activity Questionnaire (IPAQ) is considered as the most advanced international
approach to operationalise the dimensions of physical activity
The EHIS questions (PE.1.–6.) are an adaptation of the IPAQ but they have not been
validated.
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