Bidirectional associations of accelerometer-derived physical activity and stationary behavior with self-reported mental and physical health during midlife

Bethany Barone Gibbs, Barbara Sternfeld, Kara M. Whitaker, Jennifer S. Brach, Andrea L. Hergenroeder, David R. Jacobs, Jared P. Reis, Stephen Sidney, Daniel White, Kelley Pettee Gabriel

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


BACKGROUND: Moderate-to-vigorous intensity physical activity (MVPA) is associated with favorable self-rated mental and physical health. Conversely, poor self-rated health in these domains could precede unfavorable shifts in activity. We evaluated bidirectional associations of accelerometer-estimated time spent in stationary behavior (SB), light intensity physical activity (LPA), and MVPA with self-rated health over 10 years in in the CARDIA longitudinal cohort study.

METHODS: Participants (n = 894, age: 45.1 ± 3.5; 63% female; 38% black) with valid accelerometry wear and self-rated health at baseline (2005-6) and 10-year follow-up (2015-6) were included. Accelerometry data were harmonized between exams and measured mean total activity and duration (min/day) in SB, LPA, and MVPA; duration (min/day) in long-bout and short-bout SB (≥30 min vs. < 30 min) and MVPA (≥10 min vs. < 10 min) were also quantified. The Short-Form 12 Questionnaire measured both a mental component score (MCS) and physical component score (PCS) of self-rated health (points). Multivariable linear regression associated baseline accelerometry variables with 10-year changes in MCS and PCS. Similar models associated baseline MCS and PCS with 10-year changes in accelerometry measures.

RESULTS: Over 10-years, average (SD) MCS increased 1.05 (9.07) points, PCS decreased by 1.54 (7.30) points, and activity shifted toward greater SB and less mean total activity, LPA, and MVPA (all p < 0.001). Only baseline short-bout MVPA was associated with greater 10-year increases in MCS (+ 0.92 points, p = 0.021), while baseline mean total activity, MVPA, and long-bout MVPA were associated with greater 10-year changes in PCS (+ 0.53 to + 1.47 points, all p < 0.005). In the reverse direction, higher baseline MCS and PCS were associated with favorable 10-year changes in mean total activity (+ 9.75 cpm, p = 0.040, and + 15.66 cpm, p < 0.001, respectively) and other accelerometry measures; for example, higher baseline MCS was associated with - 13.57 min/day of long-bout SB (p < 0.001) and higher baseline PCS was associated with + 2.83 min/day of MVPA (p < 0.001) in fully adjusted models.

CONCLUSIONS: The presence of bidirectional associations between SB and activity with self-rated health suggests that individuals with low overall activity levels and poor self-rated health are at high risk for further declines and supports intervention programming that aims to dually increase activity levels and improve self-rated health.

Original languageEnglish (US)
Article number74
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Issue number1
StatePublished - Dec 2021

Bibliographical note

Funding Information:
Dr. Barone Gibbs was additionally supported to conduct this research through the Tomayko Fund. Dr. Brach was partially supported by a mid-career K-award from NIA (K24 AG057728).

Funding Information:
The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I & HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). Additional support conducting the research including in this manuscript was provided by the CARDIA Fitness Study (grant R01 HL078972) and CARDIA Activity Study (grant R56 HL125423). The analyses and writing were performed by the coauthors but has been reviewed by CARDIA for scientific content.

Publisher Copyright:
© 2021, The Author(s).


  • Cohort study
  • Physical activity
  • Sedentary behavior
  • Self-rated health
  • Humans
  • Middle Aged
  • Accelerometry/statistics & numerical data
  • Exercise/physiology
  • Male
  • Self Report/statistics & numerical data
  • Adult
  • Female
  • Longitudinal Studies
  • Sedentary Behavior

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Journal Article
  • Research Support, N.I.H., Extramural


Dive into the research topics of 'Bidirectional associations of accelerometer-derived physical activity and stationary behavior with self-reported mental and physical health during midlife'. Together they form a unique fingerprint.

Cite this