Background. Leisure time physical activity (LTPA) has been found to prevent several diseases, but little is known about its protective effect against decline in perceived health. The purpose of the present study is to analyze the protective effect of LTPA against the risk of decline in perceived health in a cohort of 19- to 63-year-old Finnish men (n = 1205) and women (n = 1148) with good perceived health. Methods. The incidence rate of decline in perceived health was monitored by self-administered questionnaire data from March 1980 through March 1985 through December 1990. LTPA was assessed by (1) a single-item self-assessment of global LTPA; (2) a compiled intensity-frequency measure of LTPA; (3) a total energy expenditure index of LTPA; and (4) three indexes of LTPA (i.e., commuting, fitness, and sport). The association between LTPA and risk of decline in perceived health was assessed using the Cox proportional hazard regression model. Results. Among men, the multivariate analyses revealed an increased risk of decline in perceived health with no weekly vigorous global LTPA (RR = 1.49; 95% CI 1.12-1.98) and with no monthly sport activity (RR = 1.62; 95% CI 1.12-2.35). Among women, the results only showed an increased risk of decline in perceived health with fitness activity at less than once a week (RR = 1.62; 95% CI 1.06-2.48). The total energy expenditure of weekly LTPA and the index of commuting were not associated with the risk of decline in perceived health. Conclusions. Although energy expenditure of weekly LTPA did not prove to be a protective factor against the risk of decline in perceived health, global level, intensity, and type of weekly LTPA did. Physical activity interventions may need to emphasize the amount, intensity, and type of weekly LTPA, rather than energy expenditure of weekly LTPA, for promoting overall public health among middle-aged and older men and women with good perceived health. (c) 2004 Elsevier Inc. All rights reserved.
