Seasonality and Objective Physical Activity and Sedentary Behaviour among Older Adults from Four European Countries
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Participants
2.2. Measures
2.2.1. Physical Activity and Sedentary Behaviour Data Evaluation and Accelerometry Data Collection
2.2.2. Sociodemographic Variables
2.2.3. Seasonality
2.3. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Ramsey, K.A.; Meskers, C.G.M.; Maier, A.B. Every step counts: Synthesising reviews associating objectively measured physical activity and sedentary behaviour with clinical outcomes in community-dwelling older adults. Lancet Healthy Longev. 2021, 2, e764–e772. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Global Action Plan on Physical Activity 2018–2030: More Active People for a Healthier World; World Health Organization: Geneva, Switzerland, 2018. [Google Scholar]
- Warburton, D.E.R.; Bredin, S.S.D. Health benefits of physical activity: A systematic review of current systematic reviews. Curr. Opin. Cardiol. 2017, 32, 541–556. [Google Scholar] [CrossRef] [PubMed]
- Heissel, A.; Heinen, D.; Brokmeier, L.L.; Skarabis, N.; Kangas, M.; Vancampfort, D.; Stubbs, B.; Firth, J.; Ward, P.B.; Rosenbaum, S.; et al. Exercise as medicine for depressive symptoms? A systematic review and meta-analysis with meta-regression. Br. J. Sports Med. 2023, 57, 1049–1057. [Google Scholar] [CrossRef] [PubMed]
- Schuch, F.B.; Vancampfort, D.; Firth, J.; Rosenbaum, S.; Ward, P.B.; Silva, E.S.; Hallgren, M.; De Leon, A.P.; Dunn, A.L.; Deslandes, A.C.; et al. Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies. Am. J. Psychiatry 2018, 175, 631–648. [Google Scholar] [CrossRef] [PubMed]
- Swift, D.L.; McGee, J.E.; Earnest, C.P.; Carlisle, E.; Nygard, M.; Johannsen, N.M. The Effects of Exercise and Physical Activity on Weight Loss and Maintenance. Prog. Cardiovasc. Dis. 2018, 61, 206–213. [Google Scholar] [CrossRef]
- Roberts, C.E.; Phillips, L.H.; Cooper, C.L.; Gray, S.; Allan, J.L. Effect of Different Types of Physical Activity on Activities of Daily Living in Older Adults: Systematic Review and Meta-Analysis. J. Aging Phys. Act. 2017, 25, 653–670. [Google Scholar] [CrossRef]
- Langhammer, B.; Bergland, A.; Rydwik, E. The Importance of Physical Activity Exercise among Older People. BioMed Res. Int. 2018, 2018, 7856823. [Google Scholar] [CrossRef]
- Ding, D.; Lawson, K.D.; Kolbe-Alexander, T.L.; Finkelstein, E.A.; Katzmarzyk, P.T.; van Mechelen, W.; Pratt, M.; Lancet Physical Activity Series 2 Executive Committee. The economic burden of physical inactivity: A global analysis of major non-communicable diseases. Lancet 2016, 388, 1311–1324. [Google Scholar] [CrossRef]
- Bull, F.C.; Al-Ansari, S.S.; Biddle, S.; Borodulin, K.; Buman, M.P.; Cardon, G.; Carty, C.; Chaput, J.-P.; Chastin, S.; Chou, R.; et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br. J. Sports Med. 2020, 54, 1451–1462. [Google Scholar] [CrossRef]
- World Health Organization. Globalt on Physical Activity 2022: Web Annex: Global Action Plan on Physical Activity Monitoring Framework, Indicators and Data Dictionary; World Health Organization: Geneva, Switzerland, 2022. [Google Scholar]
- Kwiecien, O.; Braun, T.; Brunello, C.F.; Faulkner, P.; Hausmann, N.; Helle, G.; Hoggarth, J.A.; Ionita, M.; Jazwa, C.S.; Kelmelis, S.; et al. What we talk about when we talk about seasonality—A transdisciplinary review. Earth-Sci. Rev. 2022, 225, 103843. [Google Scholar] [CrossRef]
- Garriga, A.; Sempere-Rubio, N.; Molina-Prados, M.J.; Faubel, R. Impact of Seasonality on Physical Activity: A Systematic Review. Int. J. Environ. Res. Public Health 2021, 19, 2. [Google Scholar] [CrossRef] [PubMed]
- Liu, P. The effect of temperature on outdoor recreation activities: Evidence from visits to federal recreation sites. Environ. Res. Lett. 2022, 17, 044037. [Google Scholar] [CrossRef]
- Harrison, F.; Goodman, A.; van Sluijs, E.M.; Andersen, L.B.; Cardon, G.; Davey, R.; Janz, K.F.; Kriemler, S.; Molloy, L.; Page, A.S.; et al. Weather and children’s physical activity; how and why do relationships vary between countries? Int. J. Behav. Nutr. Phys. Act. 2017, 14, 74. [Google Scholar] [CrossRef] [PubMed]
- Edwards, N.M.; Myer, G.D.; Kalkwarf, H.J.; Woo, J.G.; Khoury, P.R.; Hewett, T.E.; Daniels, S.R. Outdoor Temperature, Precipitation, and Wind Speed Affect Physical Activity Levels in Children: A Longitudinal Cohort Study. J. Phys. Act. Health 2015, 12, 1074–1081. [Google Scholar] [CrossRef]
- Kharlova, I.; Deng, W.H.; Mamen, J.; Mamen, A.; Fredriksen, M.V.; Fredriksen, P.M. The Weather Impact on Physical Activity of 6ߝ12 Year Old Children: A Clustered Study of the Health Oriented Pedagogical Project (HOPP). Sports 2020, 8, 9. [Google Scholar] [CrossRef]
- Goodman, A.; Page, A.S.; Cooper, A.R. Daylight saving time as a potential public health intervention: An observational study of evening daylight and objectively-measured physical activity among 23,000 children from 9 countries. Int. J. Behav. Nutr. Phys. Act. 2014, 11, 84. [Google Scholar] [CrossRef]
- Field, A. Discovering Statistics Using IBM SPSS Statistics, 3rd ed.; SAGE Publications: Thousand Oaks, CA, USA, 2013. [Google Scholar]
- Troiano, R.P.; Berrigan, D.; Dodd, K.W.; Mâsse, L.C.; Tilert, T.; Mcdowell, M. Physical activity in the United States measured by accelerometer. Med. Sci. Sports Exerc. 2008, 40, 181–188. [Google Scholar] [CrossRef]
- ESS. ESS Round 9: European Social Survey Round 9 Data (2018). Sikt—Norwegian Agency for Shared Services in Education and Research, Norway—Data Archive and Distributor of ESS Data for ESS ERIC; Data File Edition 3.1; ESS: Wilsonville, OR, USA, 2018. [Google Scholar]
- WHO. Physical Status: The Use and Interpretation of Anthropometry: Report of a World Health Organization (WHO) Expert Committee; World Health Organization: Geneva, Switzerland, 1995. [Google Scholar]
- Hallal, P.C.; Andersen, L.B.; Bull, F.C.; Guthold, R.; Haskell, W.; Ekelund, U. Global physical activity levels: Surveillance progress, pitfalls, and prospects. Lancet 2012, 380, 247–257. [Google Scholar] [CrossRef]
- Bauman, A.E.; Reis, R.S.; Sallis, J.F.; Wells, J.C.; Loos, R.J.; Martin, B.W. Correlates of physical activity: Why are some people physically active and others not? Lancet 2012, 380, 258–271. [Google Scholar] [CrossRef]
- Sun, F.; Norman, I.J.; While, A.E. Physical activity in older people: A systematic review. BMC Public Health 2013, 13, 449. [Google Scholar] [CrossRef]
- Baptista, F.; Santos, D.A.; Silva, A.M.; Mota, J.; Santos, R.; Vale, S.; Ferreira, J.P.; Raimundo, A.M.; Moreira, H.; Sardinha, L.B. Prevalence of the Portuguese population attaining sufficient physical activity. Med. Sci. Sports Exerc. 2012, 44, 466–473. [Google Scholar] [CrossRef] [PubMed]
- Sallis, J.F.; Bull, F.; Guthold, R.; Heath, G.W.; Inoue, S.; Kelly, P.; Oyeyemi, A.L.; Perez, L.G.; Richards, J.; Hallal, P.C. Progress in physical activity over the Olympic quadrennium. Lancet 2016, 388, 1325–1336. [Google Scholar] [CrossRef]
- WHO. Global Status Report on Physical Activity 2022; Contract No.: CC BY-NC-SA 3.0 IGO; World Health Organization: Geneva, Switzerland, 2022. [Google Scholar]
- USDHHS. 2018 Physical Activity Guidelines Advisory Committee Scientific Report; U.S. Department of Health and Human Services: Washington, DC, USA, 2018. [Google Scholar]
- WHO. WHO Guidelines on Physical Activity and Sedentary Behaviour; WHO: Geneva, Switzerland, 2020. [Google Scholar]
- Arnardottir, N.Y.; Oskarsdottir, N.D.; Brychta, R.J.; Koster, A.; van Domelen, D.R.; Caserotti, P.; Eiriksdottir, G.; Sverrisdottir, J.E.; Johannsson, E.; Launer, L.J.; et al. Comparison of Summer and Winter Objectively Measured Physical Activity and Sedentary Behavior in Older Adults: Age, Gene/Environment Susceptibility Reykjavik Study. Int. J. Environ. Res. Public Health 2017, 14, 1268. [Google Scholar] [CrossRef] [PubMed]
- Urbański, P.K.; Conners, R.T.; Tasiemski, T. Leisure time physical activity in persons with spinal cord injury across the seasons. Neurol. Res. 2021, 43, 22–28. [Google Scholar] [CrossRef]
- Klompstram, L.; Jaarsmam, T.; Strömbergm, A.; van der Walm, M.H.L. Seasonal variation in physical activity in patients with heart failure. Heart Lung J. Cardiopulm. Acute Care 2019, 48, 381–385. [Google Scholar] [CrossRef]
- Hoaas, H.; Zanaboni, P.; Hjalmarsen, A.; Morseth, B.; Dinesen, B.; Burge, A.T.; Cox, N.S.; Holland, A.E. Seasonal variations in objectively assessed physical activity among people with COPD in two Nordic countries and Australia: A cross-sectional study. Int. J. Chronic Obstruct. Pulm. Dis. 2019, 14, 1219–1228. [Google Scholar] [CrossRef] [PubMed]
Country | Season | Month | Average Temperature (°C) | Rainy Days | Classification |
---|---|---|---|---|---|
Portugal (Lisbon) * | Spring | March | 13.5 | 6 | Hot summer Mediterranean climate |
April | 15.2 | 7 | |||
Autumn/Winter | October | 18.7 | 7 | ||
November | 14.6 | 8 | |||
December | 12.3 | 7 | |||
Croatia (Zagreb) | Spring | March | 6.6 | 9 | Warm humid continental climate |
April | 11.8 | 11 | |||
Autumn/Winter | October | 12 | 9 | ||
November | 6.9 | 10 | |||
December | 1.8 | 10 | |||
Poland (Krakow) | Spring | March | 3.5 | 12 | Warm humid continental climate |
April | 9.3 | 10 | |||
Autumn/Winter | October | 9.7 | 9 | ||
November | 5.1 | 10 | |||
December | 0.9 | 11 | |||
Greece (Theassaloniki) | Spring | March | 9.7 | 7 | Cold semi-arid climates |
April | 14.1 | 7 | |||
Autumn/Winter | October | 16 | 5 | ||
November | 10.9 | 6 | |||
December | 5.5 | 6 |
Variables | % OR M ± SD |
---|---|
Age | 72.2 ± 6.0 |
Sex | |
Male | 32.0 |
Female | 68.0 |
Country | |
Croatia | 24.9 |
Greece | 21.3 |
Portugal | 34.9 |
Poland | 18.9 |
Education | |
Up to 9 years | 24.9 |
10–12 years | 27.2 |
More than 12 years | 47.9 |
Occupation | |
Employed | 4.5 |
Retired | 91.0 |
Doing housework | 1.3 |
Other | 2.6 |
BMI (kg/m2) | 26.7 ± 3.8 |
BMI categories | |
Normal weight | 40.1 |
Overweight | 44.3 |
Obese | 15.6 |
Physical activity recommendations | |
Achieve_1 (spring) | 61.5 |
Achieve_2 (autumn/winter) | 50.9 |
Variables | Sex | Country | ||||||
---|---|---|---|---|---|---|---|---|
Male | Female | p-Value | Croatia | Greece | Portugal | Poland | p-Value | |
Sedentary beahviour_1 (m/day) | 517.4 (495.6, 539.2) | 525.0 (511.3, 538.7) | 0.546 | 531.0 (509.1, 552.8) | 507.7 (478.2, 537.1) | 501.4 (482.4, 520.4) | 567.5 (548.3, 586.8) | <0.001 A |
Light PA_1 (m/day) | 204.9 (192.1, 217.8) | 214.0 (202.5, 225.4) | 0.344 | 215.0 (198.0, 231.9) | 185.5 (170.6, 200.3) | 230.9 (213.4, 248.5) | 198.2 (183.2, 213.2) | <0.001 B |
Moderate PA_1 (m/day) | 37.0 (28.3, 45.7) | 31.4 (26.7, 36.1) | 0.217 | 33.5 (26.9, 40.1) | 33.5 (20.6, 46.3) | 32.9 (25.6, 40.2) | 32.9 (25.1, 40.7) | 0.999 |
Vigorous PA_1 (m/day) | 0.7 (0.0, 1.3) | 0.3 (0.0, 0.6) | 0.242 | 0.1 (0.0, 0.1) | 1.0 (0.0, 2.1) | 0.2 (0.0, 0.4) | 0.6 (−0.4, 1.5) | 0.090 |
Total MVPA_1 (m/day) | 37.7 (28.6, 46.8) | 31.7 (26.9, 36.5) | 0.203 | 33.6 (27.0, 40.2) | 34.5 (21.0, 48.0) | 33.1 (25.8, 40.5) | 33.4 (25.0, 41.9) | 0.997 |
Sedentary behaviour_2 (m/day) | 574.0 (551.8, 596.1) | 558.5 (543.7, 573.2) | 0.243 | 560.5 (537.5, 583.5) | 566.0 (537.0, 594.9) | 545.1 (525.2, 565.1) | 598.1 (568.8, 627.4) | 0.026 C |
Light PA_2 (m/day) | 203.2 (189.4, 216.9) | 215.5 (204.7, 226.3) | 0.184 | 213.8 (199.1, 228.5) | 200.6 (179.9, 221.2) | 220.8 (204.1, 237.4) | 204.1 (188.2, 220.0) | 0.310 |
Moderate PA_2 (m/day) | 31.5 (24.1, 39.0) | 28.1 (24.1, 32.2) | 0.385 | 30.1 (23.7, 36.5) | 27.2 (19.9, 34.5) | 28.3 (21.0, 35.6) | 32.0 (24.0, 39.9) | 0.843 |
Vigorous PA_2 (m/day) | 0.2 (0.0, 0.3) | 0.2 (0.0, 0.4) | 0.924 | 0.1 (0.0, 0.1) | 0.6 (0.0, 1.1) | 0.1 (0.0, 0.3) | 0.1 (0.0, 0.1) | 0.024 D |
Total MVPA_2 (m/day) | 31.7 (24.2, 39.2) | 28.3 (24.2, 32.4) | 0.390 | 30.2 (23.8, 36.6) | 27.8 (20.2, 35.3) | 28.4 (21.1, 35.7) | 32.0 (24.1, 40.0) | 0.875 |
Variables | Education | BMI Categories | ||||||
≤9 Years | 10–12 Years | > 12 Years | p-Value | Normal Weight | Overweight | Obese | p-Value | |
Sedentary beahviour_1 (m/day) | 488.3 (463.7, 512.8) | 517.5 (495.5, 539.4) | 543.3 (528.0, 558.5) | <0.001 a | 526.5 (508.5, 544.5) | 524.3 (506.8, 541.8) | 511.6 (478.2, 545.1) | 0.691 |
Light PA_1 (m/day) | 227.4 (206.9, 247.9) | 213.3 (194.5, 232.1) | 201.3 (190.8, 211.9) | 0.056 | 203.9 (191.9, 216.0) | 217.0 (203.3, 230.8) | 206.5 (178.3, 234.7) | 0.380 |
Moderate PA_1 (m/day) | 39.0 (26.8, 51.3) | 28.7 (22.0, 35.5) | 32.7 (27.8, 37.6) | 0.212 | 35.9 (29.8, 42.1) | 31.1 (25.6, 36.7) | 31.2 (14.5, 47.9) | 0.554 |
Vigorous PA_1(m/day) | 0.6 (0.0, 1.2) | 0.1 (0.0, 0.2) | 0.5 (0.0, 1.0) | 0.382 | 0.6 (0.0, 1.3) | 0.1 (0.1, 0.2) | 0.7 (−0.2, 1.7) | 0.186 |
Total MVPA_1 (m/day) | 39.6 (26.9, 52.3) | 28.8 (22.1, 35.6) | 33.2 (28.1, 38.3) | 0.205 | 36.5 (30.1, 42.9) | 31.2 (25.7, 36.8) | 31.9 (14.4, 49.5) | 0.527 |
Sedentary behaviour_2 (m/day) | 536.7 (510.3, 563.1) | 553.2 (531.5, 574.9) | 583.1 (565.9, 600.3) | 0.005 b | 559.5 (539.4, 579.6) | 573.5 (554.5, 592.4) | 547.9 (519.0, 576.7) | 0.323 |
Light PA_2 (m/day) | 216.4 (196.1, 236.8) | 222.2 (206.2, 238.3) | 203.0 (191.6, 214.4) | 0.145 | 202.6 (189.6, 215.6) | 213.2 (200.0, 226.4) | 224.3 (200.8, 247.8) | 0.214 |
Moderate PA_2 (m/day) | 26.3 (17.5, 35.0) | 32.3 (24.9, 39.6) | 29.0 (24.4, 33.5) | 0.494 | 37.1 (30.1, 44.1) | 25.9 (21.7, 30.1) | 16.2 (11.3, 21.2) | <0.001 c |
Vigorous PA_2 (m/day) | 0.2 (0.0, 0.4) | 0.2 (0.0, 0.5) | 0.2 (0.0, 0.4) | 0.875 | 0.2 (0.0, 0.4) | 0.2 (0.0, 0.4) | 0.1 (0.0, 0.2) | 0.829 |
Total MVPA_2 (m/day) | 26.4 (17.6, 35.2) | 32.5 (25.1, 39.9) | 29.2 (24.6, 33.8) | 0.489 | 37.3 (30.2, 44.3) | 26.1 (21.9, 30.4) | 16.3 (11.4, 21.3) | <0.001 d |
Sex | Country | |||||||
---|---|---|---|---|---|---|---|---|
Male | Female | p-Value | Croatia | Greece | Portugal | Poland | p-Value | |
Δ Sedentary behaviour (m/day) | 56.6 (35.5, 77.6) | 33.5 (18.7, 48.2) | 0.078 | 29.6 (12.5, 46.6) | 58.3 (17.9, 98.7) | 43.8 (26.3, 61.3) | 30.6 (4.8, 56.4) | 0.365 |
Δ Light PA (m/day) | −1.7 (−15.9, 12.4) | 1.6 (−7.4, 10.5) | 0.686 | −1.2 (−15.4, 13.1) | 15.1 (−8.9, 39.1) | −10.1 (−19.9, −0.4) | 5.9 (−8.8, 20.6) | 0.096 |
Δ Moderate PA (m/day) | −5.5 (−12.5, 1.5) | −3.3 (−7.9, 1.4) | 0.596 | −3.4 (−7.7, 0.9) | −6.2 (−21.9, 9.4) | −4.6 (−9.0, −0.3) | −0.9 (−7.0, 5.2) | 0.850 |
Δ Vigorous PA (m/day) | −0.5 (−1.2, 0.2) | −0.1 (−0.4, 0.2) | 0.264 | 0.0 (0.0, 0.1) | −0.5 (−1.7, 0.7) | −0.1 (−0.3, 0.1) | −0.5 (−1.4, 0.5) | 0.565 |
Δ Total MVPA (m/day) | −6.0 (−13.3, 1.4) | −3.4 (−8.2, 1.5) | 0.553 | −3.4 (−7.7, 0.9) | −6.7 (−23.1, 9.7) | −4.7 (−9.1, −0.3) | −1.4 (−8.0, 5.2) | 0.865 |
Education | BMI Categories | |||||||
≤9 Years | 10–12 Years | >12 Years | p-Value | Normal Weight | Overweight | Obese | p-Value | |
Δ Sedentary behaviour (m/day) | 48.4 (26.6, 70.3) | 35.8 (12.0, 59.5) | 39.8 (21.2, 58.5) | 0.750 | 33.0 (14.2, 51.8) | 49.2 (30.0, 68.3) | 36.2 (4.3, 68.1) | 0.468 |
Δ Light PA (m/day) | −11.0 (−23.0, 1.1) | 8.9 (−7.5, 25.4) | 1.7 (−9.4, 12.8) | 0.162 | −1.3 (−13.2, 10.6) | −3.8 (−14.6, 6.9) | 17.8 (−6.0, 41.6) | 0.149 |
Δ Moderate PA (m/day) | −12.8 (−24.3, −1.3) | 3.6 (−2.8, 9.9) | −3.7 (−7.7, 0.3) | 0.010 a | 1.2 (−3.8, 6.2) | −5.2 (−10.0, −0.4) | −15.0 (−31.8, 1.9) | 0.020 c |
Δ Vigorous PA (m/day) | −0.4 (−1.0, 0.2) | 0.2 (−0.2, 0.5) | −0.3 (−0.9, 0.2) | 0.340 | −0.4 (−1.1, 0.3) | 0.1 (−0.1, 0.3) | −0.6 (−1.6, 0.3) | 0.182 |
Δ Total MVPA (m/day) | −13.2 (−25.2, −1.2) | 3.7 (−2.8, 10.2) | −4.0 (−8.2, 0.2) | 0.011 b | 0.8 (−4.6, 6.1) | −5.1 (−10.0, −0.2) | −15.6 (−33.3, 2.1) | 0.026 d |
Spring (Moment 1) OR (95% CI) | p-Value | Autumn/Winter (Moment 2) OR (95% CI) | p-Value | |
---|---|---|---|---|
Age | 0.92 (0.86, 0.97) | 0.004 | 0.91 (0.86, 0.97) | 0.003 |
Sex | ||||
Male | 1.00 (ref.) | 1.00 (ref.) | ||
Female | 0.69 (0.32, 1.51) | 0.357 | 0.77 (0.36, 1.65) | 0.504 |
Country | ||||
Croatia | 1.00 (ref.) | 1.00 (ref.) | ||
Greece | 0.38 (0.13, 1.11) | 0.078 | 0.43 (0.15, 1.23) | 1.116 |
Portugal | 0.53 (0.19, 1.50) | 0.232 | 0.64 (0.23, 1.79) | 0.390 |
Poland | 0.54 (0.18, 1.66) | 0.282 | 0.94 (0.32, 2.73) | 0.911 |
Education | ||||
≤9 years | 1.00 (ref.) | 1.00 (ref.) | ||
10–12 years | 0.37 (0.13, 1.08) | 0.069 | 1.36 (0.47, 3.94) | 0.571 |
>12 years | 0.81 (0.29, 2.30) | 0.692 | 0.69 (0.24, 1.99) | 0.498 |
BMI | 0.90 (0.82, 0.99) | 0.037 | 0.84 (0.75, 0.93) | <0.001 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Martins, J.; Masoumi, H.; Loureiro, V.; Gomes, M.; Ratinho, F.; Ribeiro, T.; Mehriar, M.; Rakovac, M.; Šentija, D.; Bahr, A.; et al. Seasonality and Objective Physical Activity and Sedentary Behaviour among Older Adults from Four European Countries. Healthcare 2023, 11, 2395. https://doi.org/10.3390/healthcare11172395
Martins J, Masoumi H, Loureiro V, Gomes M, Ratinho F, Ribeiro T, Mehriar M, Rakovac M, Šentija D, Bahr A, et al. Seasonality and Objective Physical Activity and Sedentary Behaviour among Older Adults from Four European Countries. Healthcare. 2023; 11(17):2395. https://doi.org/10.3390/healthcare11172395
Chicago/Turabian StyleMartins, João, Houshmand Masoumi, Vânia Loureiro, Margarida Gomes, Fortunata Ratinho, Tiago Ribeiro, Melika Mehriar, Marija Rakovac, Davor Šentija, Andrzej Bahr, and et al. 2023. "Seasonality and Objective Physical Activity and Sedentary Behaviour among Older Adults from Four European Countries" Healthcare 11, no. 17: 2395. https://doi.org/10.3390/healthcare11172395
APA StyleMartins, J., Masoumi, H., Loureiro, V., Gomes, M., Ratinho, F., Ribeiro, T., Mehriar, M., Rakovac, M., Šentija, D., Bahr, A., Tomczyk, M., Dynowski, W., Solinas, R., Pirina, M. G., Coradduzza, D., Boccuzzi, G., Çağan, B., Dalcı, A., Papageorgiou, A., ... Marques, A. (2023). Seasonality and Objective Physical Activity and Sedentary Behaviour among Older Adults from Four European Countries. Healthcare, 11(17), 2395. https://doi.org/10.3390/healthcare11172395