SLINDE, F., D. ARVIDSSON, A. SJÖBERG, and L. ROSSANDER-HULTHÉN. Minnesota Leisure Time Activity Questionnaire and Doubly Labeled Water in Adolescents. Med. Sci. Sports Exerc., Vol. 35, No. 11, pp. 1923–1928, 2003.
Purposes: To validate the energy expenditure estimated from The Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ) with total energy expenditure (TEE) measured by doubly labeled water (DLW), and to present and examine the validity of an extended version of the MLTPAQ with additional questions about inactivity during leisure time (eMLTPAQ), in a sample of Swedish 15-yr-old adolescents.
Methods: Thirty-five 15-yr-old adolescents were interviewed using the eMLTPAQ. In addition to anthropometry, indirect calorimetry was measured to assess basal metabolic rate, and TEE was assessed by the DLW method over a 14-d period.
Results: Energy expenditure calculated from MLTPAQ correlated well with TEEDLW (r = 0.49, P < 0.01), and the correlation increased when including questions about inactivity (r = 0.73, P < 0.01). However, eMLTPAQ underestimated TEE in 34 of the 35 students, with a mean difference between the methods of 2.8 MJ·d−1 (95% limits of agreement: −0.1 to 5.6 MJ·d−1), which mainly was explained by a relative high intensity in the time which remained unreported.
Conclusion: eMLTPAQ is valid in ranking adolescents energy expenditure and in describing patterns of leisure time physical activities.
Obesity in children and adolescents shows an increasing prevalence worldwide (16). Physical inactivity and hence a decrease in energy expenditure is suggested to be one of the main risk factors for developing obesity (16). Ischemic heart disease and cerebrovascular disease are the two leading causes of death throughout the world today (18) and are also strongly related to physical inactivity (3) and a decrease in cardiorespiratory fitness. But today’s common work of promoting physical activity (PA) falls short in the lack of an international agreed measure of PA (5). The measure needed must be able to be used in large-scale population surveys, and self-report is the only feasible method to fulfil that requirement. However, the majority of research studies using self-report have used different or modified instruments (5), most of them not validated against a criterion method (22). Data on physical activity are most often translated into energy expenditure, but type and duration of physical activity are often not presented.
The Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ) (31) was presented in 1978 as a tool to evaluate energy expended in leisure time activities. MLTPAQ has frequently been used in studies of physical activity in adults, and numerous validation and evaluation studies have been done against other physical activity questionnaires, accelerometers, fitness tests, and criterion methods on adults, with inconsistent results (2,7,9,14,15,20,28,30), probably due to varying degree of unreported time from the participants. In an attempt to limit the unreported time, we suggests in this study to add questions concerning inactivity, such as sleeping time and leisure-time sitting activities (the extended Minnesota Leisure Time Physical Activity Questionnaire (eMLTPAQ)).
Reeder et al. (19), in their study on a cohort of 15-yr-old adolescents from New Zealand, were the first who used MLTPAQ on adolescents. However, the method has not yet been validated in adolescents. Adolescents are midway between childhood and adulthood, but although at the same age, individuals may be at different stages in physical and mental maturity. This puts extra demands on a subjective method to examine physical activity compared with a method used on adults. On the other hand, adolescents, as opposed to adults have a quite homogeneous “occupational” activity pattern, being at school.
The doubly labeled water (DLW) method has made it possible to determine the total energy expenditure (TEE) in free-living subjects. The technique is well established and validated both in animals and humans (24,25), and is today considered to be the golden standard for assessment of TEE, which is assessed with high precision without limiting the subjects’ way of life. The result represents energy expenditure for a relatively long period of time, in contrast to short-term measurements with major limitations in way of life using direct calorimetry.
The aims of this study of a sample of Swedish 15-yr-old adolescents were to validate the TEE estimated from the MLTPAQ with the TEE measured by DLW, and to present and examine the validity of an extended version of the MLTPAQ with additional questions about inactivity during leisure time (eMLTPAQ).
Department of Clinical Nutrition, Sahlgrenska Academy at Göteborg University, Göteborg, SWEDEN
Address for correspondence: Frode Slinde, Dept. of Clinical Nutrition, Sahlgrenska Academy at Göteborg University, P.O. Box 459, 405 30 Göteborg, Sweden; E-mail: firstname.lastname@example.org.
Submitted for publication March 2003.
Accepted for publication July 2003.