Journal of Physical Activity Research
ISSN (Print): 2576-1919 ISSN (Online): 2574-4437 Website: Editor-in-chief: Peter Hart
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Journal of Physical Activity Research. 2021, 6(2), 135-141
DOI: 10.12691/jpar-6-2-12
Open AccessArticle

Physical Activity and Body Mass Index (BMI) as Predictors of Health-related Quality of Life in Montana Adults

Peter D. Hart1,

1Health Promotion Research, Havre, MT 59501

Pub. Date: October 19, 2021

Cite this paper:
Peter D. Hart. Physical Activity and Body Mass Index (BMI) as Predictors of Health-related Quality of Life in Montana Adults. Journal of Physical Activity Research. 2021; 6(2):135-141. doi: 10.12691/jpar-6-2-12


Background: Health-related quality of life (HRQOL) is an important concept related to how health status affects a person’s life. Engaging in physical activity (PA) and maintaining healthy body weight are each linked to favorable HRQOL. However, the extent to which PA and body weight independently influence HRQOL is less known. The aim of this research was to examine how meeting PA guidelines and body mass index (BMI) affect a measure of HRQOL in adults. Methods: The Montana Behavioral Risk Factor Surveillance System (BRFSS, 2019) was used for this study. Three different PA guideline variables were used and included a two-level aerobic PA (APA) (met APA or did not meet APA) measure, a two-level muscle strengthening activity (MSA) (met MSA or did not meet MSA) measure, and a two-level PA guidelines (APA/MSA) (met both APA and MSA or did not meet both) measure. BMI was calculated from self-reported height and weight (kg/m2). HRQOL was assessed from a question asking participants to rate their general health with the following response options: “excellent”, “very good”, “good”, “fair” or “poor”. Multinomial logistic regression was used to examine the independent effects of PA and BMI on each HRQOL rating (relative to excellent) while controlling for sociodemographic variables. Results: Differences in HRQOL prevalence was seen within all sociodemographic variables except sex. Additionally, BMI was significantly (p < .05) greater in adults reporting fair or poor health (Mean = 30.30, SE = 0.32) compared to those reporting excellent, very good or good health (Mean = 27.28, SE = 0.09), with a similar trend seen across all sociodemographic groups. The fully adjusted regression model including APA/MSA showed decreased odds of very good (OR = 0.75, 95% CI: 0.60 – 0.92), good (OR = 0.61, 95% CI: 0.49 – 0.78), fair (OR = 0.56, 95% CI: 0.40 – 0.78), and poor health (OR = 0.44, 95% CI: 0.28 – 0.69) (relative to excellent health) for adults meeting both APA and MSA. In the same model, increased odds was seen for very good (OR = 1.08, 95% CI: 1.06 – 1.10), good (OR = 1.15, 95% CI: 1.13 – 1.18), fair (OR = 1.19, 95% CI: 1.16 – 1.23), and poor health (OR = 1.16, 95% CI: 1.12 – 1.21) (relative to excellent health) for each 1-unit increase in BMI (1.00 kg/m2). Similar findings were seen in the separate APA model but not the MSA model. Conclusion: This study found that meeting PA guidelines and BMI were both independently related to HRQOL in adults. However, meeting MSA showed lower effects and inconsistent effects on HRQOL. Health promotion specialists concerned with improving HRQOL should promote both APA and MSA guidelines along with healthy body weight behavior. Physical activity programming should consider APA a priority over MSA for improving HRQOL in Montana adults.

body mass index (BMI) physical activity (PA) muscle strengthening activity (MSA) health-related quality of life (HRQOL)

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[1]  Julian V, Thivel D, Miguet M, Pereira B, Lambert C, Costes F, Richard R, Duclos M. Eccentric Cycling Training Improves Health-Related Quality of Life in Adolescents with Obesity. Obesity Facts. 2020; 13(6): 548-59.
[2]  MacDonald CS, Nielsen SM, Bjørner J, Johansen MY, Christensen R, Vaag A, Lieberman DE, Pedersen BK, Langberg H, Ried-Larsen M, Midtgaard J. One-year intensive lifestyle intervention and improvements in health-related quality of life and mental health in persons with type 2 diabetes: a secondary analysis of the U-TURN randomized controlled trial. BMJ Open Diabetes Research and Care. 2021 Jan 1; 9(1): e001840.
[3]  Tous-Espelosín M, Gorostegi-Anduaga I, Corres P, Martinez Aguirre-Betolaza A, Maldonado-Martín S. Impact on Health-Related Quality of Life after Different Aerobic Exercise Programs in Physically Inactive Adults with Overweight/Obesity and Primary Hypertension: Data from the EXERDIET-HTA Study. International Journal of Environmental Research and Public Health. 2020 Jan; 17(24): 9349.
[4]  Ryu M, Lee S, Kim H, Baek WC, Kimm H. Effect of Aerobic Physical Activity on Health-Related Quality of Life in Middle Aged Women with Osteoarthritis: Korea National Health and Nutrition Examination Survey (2016–2017). International journal of environmental research and public health. 2020 Jan; 17(2): 527.
[5]  Xu F, Cohen SA, Lofgren IE, Greene GW, Delmonico MJ, Greaney ML. Relationship between diet quality, physical activity and health-related quality of life in older adults: Findings from 2007–2014 national health and nutrition examination survey. The journal of nutrition, health & aging. 2018 Nov; 22(9): 1072-9.
[6]  Marcos-Delgado A, Fernández-Villa T, Martínez-González MÁ, Salas-Salvadó J, Corella D, Castañer O, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D. The effect of physical activity and high body mass index on health-related quality of life in individuals with metabolic syndrome. International Journal of Environmental Research and Public Health. 2020 Jan; 17(10): 3728.
[7]  Office of Disease Prevention and Health Promotion. (n.d.). Health-Related Quality of Life & Well-Being. Healthy People 2020. U.S. Department of Health and Human Services.
[8]  Hart PD. Meeting recommended levels of physical activity and health-related quality of life in rural adults. Journal of lifestyle medicine. 2016 Mar; 6(1): 1.
[9]  Hart PD. Sex differences in the physical inactivity and health-related quality of life relationship among rural adults. Health promotion perspectives. 2016; 6(4): 185.
[10]  Hart PD, Buck DJ. The effect of resistance training on health-related quality of life in older adults: Systematic review and meta-analysis. Health promotion perspectives. 2019; 9(1): 1.
[11]  McArdle WD, Katch FI, Katch VL. Exercise physiology: nutrition, energy, and human performance. Lippincott Williams & Wilkins; 2010.
[12]  Wilkins J, Ghosh P, Vivar J, Chakraborty B, Ghosh S. Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008. BMC obesity. 2018 Dec; 5(1): 1-2.
[13]  Amiri P, Jalali-Farahani S, Rezaei M, Cheraghi L, Hosseinpanah F, Azizi F. Which obesity phenotypes predict poor health-related quality of life in adult men and women? Tehran Lipid and Glucose Study. PloS one. 2018 Sep 12; 13(9): e0203028.
[14]  Piercy KL, Troiano RP. Physical activity guidelines for Americans from the US department of health and human services: Cardiovascular benefits and recommendations. Circulation: Cardiovascular Quality and Outcomes. 2018 Nov; 11(11): e005263.
[15]  2018 Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC: U.S. Department of Health and Human Services, 2018.
[16]  Centers for Disease Control and Prevention. The BRFSS data user guide. August 15, 2013.
[17]  Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Overview: BRFSS 2019. July 26, 2019.
[18]  SAS Institute Inc. 2015. SAS/STAT® 14.1 User’s Guide. Cary, NC: SAS Institute Inc.
[19]  IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp.
[20]  Zou D, Lloyd JE, Baumbusch JL. Using SPSS to analyze complex survey data: a primer. Journal of Modern Applied Statistical Methods. 2020; 18(1): 16.
[21]  Siller AB, Tompkins L. The big four: Analyzing complex sample survey data using SAS, SPSS, STATA, and SUDAAN. Inproceedings of the thirty-first annual SAS® Users Group international conference 2006 Mar 27 (pp. 26-29).
[22]  Sun K, Song J, Lee J, Chang RW, Eaton CB, Ehrlich-Jones L, Kwoh KC, Manheim LM, Semanik PA, Sharma L, Sohn MW. Relationship of meeting physical activity guidelines with health-related utility. Arthritis care & research. 2014 Jul; 66(7): 1041-7.