An integrative methodology for classifying physical activity level in apparently healthy populations for use in public health

Physical inactivity is one of the most important risk factors contributing to morbidity and mortality in the world, although sedentary behavior (SB), low-intensity physical activity (LIPA), and shorter sleep duration have also been associated with various chronic diseases and physiopathological conditions that may affect health, irrespective of one’s level of physical activity (PA). Current methods to evaluate and classify the PA level in the population appear to be limited, as they primarily focus on time spent performing moderate-to-vigorous PA (MVPA). The aim of this article is to analyze the scientific literature in regard to various combinations of patterns among sleep, SB, LIPA, and MVPA, in order to propose a more integrative PA classification in apparently healthy children, adolescents, and adults. In general, the most common classification is composed of four categories that combine MVPA with SB level as follows: i) “physically active” or “physically inactive” (meets or does not meet weekly MVPA recommendations) and ii) “high SB” or “low SB” (depending on amount of accumulated sedentary time per day).There is a consensus regarding the classification of physically active or not, but agreement has not been reached on the classification of a high SB or low SB level. This new, integrative approach appears to be an appropriate methodological proposal for categorizing the level of PA, with the aim of providing health professionals and researchers a more comprehensive vision of PA behaviors among the population.