Differential associations of physical activity and exercise to physical fitness

Objectives Physical activity (PA) and exercise behavior are important strategies and assessment indicators for health promotion. However, past studies have measured PA and exercise differently, leading to inconsistent and difficult-to-compare results regarding their association with health. To elucidate the relationship between the Global Physical Activity Questionnaire (GPAQ) and self-reported exercise behavior and their association with health outcomes, this study aims to determine which approach reflects more health benefits. Study design A cross-sectional study was conducted using data from the 2020 CHCIS program in Taiwan. Methods A total of 1631 participants aged 40–64 years who completed both physical fitness assessments and the Global Physical Activity Questionnaire (GPAQ) were included. Exercise behavior was categorized as never, irregular, or regular, while physical activity (PA) was classified into two groups based on metabolic equivalents (METs), using a cutoff of 600 MET-minutes per week. Associations with physical fitness outcomes were examined using logistic regression in SAS version 9.4. Results Our findings revealed that individuals who did not engage in exercise demonstrated lower flexibility, while those who exercised regularly but had low PA-METs showed poor muscular endurance. Additionally, individuals who did not exercise and had low PA-METs exhibited poor cardiorespiratory endurance. Conclusions Our study revealed diverse connections between PA, exercise, and physical fitness. When promoting PA, it is suggested to exclude work-related PA and prioritize purposeful PA with adequate intensity, duration, and regularity to maximize the benefits for physical fitness.