Differential associations of physical activity and exercise to physical fitness

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. This study used the 2020 Changhua Community-Based Integrated Screening database and included individuals aged 40–64 who participated in both physical fitness tests and GPAQ surveys. A total of 1,631 individuals were included as analysis samples. Exercise behaviors are classified into never, irregular and regular based on the lifestyle records in the screening database. Furthermore, metabolic equivalents were computed using the GPAQ questionnaire, and PA was classified into two groups using a cut-off point of 600. Logistic regression was performed using SAS version 9.4. 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. 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.