Top 10 Papers from Ten Years: Physical Activity & Health

Post date: 29-Jul-2015 07:25:54

Round 1: The Nominations

The BMJ recently ran a feature article that listed “twenty top papers to mark The BMJ’s two digital decades” and, for the last few years I have produced a summer reading list for students and visitors to this website so inspired by these ideas I started to think of my own list of the ten most important physical activity and health papers from the last ten years. Although I’ve reduced the timescale, number and field from the BMJ version, I have opened out the publications to include articles from any publication. Choices can be any type of article (eg primary study, systematic reviews, editorials or other) and can be from any field or discipline but must add to the body of knowledge that examines the use of physical activity as a means of improving health.

On this page, you will find my first attempt at creating a shortlist for such an arbitrary collection of articles and I would like to invite readers to make their own nominations over the summer. I then hope to refine the list based on the suggestions and at the end of August create a final list, you never know, I might even put some of the content to a vote as well.

There are plenty of metrics available these days that would allow for a more mechanistic ranking of papers but I suggest that we avoid these in favour of papers that we feel deserve to be in such a list. So, in no particular order…

Nominations for the shortlist

Blair, S. N. (2009). Physical inactivity: the biggest public health problem of the 21st century. British Journal of Sports Medicine, 43(1), 1-2. [www]

The shortest paper on the list, yet one of the most cited due to its clarity in explaining the effect of poor physical fitness on mortality rates.

Waters, L., Reeves, M., Fjeldsoe, B., & Eakin, E. (2012). Control group improvements in physical activity intervention trials and possible explanatory factors: a systematic review. J Phys Act Health, 9(6), 884-895. [www]

One of the challenges of evaluating an intervention is the use of control groups. RCTs are often seen as the gold standard in the scientific world yet physical activity trials struggle to cope with the effect of volunteers for trials being quite likely to change behaviour regardless of being in the intervention or control group. Physical activity behaviour is complex and this paper examines just one of the factors that complicates our interpretation of findings.

Hagger, M. S., & Chatzisarantis, N. L. (2014). An integrated behavior change model for physical activity. Exercise and sport sciences reviews, 42(2), 62-69. [www]

People that exercise regularly are often the most likely to believe that we are all in control of all of our lifestyle choices at all times. Daniel Kahnemann won a nobel prize for his work on dual process theory and this paper reviews the idea that there are two systems at work in deciding what choices we make regarding physical activity.

The Lancet, Physical Activity Working Group Series, July 2012 [www]My one cheat of the list as I am counting a whole issue as one entry in the top ten. The pre-Olympics special series published in the Lancet of July, 2012 contains a number of key articles on surveillance and interventions that are highly cited and very readable. As with several articles on this list, this issue of the Lancet already serves as a staging post in the history of physical activity research. Two of the papers in this issue were…

Hallal, P. C., et al (2012) Global physical activity levels: surveillance progress, pitfalls, and prospects. The Lancet, 380(9838), 247-257.[www]

Kohl, H. al (2012). The pandemic of physical inactivity: global action for public health. The Lancet, 380(9838), 294-305.

Courneya, K. S. (2010). Efficacy, effectiveness, and behavior change trials in exercise research. Int J Behav Nutr Phys Act, 7(1), 81 [ ]

A paper that I have only recently found and I find its low number of citations surprising however, it addresses a number of issues around the development of behaviour change trials with clarity and I will be adding this to a number of reading lists in the next year.

Gaglio, B., Shoup, J. A., & Glasgow, R. E. (2013). The RE-AIM framework: a systematic review of use over time. American Journal of Public Health, 103(6), e38-e46.

The RE-AIM framework has been used extensively to frame analysis of intervention planning and success.

Naci, H., & Ioannidis, J. P. (2013). Comparative effectiveness of exercise and drug interventions on mortality outcomes: meta-epidemiological study. BMJ, 347, f5577

Professor Jeremy Morris suggested that physical activity was the best buy in public health and many have suggested that if it were a pill then it would be one of the most prescribed and successful treatments in the world. This paper examines just that notion.

Pettman, T. L., Armstrong, R., Doyle, J., Burford, B., Anderson, L. M., Hillgrove, T., ... & Waters, E. (2012). Strengthening evaluation to capture the breadth of public health practice: ideal vs. real. Journal of Public Health, 34(1), 151-155.

The challenge of finding a place where good quality research can be done in parallel with the pressures of real-world interventions is one that many have discussed ( eg Yancey & Sallis (2009), Bauman & Nutbeam, 2013). This is a good example of that discussion.

Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., ... & Wood, C. E. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Annals of Behavioral Medicine, 46(1), 81-95.

Over the last few years, Susan Michie and the UCL team have produced a number of key papers and books on their attempts at corralling the various behaviour change theories into a recognisable framework.

Gibala, M. J., Little, J. P., MacDonald, M. J., & Hawley, J. A. (2012). Physiological adaptations to low‐volume, high‐intensity interval training in health and disease. The Journal of Physiology, 590(5), 1077-1084.

HIIT for health has been a strong theme in research over the last ten years with many physiologists exploring the potential benefits of short bursts of high-intensity exercise. Others have then gone on to consider whether HIIT is a realistic proposition for the wider population to engage in (see Biddle and Batterham, 2015)

Greaves, C. J., Sheppard, K. E., Abraham, C., Hardeman, W., Roden, M., Evans, P. H., & Schwarz, P. (2011). Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health, 11(1), 119.

Good science is about testing new and old ideas in a multitude of ways and settings and then periodically reviewing the body of evidence. This review of reviews has covered a large number of studies and systematic reviews.

Bull, F.C., Gauvin, L., Bauman, A.E., Shilton, T., Kohl, H.W. & Salmon, A. (2010) The Toronto Charter for Physical Activity: a global call for action. Journal of Physical Activity & Health. Vol. 7, No. May: 421–422.

The body of evidence that suggests physical activity is beneficial for health is large and fairly conclusive. The physical activity community needs to improve its ability to lobby for policy change and this key paper was an attempt to create a focussed list of actions that might achieve this.

Ekkekakis, P., Parfitt, G., & Petruzzello, S. J. (2011). The pleasure and displeasure people feel when they exercise at different intensities. Sports Medicine, 41(8), 641-671.

It’s clear that there are many health benefits of physical activity but it is less clear how we can best promote physical activity as something for people to engage in. More intrinsic drivers such as pleasure are often ignored in favour of highlighting the long term effects of better health. This article examines the immediate experiences of participants, a topic that has also been examined in older populations by Phoenix and Orr

Malhotra, A., Noakes, T., & Phinney, S. (2015). It is time to bust the myth of physical inactivity and obesity: you cannot outrun a bad diet. British Journal of Sports Medicine, bjsports-2015. [www]

An article that epitomises the challenges of researching fitness, fatness, physical activity and nutrition and the balance between the need for scientific rigour and the need for clarity and consistency in the physical activity message. The responses are worth a read, in particular this one from Kelly et al

In summary, I realise that I can’t commit to ten papers yet. I don’t seem to have used my self-imposed ten year criteria to its maximum effect, I have a bias towards behaviour change papers rather than more biomedical or physiological and the only thing that I am confident about is that there are plenty of important papers that I will have missed out.

I would love to have more suggestions of papers for the list and I will be pestering friends, colleagues and strangers to add their own contributions over coming weeks.

If you can spare a few minutes to add a paper or to comment on my choices then please use the comments box below, tweet me at @benjanefitness or email me at At the end of August I will review the list, and publish an updated version.



July, 2015

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