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OPEN

A pilot study of a joint outdoor
exercise program for dog owners
and dogs
K. Smedberg 1,9*, E. Lundbeck 1,9, E. Roman 1,2, J. W. Eriksson 3, S. Spörndly‑Nees 4,5,
L. V. Kallings 6,7, A. Bergh 8 & J. Söder 8
Increasing levels of physical inactivity is a global burden for mankind and is also an emerging
problem in companion dogs. In both humans and dogs, insufficient physical activity is associatedwith increased risk for noncommunicable diseases and impaired quality of life (QoL). The aim of thecurrent pilot study was to evaluate effects of a joint outdoor exercise program for dog owners (n = 22)
and dogs (n = 22) with focus on QoL and body measurements. Results indicate that an eight-week
exercise intervention alone, with a target distance of at least 2 km twice a week, may be sufficient tosignificantly increase self-reported QoL and acceptance of bodily appearance in dog owners despite
no reductions in body measurements. In dogs, a significantly reduced body condition score (BCS) was
registered, despite no considerable changes in feeding. The increased owner motivation for continued
joint exercise suggests potential for lifestyle changes, which could be investigated in future studies
including control groups and long-term follow-ups. The importance of the human-animal bond as a
success factor for increased mutual physical activity and health benefits in both dog owners and dogs
is recommended to be studied in a more in-depth manner.
As the world is recovering from the COVID-19 pandemic, the epidemic of physical inactivity remains a global
threat. Insufficient physical activity is classified as the fourth leading risk factor for mortality and constitutes
a well-known risk factor for major noncommunicable diseases such as ischemic heart disease, type 2 diabetes
and colon and breast c­ ancer1–3. Even though evidence for the benefits of physical activity has been available for
decades, 1.4 billion adults (27.5% of the adult population) do not meet the recommendations for physical activity
according to the latest global estimates from ­20164. Insufficient physical activity is also an emerging problem forour companion ­dogs5,6. Even though several studies have shown that dog ownership is associated with higher
levels of physical a­ ctivity6–10, up to 40% of Swedish dogs are overweight and similar numbers have been reported
from other western c­ ountries11–13. As in humans, overweight in dogs is mostly caused by positive energy balance
due to a lack of physical activity or excessive energy ­intake6. The consequences of overweight in dogs mimic theones in humans, with increased risk for metabolic disturbances and chronic d­ iseases14–16.
Apart from the increased risk for noncommunicable diseases, physical inactivity also has negative effects on
mental health and quality of life (QoL)4. Consequently, increased physical activity has been shown to increasemental wellbeing and QoL in h
­ uman17,18. In this respect, it has been argued that physical activity undertaken
outdoors is preferable, since it is associated with greater reductions of stress and depressive symptoms andincreased feelings of revitalization and positive engagement compared to indoor physical a­ ctivity19–21. There is alack of studies on how physical inactivity affects mental wellbeing in dogs, but it has been shown that obesity indogs is associated with a reduction of QoL, which is improved after successful weight l­ oss22.
In 2018, the World Health Organization (WHO) adopted the Global Action Plan on Physical Activity
2018–2030 (the GAPPA recommendations) to provide countries with a framework of effective and feasible
policy actions to increase physical activity at all levels, stressing a strategic combination of “upstream” policy
1

Department of Animal Biosciences, Swedish University of Agricultural Sciences, Uppsala, Sweden. 2Departmentof Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden. 3Department of Medical Sciences,
Uppsala University, Uppsala, Sweden. 4Department of Women’s and Children’s Health, Physiotherapy and
Behavioural Medicine, Uppsala University, Uppsala, Sweden. 5Primary Care and Health, Region Uppsala, Uppsala,Sweden. 6Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences,
Stockholm, Sweden. 7Family Medicine and Preventive Medicine, Department of Public Health and Caring Sciences,
Uppsala University, Uppsala, Sweden. 8Department of Clinical Sciences, Swedish University of Agricultural
Sciences, Uppsala, Sweden. 9These authors contributed equally: K. Smedberg and E. Lundbeck. *email:klara.smedberg@slu.se
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actions and “downstream” individually focused educational and informational ­approaches23. In their first Global
status report on progress of the implementation of GAPPA recommendations, the WHO concluded that implementation so far has been slow and u­ neven24. One recommendation for the way forward that the report offers isto effectively engage nongovernmental actors and the community, and to build capacity in people. All countries
are recommended to “test innovative solutions across diverse contexts”24.
The objective of the current study was to evaluate one such innovative solution; a joint outdoor exercise
program for dog owners and dogs, originally designed by the Swedish Working Dog Association and funded by
the Swedish Outdoor ­Association25, with the aim of increasing outdoor physical activity and improving healthand wellbeing in both parties. One Health approaches to increase physical activity in both dog owners and dogs
have been advocated in previous studies, as dog owners and dogs often have a shared lifestyle and mutual habitsof physical ­activity12,26,27. As Sweden has approximately 800,000 registered dog owners and 1,100,000 ­dogs28, dogowners constitute a considerable target group for strategies to increase physical activity. In the current study,
effects of the joint outdoor exercise program were evaluated on self-assessed physical activity in dog owners,
owner-assessed QoL in dog owners and dogs and on different body measurements in both parties.

Methods

Ethical statement

The study was approved by the Ethics Committee for Animal Experiments, Uppsala, Sweden (Dnr 5.8.1815533/2018) and by the Swedish Ethical Review Authority, Stockholm, Sweden (Dnr 2021-01014). It was conducted in accordance with the Declaration of Helsinki, the guidelines of the Swedish Legislation on Animal
Experimentation (Animal Welfare Act SFS 2018:1192) and the European Union Directive on the Protection ofAnimals Used for Scientific Purposes (Directive 2010/63/EU). Informed written consent was obtained from all
dog owners before entering the study.

Study population

Dog owners
Dog owners were invited to participate in an intervention pilot study with a joint outdoor exercise programwith their dogs, and voluntarily signed up for the study through an internet-based application form distributed
through social media and on the websites of the Swedish Working Dog Association and the Swedish Universityof Agricultural Sciences (SLU). Participants were included on a non-randomized basis based on inclusion andexclusion criteria. The inclusion criteria were age ≥ 18 years and in physical and mental condition allowing
participation at the minimum level in the exercise program. The exclusion criteria included diseases that could
entail a risk when participating in the study, i.e. known ischemic heart disease or heart failure, active malignancy,
type 1 diabetes, chronic pulmonary diseases or severe psychiatric disorders, including alcohol and substanceuse disorders.
Dogs
The inclusion criteria for participating dogs were age ≥ 1 year and in physical condition allowing participation
at the minimum level in the exercise program. The exclusion criteria included known systemic or orthopedic
disease that could entail a risk when participating in the study, or known aggressiveness or timidity that could
affect the ability to be handled by researchers. All dogs participated in the study with their owner or handler.

Study protocol

The overall experimental outline is shown in Fig. 1. Dog owners and dogs participated in an eight-week joint
outdoor exercise program designed by the Swedish Working Dog Association, with the aim of increasing physicalactivity in dog owners and dogs and thereby promoting health and wellbeing in both p­ arties25. Before the startof the intervention, dog owners answered a questionnaire regarding their own self-assessed QoL, and anotherquestionnaire regarding QoL and feeding routines/feeding-related behavior in their dogs. Dog owners werealso asked to assess their own weekly physical activity and daily sedentary time. The same questionnaires wereanswered in the end of the last week of the exercise program (henceforth referred to as “after the intervention”),
with additional questions on perceived overall changes in the assessed perceptions, behaviors or routines in dog
owners and dogs. Both dog owners and dogs underwent body measurements before and after the intervention,and dogs underwent clinical examinations. For dog owners, blood pressure was measured before and after theintervention. All clinical evaluations were conducted in Uppsala, Sweden during August to October 2021.
Joint outdoor exercise program
The eight-week outdoor exercise program included joint jogging and circuit training sessions for dog owners
and dogs. In order to be suitable for most dog owners and dogs, irrespective of previous exercise experience or
physical capacity, four different target jogging levels were available; 2, 5, 7.5 or 10 km. Dog owners individually
selected a suitable target jogging distance for themselves as well as for their dogs, with the goal of reaching theselected distance at the end of the eight week. Jogging sessions were performed twice a week, except for participants in the 10 km group, who performed three jogging sessions per week. Both distance and intensity were
gradually increased throughout the eight weeks. Participants aiming for distances between 2 and 7.5 km were
instructed to alternate between jogging and walking until the very last week of the exercise program. For participants aiming for 10 km, intensity was slowly increased throughout the program through interval sessions with
gradually decreasing resting periods. Circuit training exercises designed for joint performance by dog owners
and dogs were conducted once a week for all participants. Six different exercises were performed at each session;
four strength exercises focusing on leg/hindleg, arms/foreleg, core and neck muscles and two exercises focusing
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QuesonnaireQuesonnaire

QoL, physical acvity,
sedentary me

QoL, behaviors related to QoL,
feeding

Body measurements
Blood pressure

Body measurements
Clinical examinaon

Joint outdoor exercise program

QuesonnaireQuesonnaire

QoL, physical acvity,
sedentary me

QoL, behaviors related to QoL,
feeding

Addional follow-up
quesons

Addional follow-up
quesons

Body measurements
Blood pressure

Body measurements
Clinical examinaon

Figure 1.  Experimental outline of the joint outdoor exercise program for dog owners and dogs. Questionnaires,body measurements and blood pressure were used as outcome measures before and after the intervention.
Additional questions on perceived overall changes were included in the follow-up questionnaires. QoL quality oflife.

on agility and explosive s­ peed29. Time per exercise was gradually increased from 30 to 60 s during the program.
Throughout the exercise program, it was optional to have the dog on or off leash.

Outcome measures

Questionnaires
All questionnaires were designed in the digital software Netigate (Netigate AB, Stockholm, Sweden). A Likert
scale of 1–5 was used in all questionnaires, except for time assessments of physical activity and sedentary behavior
in owners and questions on feeding routines in dogs. The questionnaires were answered before the start of thejoint outdoor exercise program and, as follow-up, in the last week of the program. The follow-up questionnaires
contained additional questions on perceived overall changes in assessed perceptions, behaviors or routines indog owners and dogs. The additional questions were constructed as statements in which dog owners were asked
to evaluate a subjectively perceived change on a Likert scale—for example “I assess my QoL to be better now
compared to before the joint exercise program”, “I assess my dog as more playful now compared to before the joint
exercise program”. All questionnaires regarding dog owners and dogs are included in Supplementary Materials
1 (in Swedish) and in Supplementary Materials 2 (translated into English).
Dog owner questionnaires
The dog owner questionnaires consisted of questions on QoL, physical activity and sedentary time. For QoL
assessments, eleven questions from the questionnaire the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) were u­ sed30. These specific questions were selected since it was hypothesized that theiroutcome could be affected by physical activity, and because their Likert scale had a similar arrangement as theone used in the dog questionnaire (that is, the highest numbers represented “Very good” or “Completely” etc.).
The overall focus of the selected questions was on QoL, enjoyment and energy for everyday life, satisfaction with
one’s health, acceptance for bodily appearance, safety in daily life, opportunities for leisure activities and abilities
to concentrate and get around physically. For assessment of time spent on physical activity per week, two questions designed by the Swedish National Board of Health and ­Welfare31 were used. These questions are used in the
Swedish health care system to identify people that are insufficiently physically active, and for monitoring the level
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www.nature.com/scientificreports/of physical activity post intervention. The questions distinguish between time spent on everyday physical activity,
such as walking or gardening, and time spent exercising. The latter is defined as physical activities resulting inshortness of breath, such as jogging and other sport activities. For everyday physical activity, seven categories
were presented; “0 min”, “ < 30 min”, “30–59 min”, “60–89 min”, “90–149 min”, “150–300 min” and “ > 300 min”.
For exercise, six categories were presented; “0 min”, “ < 30 min”, “30–59 min”, “60–89 min”, “90–120 min”, and“ > 120 min”. For assessment of daily sedentary time (sleep excluded), the stationary single-item question developed by Kallings et al.32 was used. Seven categories were presented, ranging from “Virtually all day”, “13–15 h”,“10–12 h”, “7–9 h”, “4–6 h”, “1–3 h” to “Never”. The follow-up questionnaire contained two additional questions;one on perceived overall changes of QoL and one on motivation to exercise together with the dog. The follow-up
questions were created by the authors of this study.
Dog questionnaires
The dog questionnaires consisted of three sections, which in all contained eleven question blocks. The first section
consisted of one question block with three questions on overall QoL in dogs, created by the authors of this study
with inspiration from questionnaires developed by W
­ HO30 and L­ avan33. In this section, dog owners were asked
to evaluate three statements: “My dog has more good days than bad days”, “My dog likes its life” and “My dog has
a good QoL” on a Likert scale from 1 (“totally disagree”) to 5 (“totally agree”). At follow-up, this section had one
additional question on perceived overall changes in QoL, created by the authors of this study. The second section
consisted of nine questions block with in total 76 questions assessing different canine behaviors related to QoL.
The included blocks were "Exercise and obedience", "Fear and anxiety", "Curiosity", "Tendency to get excited oragitated", "Affection and contact-seeking", "Playfulness", "Social contact", "Passivity, rest and sleep" and "Vitality,
activity and movement". The vast majority of the questions in this section was based on the Canine Behavioral
Assessment and Research Questionnaire (C-BARQ) developed by Hsu and ­Serpell34, with slight modifications.
Since known aggressiveness was an exclusion criterion for dogs participating in the study, C-BARQ-questions
regarding aggression were omitted. In order to get a more comprehensive coverage of behaviors related to rest andactivity, 16 questions in the blocks "Passivity, rest and sleep" and "Vitality, activity and movement" were designedby the authors. Inspiration was taken from questionnaires developed by Lavan (2013) regarding happiness andphysical ­functioning33 and by German et al. (2012) regarding v­ itality22. At follow-up, all these question blocks
had one additional question each on perceived overall changes within each behavior block, except for the block“Vitality, activity and movement” which had two additional questions; one on perceived subjective changes
in vitality and one on perceived subjective changes in cardio fitness in the dog. The follow-up questions werecreated by the authors of this study, and consisted of statements that dog owners were asked to evaluate, suchas “I assess my dog’s cardio fitness to be better now compared to before the joint exercise program”. The third
section consisted of one question block with seven questions on feeding habits and feeding-related behaviors,such as tendency to beg for food. These questions were created by the authors with inspiration from questionnaires developed by Lavan (2013) regarding a­ ppetite33. At follow-up, this section had one additional question on
perceived subjective overall changes in the dog’s appetite. This question was created by the authors of this study.

Body measurements and blood pressure

Dog owners
Height was measured to the nearest mm with a seca 123 stadiometer (seca GmbH & Co., Hamburg, Germany),
with the head positioned in a Frankfort plane with the lower eye socket in horizontal level with the upper ear­canal35. Bodyweight was measured to the nearest hg with a Kruuse Scale 250 digital veterinary scale (Jørgen
Kruuse A/S Langeskov, Denmark). Body mass index (BMI) was calculated as described by W
­ HO36 by dividing
2
body weight (kg) by height (m) squared. A BMI range of 18.5 to < 25 kg/m was considered normal, ≥ 25 to < 30
as overweight and ≥ 30 as ­obesity36. Waist-hip ratio (WHR) was calculated as described by ­WHO37 by dividing
mean waist circumference (cm) by mean hip circumference (cm). Waist and hip circumferences were measured
in triplicates to the nearest 0.5 cm with a measurement tape; for waist at the midpoint between the lower marginof the lowest palpable rib and the top of the iliac crest, and for hip at the widest portion of the ­buttocks37. Bothmeasurements were conducted during end of expiration with the subject standing with feet close together andarms at the sides. Means from triplicate measurements of waist and hip circumference were used for calculations.
Blood pressure was measured with a sphygmomanometer for manual readings with a cuff size of 12 × 35 cm(Welch Allyn, Skaneateles Falls, New York, U.S.) on the owners’ right arm after 5 min of resting in sitting position. Values < 130/85 mm Hg were considered n­ ormal38,39.
Dogs
Body condition score (BCS) of dogs was assessed by a veterinarian with specific expertise. Assessments were
performed by observation and palpation of areas over the ribs, waist and abdominal line, according to guidelines
from the World Small Animal Veterinary Association (WSAVA) based on the 9-point BCS scale validated by­Laflamme40. According to this scale, a BCS of 1–3 represents underweight, 4–5 ideal weight, 6 slight overweight,
7 overweight and 8–9 represent obesity. Further, a clinical examination with specific focus on orthopedic status
was performed by a veterinarian.

Data processing and statistical analyses

In this study, quantitative data were generated from body measurements and questionnaires. Microsoft Excel,
SAS (SAS 9.4 Institute Inc., Cary, NC), and GraphPad Prism (GraphPad Prism 5.0 San Diego, CA) were used fordata processing, statistical analyses and creation of figures. Data from participants that cancelled or dropped out
during intervention was excluded. D’Agostino-Pearson omnibus normality test was used for testing of normal
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distribution of data, except in the mixed model repeated measures analyses where visual assessment of residuals was used. All data were normally distributed except for data on exercise time before the intervention andeveryday physical activity after the intervention. Results are presented as mean value ± standard deviation (SD)or median and range (min–max), except for visualization of data in Figs. 2 and 3 where standard error of mean
(SEM) was used. Paired analyses were two-tailed. Threshold for statistical significance was set to P < 0.05 in all
analyses.
Data processing of “everyday physical activity”, “exercise” and “sedentary behavior”
For calculation of time spent in everyday physical activity, exercise and sedentary behavior, the middle value
in the time interval for each answer category was used. Hence, for everyday physical activity and exercise, themiddle value for “ < 30 min” was set to 15 min, the middle value for “30–59 min” to 45 min, etc. “0 min” counted
as 0 min, “ > 300 min” as 300 min and “ > 120 min” as 120 min. For sedentary time, “Virtually all day” counted
as 15 h and “Never” as 0 h. For calculations of proportion of dog owners fulfilling global recommendations forphysical activity, WHO recommendations for adults aged 18–64 were used; at least 150–300 min of moderateintensity aerobic physical activity; or at least 75–150 min of vigorous-intensity aerobic physical activity; or anequivalent combination of moderate- and vigorous-intensity activity throughout the w­ eek41. Everyday physicalactivity was here equated with moderate-intensity aerobic physical activity as defined by ­WHO41, and exercise
was equated with vigorous-intensity aerobic physical ­activity41. An “equivalent combination” of moderate- andvigorous-intensity activity was equated with total physical activity load (also called “activity minutes”) per week,
as described by Olsson et al.42. For calculation of total physical activity load (“activity minutes”), time spent
exercising was multiplied by two to account for the proposed higher intensity and summed with the time spentin everyday physical a­ ctivity31.
Paired statistical analyses and linear regressions
Wilcoxon matched-pairs signed rank test was used for comparisons of total physical activity load, everyday physical activity, exercise and sedentary time for the whole cohort of dog owners before and after the joint exercise
program as all measurements were not normally distributed. A paired t-test was used for pre–post comparisonsof blood pressure, waist and hip measurements as well as waist-hip ratio for the whole cohort of dog owners.
Feeding routines and feeding-related behavior for the whole cohort of dogs was also analysed with a paired
t-test. Associations between BMI in dog owners and BCS in their dogs were investigated with linear regressions.
Mixed model repeated measures analyses
For mixed model repeated measures analyses, data from participants were divided into two groups based on
selected target distance: 2 km and 5–10 km. Mixed model repeated measures analyses were used for comparisonsof QoL in dog owners and dogs, BMI and BCS as well as behaviors related to QoL in dogs. These comparisonswere made for the whole cohort of dog owners and dogs before and after the intervention, as well as between
groups (2 km and 5–10 km) and pairwise comparisons both before and after the intervention and between groups(interactions). Tukey–Kramer adjustments were used to correct for multiple comparisons in the mixed model.
Descriptive statistics
Data from additional questions on overall perceived changes after the intervention in the follow-up questionnaires (Fig. 1) were analyzed by descriptive statistics for the whole cohort of dog owners and dogs respectively.
A mean value greater than 3 on the five-point Likert scale was interpreted as a perception of overall change.

Results

Study population

A total of 35 pairs signed up for the study. Six pairs cancelled after completing the baseline questionnaires, andan additional seven pairs dropped out during the exercise intervention. The remaining 22 pairs completed thewhole study. Ten participants had a temporary break at some point during the joint exercise program, of which
seven participants stated that the break was due to lighter injury or illness in themselves or their dog. Eight dog
owners selected the target jogging distance 2 km and 14 dog owners selected a distance of 5–10 km. In the lattergroup, nine participants selected the distance of 5 km, four selected 7.5 km and one selected 10 km.
Dog owners
The mean age of the participants was 45 ± 12 years. Before the intervention, BMI ranged from underweight
to obesity (16.5–33.2) according to the categorization by W
­ HO36. Distribution of dog owner BMI is shown in
Table 1.
Dogs
Dogs of 17 different breeds participated in the study. The mean age of dogs was 5 ± 3 years. On the 9-point BCS
scale, dogs ranged from 3–7 (median 5) before the joint exercise program, i.e. slightly underweight to overweight.
Distribution of BSC in dogs is shown in Table 1. Three dogs were included despite having owner-reported healthissues such as mild joint disease, well-controlled hypothyroidism or allergy, as they were assessed by the examining veterinarian to be in a condition allowing participation in the study. No remarks associated with the exercise
program were registered after the intervention.

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Dog owner data

Total number (n)Proportion (%)

GenderFemales

19

86

Males

3

14

Other

0

0

Age
18–30 years

418

31–50 years

836> 50 years

10

45

BMI
< 18.51

5

18.5 – < 25

1150

≥ 25 – < 30

3

14

≥ 30

7

32

Dog data

Total number (n)Proportion (%)

Sex
Intact females

732

Intact males

732

Neutered females

4

18

Neutered males

4

18

Age
1–3 years

836

4–7 years

941> 8 years

5

23

BCS
1–3

1

5

4–5

14

64

6

6

27

7

1

5

8–9

0

0

Table 1.  Baseline characteristics of participating dog owners (n = 22) and dogs (n = 22). BMI, body massindex, BCS body condition score.

Outcome measures

Dog owner‑assessed physical activity and sedentary time
There was a significant increase of both total physical activity load (“activity minutes”) and time spent on exercise
in dog owners after the intervention compared to before, and a significant decrease of sedentary time (Table 2).
After the intervention, all dog owners fulfilled global recommendations of a total physical activity load of atleast 150 min per week (Table 3).
Quality of life in dog owners and dogs
Data for QoL of dog owners and dogs is presented in Fig. 2. A significantly increased (P = 0.02) QoL in all
dog owners was registered after the intervention (4.1 ± 0.7) compared to before (3.9 ± 0.6), a change that was
driven by the 2 km group (P = 0.04). This improvement was supported by the mean of the additional followup question on perceived overall changes after the intervention (3.4 ± 1.3). Owner-assessed QoL in dogs wasconstantly high and did not change after the intervention (4.7 ± 0.5 versus 4.7 ± 0.5, P = 0.95). Neither was there
any pre–post changes (P ≥ 0.83) in QoL in dogs within the two target distance groups. However, the additional

Dog owner-assessed physical activity and sedentary time

Before Mean/Median (Range)

After Mean/Median (Range)

P-value

Total physical activity load/”activity minutes” (minutes per week)

357/368 (105–540)

423/443 (225–540)

0.008

Everyday physical activity (minutes per week)

238/300 (75–300)

252/300 (75–300)

0.555

Exercise (minutes per week)

59/60 (0–120)

86/105 (0–120)

0.001

Sedentary time (hours per day)7.5/6.5 (2–14)

6.1/5 (2–11)

0.039

Table 2.  Dog owner-assessed physical activity and sedentary time before and after the exercise intervention
for dog owners (n = 22).

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Descriptive statistics of dog owner-fulfilment of global recommendations of physical activity

Before proportion (%)

After proportion (%)

150 min of total physical activity load/”activity minutes” per week

91

100

150 min of moderate-intensity aerobic physical activity per week

77

82

75 min of exercise vigorous-intensity aerobic physical activity per week

50

73

Table 3.  Proportion of dog owners (n = 22) fulfilling global ­recommendations41 for total physical activity
load/”activity minutes”, moderate-intensity aerobic physical activity and vigorous-intensity aerobic physicalactivity before and after the intervention.

Figure 2.  Line graph showing owner-assessed QoL in dog owners and dogs before and after the exercise
intervention. A mixed model repeated measures analysis was used based on the two target distance groups;
2 km (n = 8) and 5–10 km (n = 14). Filled symbols represent mean ± SEM for owners for the two target distancegroups and unfilled symbols represent the corresponding for dogs. The star (*) represents significant results forthe whole cohort of owners and within group, respectively (P < 0.05). QoL quality of life.

follow-up question on overall changes in QoL of dogs indicated a perceived partial improvement of QoL after
the intervention (3.4 ± 1.3).
Behaviors related to quality of life in dogs
There was no significant difference in behaviors related to QoL in the whole cohort of dogs after the intervention
compared to before (P ≥ 0.10) in any of the nine question blocks (Supplementary Material 3). Neither was there
any pre–post difference within the two target distance groups in any in the blocks, respectively (P ≥ 0.27). For
eight of the nine question blocks, no overall changes in behaviors were perceived according to the additional
follow-up questions. However, for the follow-up question on cardio fitness in the block “Vitality, activity andmovement” a mean of 3.4 ± 1.5 was registered, indicating that dog owners did experience a partial improvementof cardio fitness in their dogs.
Dog owner motivation for joint exercise with their dog and self‑acceptance of bodily appearances
A majority of owners (86%, n = 19) stated that their motivation for joint exercise with their dog had increased
after the intervention, according to the additional follow-up question on motivation (4.1 ± 1.2). Ten respondents
registered the maximal score of 5 for this question (“I totally agree”), and nine registered the number 4 (“I agree
partially”). In the questionnaire on dog owner QoL, the question on self-acceptance of bodily appearances stoodout, showing a significant increase (P = 0.03) in all dog owners after the intervention (3.5 ± 1.4) compared tobefore (3.1 ± 1.2). Forty-one percent of dog owners (n = 9) stated that their self-acceptance of bodily appearances
had increased by choosing a higher score after the intervention.

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c

b

27.0

0.89

26.0

0.88

25.0
24.0
23.0

6.0
5.8

Body condition score (BCS 1-9)

0.90

Waist-hip ratio

Body mass index (BMI)

a

28.0

0.87
0.86
0.85

22.0

BMI owner (2 km)

0.84

Waist-hip ratio owner (2 km)

BMI owner (5-10 km)
1

2

Before

After

5.6
5.4
5.2
5.0
4.8
4.6

**

4.4
4.2

BCS dog (2 km)
BCS dog (5-10 km)

Waist-hip ratio owner (5-10 km)
1

Before

2

After

1

Before2

AfterFigure 3.  Line graphs showing (a) BMI in owners, (b) waist-hip ratio in owners and (c) BCS in dogs, before
and after the intervention. A mixed model repeated measures analysis was used based on the two target distancegroups; 2 km (n = 8) and 5–10 km (n = 14). Filled symbols represent mean ± SEM for dog owners and unfilled
symbols represent the corresponding for dogs. Stars (**) represent significant results for the whole cohort ofdogs (P < 0.01).
Feeding routines and feeding‑related behavior in dogs
No considerable changes were registered regarding feeding frequency, administered amount of feed or ownerassessed fullness after feeding after the intervention in comparison to before (Supplementary Material 3). Neither
was there a significant change (P = 0.54) in the question block for feeding-related behaviors (such as appetite,tendency to steal or beg for food) after the intervention (3.5 ± 0.6) compared to before (3.4 ± 0.7), and no overallchange in appetite was perceived according to the mean (2.1 ± 1.5) of the additional follow-up question in thissection.
Body measurements in dog owners and dogs
Body mass index and waist-hip ratio in dog owners are shown in Fig. 3a,b. There was no significant change in
BMI in all dog owners after the intervention (25.1 ± 4.6) compared to before (25.3 ± 4.7, P = 0.56), nor within
the two target distance groups after compared to before the intervention, respectively (P ≥ 0.10). Neither were
there any significant changes in waist-hip ratio in all dog owners after the intervention (0.87 ± 0.1) compared
to before (0.87 ± 0.1, P = 1), nor in waist or hip circumferences (Supplementary Material 3). There were no significant pre–post changes within the two target distance groups for waist/hip measurements or ratio (P ≥ 0.27).
Body condition score in dogs is shown in Fig. 3c. A significantly reduced BCS (P = 0.008) in all dogs was
registered after the intervention (4.7 ± 0.6) compared to before (5.1 ± 0.9.) There were no significant pre–post differences in BCS within the two target distance groups (P ≥ 0.12). Post-intervention BCS scores ranged from 4–6(median 5), implicating that no dogs were longer scored as either underweight (BCS ≤ 3) or overweight (BCS 7)
after the exercise program. There was no association between BMI in dog owners and BCS in their dogs, neither
before the intervention nor after (P ≥ 0.37).
Blood pressure in dog owners
Systolic and diastolic blood pressure data for dog owners is presented in Supplementary Material 3. Mean values were below the defined cut-off for normal values both before and after the intervention, with no significant
pre–post changes. Three dog owners reported that they were under medical treatment for hypertonia.

Discussion

This unique pilot study of a joint outdoor exercise program for dog owners and their dogs showed that QoL in
dog owners significantly increased and that BCS of dogs significantly decreased after the intervention. No changes
in body measurements or blood pressure were registered in dog owners, but owner motivation for exercising
together with their dog, as well as their self-acceptance for bodily appearances increased after the intervention.
Significant increases in self-assessed weekly total physical activity load and vigorous-intensity aerobic physical activity were registered by dog owners after the intervention, resulting in a 100% fulfilment of WHO global
recommendations of physical activity from 2­ 02041. Moreover, daily sedentary time was significantly decreased.
Taken together, this indicates that the intervention increased physical activity in dog owners, which was statedby the Swedish Working Dog Association as one of the aims of the joint outdoor exercise p­ rogram25. It should
be noted that 91% of the dog owners fulfilled the recommendations for total physical activity load even before
the intervention, which is in line with previous studies showing an association between dog ownership andhigher levels of physical ­activity7–10, as the corresponding proportion for the Swedish population in 2021 was
67%43. No assessments of physical activity time in dogs were made, but the decrease in BCS in combination
with the owner-perceived improvement in cardio fitness in dogs indicate that the exercise program did resultin a corresponding increase of physical activity in dogs. Whether the current exercise program may constitutea sustainable way to increase physical activity time in dogs should be explore further, since previous research

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have indicated that lack of exercise is an emerging problem for our companion d­ ogs5,26,44 and as such, successful
strategies to increase their physical activity are warranted.
A significantly increased QoL was registered in all dog owners after the intervention, which supports previous
research on the effect of physical activity on Q
­ oL17,18,45. It is also in line with previous findings on the positiveeffects of outdoor physical activity on different aspects of mental w­ ellbeing19–21. The improvement in QoL in thecurrent study was driven by participants who selected the shortest target distance (2 km), indicating that jogging even short distances on a regular basis can be beneficial for self-perceived wellbeing and that a joint active
lifestyle should be encouraged even for people unable to exercise at a higher level. No changes were registeredin overall QoL in dogs, nor in canine behaviors related to QoL. However, according to the additional follow-up
question on perceived changes after the intervention, a slight improvement in QoL in dogs was still experienced.
A novel aspect of the present study was that it did not focus on QoL in primarily overweight or obese dogs, as
opposed to previous r­ esearch22,46. In fact, 14 out of the 22 participating dogs in the present study were assessed as
ideal weight (BCS 4–5) at the onset of the intervention. Thus, our results do not exclude the possibility that evennormal weight dogs may benefit both physically and mentally from physical exercise, but that the questionnaires
could not detect any subtle changes. In addition, a high owner-assessed overall QoL was registered for the dog
population before the exercise intervention, leaving little room for improvement.
There were no significant changes in dog owner BMI or waist-hip ratio after the exercise intervention, neither for the whole cohort of owners nor on group level (2 km versus 5–10 km). It is noteworthy that an increasein acceptance for bodily appearances still was registered by 44% of dog owners, despite absence of changes inobjectively assessed body measurements. It is possible that an impedance scale could have identified changes
in body composition that were not detected with tape measurements or BMI calculations. However, it has beensuggested that pronounced effects on body composition are not to be expected from exercise interventions
without caloric r­ estrictions47–49. Even so, there are contrasting studies that do in fact show substantial reductionsof BMI and other body measurements as a result of isolated exercise i­ nterventions50–52. However, these studies
are generally based on obese populations and exercise interventions lasting 12–14 weeks. At the outset of thepresent study, participants ranged from underweight to obesity with a mean BMI of 25.3 ± 4.7, therefore making
a significant reduction of BMI on cohort level less likely. Also, the intervention lasted only eight weeks, which
may be too short a period for effects on BMI to be expected. Mean blood pressure in dog owners was below thedefined cut-off for normal values, both before and after the intervention, and showed no significant pre–postchanges. According to previous research, physical activity does not have pronounced effects on blood pressure
in normotensive i­ndividuals48,53, and thus a significant reduction of blood pressure on cohort level should not
be expected in the present study.
In dogs, a significantly decreased BCS was registered, despite no considerable reported changes in feeding
frequency or administered amount of feed. Here, it should be noted that assessment of body composition, BMI in
humans and BCS in dogs, differ widely; while BMI is calculated from length and body w­ eight36, BCS assessment
is exclusively based on palpatory and visual hallmarks associated to total body fat c­ ontent40. After the intervention, a majority of dogs were assessed as normal weight (BCS 4–5). Only two dogs were still assessed as slightly
overweight (BCS 6) and no dog was assessed as overweight (BCS 7). In a previous three months’ intervention
where overweight dogs were prescribed at least 30 min of daily exercise together with their owner, BCS decreased­significantly14. However, other studies have concluded that physical activity as a tool for weight reduction indogs has a non-significant effect on BCS compared to the effect of caloric r­ estriction16,54. The positive result in
the current study of a decreased BCS as an outcome of exercise without caloric restriction in slightly overweightdogs should be investigated further. Research including merely slightly overweight dogs currently is scarce, but
studies by Lindåse et al. and Gille et al.11,13 indicate a high prevalence of slightly overweight individuals in the
Swedish dog population, highlighting the need to include dogs from different weight categories in future studies.
There is another aspect to consider in the broader perspective. In general, standardized exercise programs
used in research are designed to study the effects of physical activity on specific anthropometric and physiological­variables47–50. In contrast, the joint exercise program from the Swedish Working Dog Association was originallydesigned to increase outdoor physical activity in dog owners and dogs, thereby improving health and wellbeing
and promoting sustainable lifestyle changes in both p­ arties25. In the current study, a vast majority (86%) of thedog owners stated that their motivation for joint exercise with their dog had increased after the intervention,suggesting a possible prospect of such lifestyle changes. As an active lifestyle has been shown to be positively
associated with healthier dietary h­ abits55–58, continued joint exercise might result in synergistic positive effects
on overall health in a longer perspective. The specific reasons behind the increase in dog owner motivation forjoint exercise are unknown, but might be due to the sense of companionship, support and security that the dog
provided during the exercise sessions. It has previously been shown that the social support from a dog can aid
in mutual weight loss programs for dog owners and d­ ogs12,27. This points at the importance of considering thehuman-animal bond, a term defined as “the mutually beneficial and dynamic relationship between people andother animals that is influenced by behaviors that are essential to the health and wellbeing of both”59, in healthresearch in humans and companion dogs. In addition, dog owners might have experienced exercise-induced
health benefits in their dogs, i.e. ideal BCS, which they wish to maintain by continued joint physical activity. The
increased QoL and self-acceptance for bodily appearances in owners may also be a ground for the strong motivation to continue to exercise with the ­dog60, and is in line with previous studies noticing a positive assessment of
oneself as an effect of physical e­ xercise61–63. Moreover, the fact that the joint exercise program was undertaken
outdoors may be of relevance as Thompson Coon et al.21 has reported that motivation for repeated exercise isgreater for outdoor physical activity compared to indoor activity.

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Study limitations

In the present pilot study, participating dog owners and dogs acted as their own controls, and the study wasable to detect significant changes in QoL in owners and BCS in dogs comparing results from the eighth weeks’intervention with base line. However, in future studies of joint dog owner-dog exercise, it is recommended toinclude both negative controls (dog owners and dogs) that do not take part in the exercise program and controls (humans) that take part in the exercise program but without dogs. Such set up could further deepen thefindings and might also result in additional data on factors that may stimulate physical activity. All questionsin the questionnaires were not validated, and a relatively low number of participants was included in this study.
For future research, a larger number of participants is recommended, in order to detect changes that might nothave been possible to identify in this study. Moreover, as dog owners voluntarily signed up for the joint exercise
program, it cannot be excluded that the participants were more physically active and more motivated to exercise
with their dog compared to the average dog owner even at the outset of the study. However, the high number ofparticipants selecting the 2 km target distance might indicate that many in fact were not particularly physically
active on a high level at the outset of the study. Moreover, there was no long-term follow up. This should be
included in future studies, especially since the current study showed promising results regarding motivation forcontinued joint dog owner-dog exercise.

Conclusions

This joint outdoor exercise program showed health benefits of a shared active lifestyle for both dog owners anddogs. The study indicates that an eight-week exercise intervention alone, with a target distance of at least 2 km
twice a week, may be sufficient to significantly increase QoL and acceptance of bodily appearance in dog owners
and change slightly overweight dogs into an ideal body condition. The increased motivation for continued joint
exercise may suggest potential for long-term lifestyle changes. The importance of the human-animal bond as a
success factor for increased mutual physical activity and health benefits in both dog owners and dogs is recommended to be studied in a more in-depth manner in future studies.

Data availability

The authors confirm that the data supporting the findings of this study is available within the article and its
supplementary material, with the exception of dog owner raw data, since it contains information that may
compromise the privacy of participating dog owners. This raw data is stored on local servers at the Universityof Agricultural Sciences, Uppsala, Sweden and is available in de-identified form from the corresponding author
upon reasonable request.
Received: 28 June 2023; Accepted: 17 June 2024

References

1. Kohl, H. W. et al. The pandemic of physical inactivity: Global action for public health. Lancet 380, 294–305. https://​doi.​org/​10.​1016/​s0140-​6736(12)​60898-8 (2012).
2. Ding, D. et al. The economic burden of physical inactivity: A global analysis of major non-communicable diseases. Lancet 388,
1311–1324. https://​doi.​org/​10.​1016/​s0140-​6736(16)​30383-x (2016).
3. Lee, I. M. et al. Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease andlife expectancy. Lancet 380, 219–229. https://​doi.​org/​10.​1016/​s0140-​6736(12)​61031-9 (2012).
4. Guthold, R., Stevens, G. A., Riley, L. M. & Bull, F. C. Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled
analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob. Health 6, e1077–e1086. https://​doi.​org/​10.​1016/​s2214-​109x(18)​30357-7 (2018).
5. Bland, I. M., Guthrie-Jones, A., Taylor, R. D. & Hill, J. Dog obesity: Owner attitudes and behaviour. Prev. Vet. Med. 92, 333–340.
https://​doi.​org/​10.​1016/j.​preve​tmed.​2009.​08.​016 (2009).
6. Bland, I. M., Guthrie-Jones, A., Taylor, R. D. & Hill, J. Dog obesity: Veterinary practices’ and owners’ opinions on cause andmanagement. Prev. Vet. Med. 94, 310–315. https://​doi.​org/​10.​1016/j.​preve​tmed.​2010.​01.​013 (2010).
7. Ballin, M., Antonsson, O., Rosenqvist, V., Nordström, P. & Nordström, A. Association of dog ownership with accelerometermeasured physical activity and daily steps in 70-year-old individuals: A population-based cross-sectional study. BMC Public Healthhttps://​doi.​org/​10.​1186/​s12889-​021-​12401-4 (2021).
8. Christian, H. E. et al. Dog ownership and physical activity: A review of the evidence. J. Phys. Act. Health 10, 750–759. https://​doi.​
org/​10.​1123/​jpah.​10.5.​750 (2013).
9. Hielscher-Zdzieblik, B., Ganslosser, U., Serpell, J. & Froboese, I. The long-term influence of puppy acquisition on physical activity:
Results of a 3-year, longitudinal, pilot study. Healthcare 10, 16. https://​doi.​org/​10.​3390/​healt​hcare​10091​687 (2022).
10. Westgarth, C. et al. Dog owners are more likely to meet physical activity guidelines than people without a dog: An investigation of
the association between dog ownership and physical activity levels in a UK community. Sci. Rep. https://​doi.​org/​10.​1038/​s41598-​
019-​41254-6 (2019).
11. Lindåse, S., Feltenmark, T., Krantz, M. & Söder, J. Overweight in Swedish show dogs–prevalence and association with performancein competition. Acta Vet. Scand. https://​doi.​org/​10.​1186/​s13028-​021-​00582-2 (2021).
12. Niese, J. R. et al. Evaluating the potential benefit of a combined weight loss program in dogs and their owners. Front. Vet. Sci.
https://​doi.​org/​10.​3389/​fvets.​2021.​653920 (2021).
13. Gille, S. et al. Dog owners’ perceptions of canine body composition and effect of standardized education for dog owners on body
condition assessment of their own dogs. Vet. Sci. 10, 447. https://​doi.​org/​10.​3390/​vetsc​i1007​0447 (2023).
14. Lawler, D. F. et al. Diet restriction and ageing in the dog: Major observations over two decades. Br. J. Nutr. 99, 793–805. https://​doi.​org/​10.​1017/​s0007​11450​78716​86 (2008).
15. Söder, J. et al. Indication of metabolic inflexibility to food intake in spontaneously overweight Labrador Retriever dogs. BMC Vet.
Res. https://​doi.​org/​10.​1186/​s12917-​019-​1845-5 (2019).
16. Vitger, A. D., Stallknecht, B. M., Nielsen, D. H. & Bjornvad, C. R. Integration of a physical training program in a weight loss planfor overweight pet dogs. J. Am. Vet. Med. Assoc. 248, 174–182. https://​doi.​org/​10.​2460/​javma.​248.2.​174 (2016).

Scientific Reports |Vol:.(1234567890)(2024) 14:14321 |https://doi.org/10.1038/s41598-024-65033-0

10www.nature.com/scientificreports/
17. Gillison, F. B., Skevington, S. M., Sato, A., Standage, M. & Evangelidou, S. The effects of exercise interventions on quality of life inclinical and healthy populations; a meta-analysis. Soc. Sci. Med. 68, 1700–1710. https://​doi.​org/​10.​1016/j.​socsc​imed.​2009.​02.​028(2009).
18. Marquez, D. X. et al. A systematic review of physical activity and quality of life and well-being. Transl. Behav. Med. 10, 1098–1109.
https://​doi.​org/​10.​1093/​tbm/​ibz198 (2020).
19. Coventry, P. A. et al. Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis. SSM
Popul. Health. 16, 100934. https://​doi.​org/​10.​1016/j.​ssmph.​2021.​100934 (2021).
20. Kajosaari, A. & Pasanen, T. P. Restorative benefits of everyday green exercise: A spatial approach. Landsc. Urban Plan. 206, 103978.
https://​doi.​org/​10.​1016/j.​landu​rbplan.​2020.​103978 (2021).
21. Thompson Coon, J. et al. Does participating in physical activity in outdoor natural environments have a greater effect on physicaland mental wellbeing than physical activity indoors? A systematic review. Environ. Sci. Technol. 45, 1761–1772. https://​doi.​org/​
10.​1021/​es102​947t (2011).
22. German, A. J. et al. Quality of life is reduced in obese dogs but improves after successful weight loss. Vet. J. 192, 428–434. https://​doi.​org/​10.​1016/j.​tvjl.​2011.​09.​015 (2012).
23. World Health Organization. Global action plan on physical activity 2018–2030: more active people for a healthier world. https://​apps.​who.​int/​iris/​handle/​10665/​272722 (Accessed 01 June 2023).
24. World Health Organization. Global status report on physical activity 2022. https://​www.​who.​int/​teams/​health-​promo​tion/​physi​
cal-​activ​ity/​global-​status-​report-​on-​physi​cal-​activ​ity-​2022 (Accessed 01 June 2023).
25. Swedish Working Dog Association. Upp och hoppa - sund med hund. https://b​ ruksh​ undkl​ ubben.s​ e/u​ tbild​ ning-a​ ktivi​ tet/u​ pp-o​ ch-​
hoppa/​proje​ktet/ (Accessed 01 June 2023).
26. Banton, S., von Massow, M., Pezzali, J. G., Verbrugghe, A. & Shoveller, A. K. Jog with your dog: Dog owner exercise routines predict
dog exercise routines and perception of ideal body weight. Plos One 17, e0272299. https://​doi.​org/​10.​1371/​journ​al.​pone.​02722​99(2022).
27. Kushner, R. F., Blatner, D. J., Jewell, D. E. & Rudloff, K. The PPET study: People and pets exercising together*. Obesity. 14,
1762–1770. https://​doi.​org/​10.​1038/​oby.​2006.​203 (2006).
28. The Swedish Board of Agriculture. Statistics from the dog register. Available online: https://​jordb​ruksv​erket.​se/e-​tjans​ter-​datab​
aser-​och-​appar/e-​tjans​ter-​och-​datab​aser-​djur/​hundr​egist​ret/​stati​stik-​ur-​hundr​egist​ret (Accessed 01 June 2023).
29. The Swedish Working Dog Association. Video gallery. https://​bruks​hundk​lubben.​se/​utbil​dning-​aktiv​itet/​video​galle​ri/​10414(Accessed 01 June 2023).
30. World Health Organization. WHOQOL: Measuring Quality of Life. https://​www.​who.​int/​tools/​whoqol/​whoqol-​bref (Accessed
01 June 2023).
31. The Swedish National Board of Health and Welfare. Disease Prevention in the Swedish Healthcare System: Health situation,national guidelines and implementation, Indicators, Appendix. https://​www.​socia​lstyr​elsen.​se/​globa​lasse​ts/​share​point-​dokum​
ent/​artik​elkat​alog/​natio​nella-​riktl​injer/​2018-6-​24.​pdf (Accessed 01 June 2023).
32. Kallings, L. V., Olsson, S. J. G., Ekblom, Ö., Ekblom-Bak, E. & Börjesson, M. The SED-GIH: A single-item question for assessmentof stationary behavior—A study of concurrent and convergent validity. Int. J. Environ. Res. Public Health 16, 4766. https://​doi.​org/​
10.​3390/​ijerp​h1623​4766 (2019).
33. Lavan, R. P. Development and validation of a survey for quality of life assessment by owners of healthy dogs. Vet. J. 197, 578–582.
https://​doi.​org/​10.​1016/j.​tvjl.​2013.​03.​021 (2013).
34. Hsu, Y. & Serpell, J. A. Development and validation of a questionnaire for measuring behavior and temperament traits in pet dogs.
J. Am. Vet. Med. Assoc. 223, 1293–1300. https://​doi.​org/​10.​2460/​javma.​2003.​223.​1293 (2003).
35. Madden, A. M. & Smith, S. Body composition and morphological assessment of nutritional status in adults: A review of anthropometric variables. J. Hum. Nutr. Diet. 29, 7–25. https://​doi.​org/​10.​1111/​jhn.​12278 (2016).
36. World Health Organization, Expert Committee. Physical status: the use and interpretation of anthropometry. https://​apps.​who.​
int/​iris/​handle/​10665/​37003 (Accessed 01 June 2023).
37. World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, Switzerland,
8–11 December 2008. Available online: https://​www.​who.​int/​publi​catio​ns/i/​item/​97892​41501​491 (Accessed 01 June 2023).
38. Unger, T. et al. 2020 International society of hypertension global hypertension practice guidelines. Hypertension 75, 1334–1357.
https://​doi.​org/​10.​1161/​hyper​tensi​onaha.​120.​15026 (2020).
39. Muntner, P. et al. Measurement of blood pressure in humans: A scientific statement from the American Heart Association. Hyper‑
tension https://​doi.​org/​10.​1161/​hyp.​00000​00000​000087 (2019).
40. Laflamme, D. Development and validation of a body condition score system for dogs. Canine Pract. 22, 10–15 (1997).
41. World Health Organization. WHO guidelines on physical activity and sedentary behaviour: web annex: evidence profiles. https://​www.​who.​int/​publi​catio​ns/i/​item/​97892​40015​128 (Accessed 01 June 2023).
42. Olsson, S. J. G., Ekblom, O., Andersson, E., Borjesson, M. & Kallings, L. V. Categorical answer modes provide superior validity toopen answers when asking for level of physical activity: A cross-sectional study. Scand. J. Public Health 44, 70–76. https://​doi.​org/​
10.​1177/​14034​94815​602830 (2016).
43. Public Health Agency of Sweden. Public health survey - health on equal terms. https://​www.​folkh​alsom​yndig​heten.​se/​folkh​alsor​
appor​tering-​stati​stik/​om-​vara-​datai​nsaml​ingar/​natio​nella-​folkh​alsoe​nkaten/ (Accessed 01 June 2023).
44. Reeves, M. J., Rafferty, A. P., Miller, C. E. & Lyon-Callo, S. K. The impact of dog walking on leisure-time physical activity: Resultsfrom a population-based survey of Michigan adults. J. Phys. Act. Health 8, 436–444. https://​doi.​org/​10.​1123/​jpah.8.​3.​436 (2011).
45. Mahmoudi, A., Amirshaghaghi, F., Aminzadeh, R. & Turkmani, E. M. Effect of aerobic, resistance, and combined exercise training
on depressive symptoms, quality of life, and muscle strength in healthy older adults: A systematic review and meta-analysis ofrandomized controlled trials. Biol. Res. Nurs. 24, 541–559. https://​doi.​org/​10.​1177/​10998​00422​11048​50 (2022).
46. Yam, P. S. et al. Validity, practical utility and reliability of Actigraph accelerometry for the measurement of habitual physical activity
in dogs. J. Small Anim. Pract. 52, 86–92. https://​doi.​org/​10.​1111/j.​1748-​5827.​2010.​01025.x (2011).
47. Morze, J. et al. Impact of different training modalities on anthropometric outcomes in patients with obesity: A systematic review
and network meta-analysis. Obes. Rev. https://​doi.​org/​10.​1111/​obr.​13218 (2021).
48. Thorogood, A. et al. Isolated aerobic exercise and weight Loss: A Systematic review and meta-analysis of randomized controlled
trials. Am. J. Med. 124, 747–755. https://​doi.​org/​10.​1016/j.​amjmed.​2011.​02.​037 (2011).
49. Wang, S. Y., Zhou, H. Y., Zhao, C. T. & He, H. Effect of exercise training on body composition and inflammatory cytokine levelsin overweight and obese individuals: A systematic review and network meta-analysis. Front. Immunol. 13, 13. https://​doi.​org/​10.​3389/​fimmu.​2022.​921085 (2022).
50. Mezghani, N. et al. The impact of exercise training intensity on physiological adaptations and insulin resistance in women withabdominal obesity. Healthcare 10, 17. https://​doi.​org/​10.​3390/​healt​hcare​10122​533 (2022).
51. Ross, R. et al. Exercise-induced reduction in obesity and insulin resistance in women: A randomized controlled trial. Obes. Res.
12, 789–798. https://​doi.​org/​10.​1038/​oby.​2004.​95 (2004).
52. Skrypnik, D. et al. Effects of endurance and endurance strength training on body composition and physical capacity in womenwith abdominal obesity. Obes. Facts 8, 175–187. https://​doi.​org/​10.​1159/​00043​1002 (2015).
53. Cornelissen, V. A. & Smart, N. A. Exercise training for blood pressure: A systematic review and meta-analysis. Am. Heart J. 2,
e004473–e004473. https://​doi.​org/​10.​1161/​jaha.​112.​004473 (2013).

Scientific Reports |(2024) 14:14321 |https://doi.org/10.1038/s41598-024-65033-0

11Vol.:(0123456789)

www.nature.com/scientificreports/
54. Chapman, M., Woods, G. R. T., Ladha, C., Westgarth, C. & German, A. J. An open-label randomised clinical trial to compare theefficacy of dietary caloric restriction and physical activity for weight loss in overweight pet dogs. Vet. J. 243, 65–73. https://​doi.​
org/​10.​1016/j.​tvjl.​2018.​11.​013 (2019).
55. Christofaro, D. G. D. et al. Physical activity is associated with improved eating habits during the COVID-19 pandemic. Front.
Psychol. https://​doi.​org/​10.​3389/​fpsyg.​2021.​664568 (2021).
56. Marventano, S. et al. Mediterranean diet adherence in the Mediterranean healthy eating, aging and lifestyle (MEAL) study cohort.
Int. J. Food Sci. Nutr. 69, 100–107. https://​doi.​org/​10.​1080/​09637​486.​2017.​13321​70 (2018).
57. Pavičić Žeželj, S., Kenđel Jovanović, G. & Krešić, G. The association between the Mediterranean diet and high physical activity
among the working population in Croatia. Med. Pr. 70, 169–176. https://​doi.​org/​10.​13075/​mp.​5893.​00773 (2019).
58. Perea Sanchez, J. M. et al. The effects of physical activity on dietary habits in young adults from Madrid. Int. J. Vitam Nutr. Res. 82,
405–411. https://​doi.​org/​10.​1024/​0300-​9831/​a0001​38 (2012).
59. American Veterinary Medical Association. The Human-Animal Interaction and Human-Animal Bond, AVMA Policies. https://​www.​avma.​org/​resou​rces-​tools/​avma-​polic​ies/​human-​animal-​inter​action-​and-​human-​animal-​bond (Accessed 01 June 2023).
60. Andrew, R., Tiggemann, M. & Clark, L. Positive body image and young women’s health: Implications for sun protection, cancer
screening, weight loss and alcohol consumption behaviours. J. Health Psychol. 21, 28–39 (2016).
61. Rodgers, W. M., Hall, C. R., Blanchard, C. M., McAuley, E. & Munroe, K. J. Task and scheduling self-efficacy as predictors of exercise
behavior. Psychol. Health 17, 405–416. https://​doi.​org/​10.​1080/​08870​44022​00000​4902 (2002).
62. Ryan, M. P. The antidepressant effects of physical activity: Mediating self-esteem and self-efficacy mechanisms. Psychol. Health 23,
279–307. https://​doi.​org/​10.​1080/​14768​32060​11855​02 (2008).
63. Shipway, R. & Holloway, I. Running free: Embracing A healthy lifestyle through distance running. Perspect. Public Health 130,
270–276. https://​doi.​org/​10.​1177/​17579​13910​379191 (2010).

Acknowledgements

We thank all participating dog owners and dogs and Britta Agardh from The Swedish Working Dog Association
for their contribution to this study.

Author contributions

A. Bergh, E. Roman and J. Söder designed the study. A. Bergh, L.V. Kallings, E. Lundbeck, E. Roman, S. SpörndlyNees and J. Söder performed data collection. K. Smedberg, E. Lundbeck, and J. Söder performed statisticalanalyses and drafted the manuscript. All authors interpreted the results, reviewed and approved the last versionof the manuscript.

Funding

Open access funding provided by Swedish University of Agricultural Sciences. The salary of K. Smedberg was
funded by the Uppsala Diabetes Centre (UDC), Sweden. J. Söder received research grants from the “Research
Foundation of Agria and the Swedish Kennel Club” and A. Bergh received research grants from “SLU Future One
Health”, Swedish University of Agricultural Sciences. The funders had no role in study design, data collection
and analyses, decision to publish or preparation of the manuscript.

Competing interests

The authors declare no competing interests.

Additional information

Supplementary Information The online version contains supplementary material available at https://​doi.​org/​
10.​1038/​s41598-​024-​65033-0.
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Scientific Reports |Vol:.(1234567890)(2024) 14:14321 |https://doi.org/10.1038/s41598-024-65033-0

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