Dataset Information

Association of Leisure-Time Physical Activity Across the Adult Life Course With All-Cause and Cause-Specific Mortality.

ABSTRACT: Importance:Although the benefits of leisure-time physical activity (LTPA) in middle age are established, the health effects of long-term participation and changes in LTPA between adolescence and middle age have not been documented. Objective:To determine whether an association exists between LTPA life course patterns and mortality. Design, Setting, and Participants:This prospective cohort study used data from the National Institutes of Health-AARP (formerly American Association of Retired Persons) Diet and Health Study established in 1995 to 1996. Data analysis was conducted from March 2017 through February 2018. Data were analyzed for 315?059 adult AARP members living in 6 states, namely, California, Florida, Louisiana, New Jersey, North Carolina, or Pennsylvania, or 2 metropolitan areas, Atlanta, Georgia, or Detroit, Michigan. Exposures:Self-reported LTPA (hours per week) at the baseline interview for ages grouped as 15 to 18, 19 to 29, 35 to 39, and 40 to 61 years. Main Outcomes and Measures:All-cause, cardiovascular disease (CVD)-related, and cancer-related mortality records available through December 31, 2011. Results:Of 315?059 participants, 183?451 (58.2%) were men, and the participants were 50 to 71 years of age at enrollment. Ten LTPA trajectories (categorized as maintaining, increasing, and decreasing LTPA across time) were identified, and 71?377 deaths due to all causes, 22?219 deaths due to CVD, and 16?388 deaths due to cancer occurred. Compared with participants who were consistently inactive throughout adulthood, participants who maintained the highest amount of LTPA in each age period were at lower risks for all-cause, CVD-related, and cancer-related mortality. For example, compared with participants who were consistently inactive, maintaining higher amounts of LTPA was associated with lower all-cause (hazard ratio [HR], 0.64; 95% CI, 0.60-0.68), CVD-related (HR, 0.58; 95% CI, 0.53-0.64), and cancer-related (HR, 0.86; 95% CI, 0.77-0.97) mortality. Adults who were less active throughout most of the adult life course but increased LTPA in later adulthood (40-61 years of age) also had lower risk for all-cause (HR, 0.65; 95% CI, 0.62-0.68), CVD-related (HR, 0.57; 95% CI, 0.53-0.61), and cancer-related (HR, 0.84; 95% CI, 0.77-0.92) mortality. Conclusions and Relevance:Maintaining higher LTPA levels and increasing LTPA in later adulthood were associated with comparable low risk of mortality, suggesting that midlife is not too late to start physical activity. Inactive adults may be encouraged to be more active, whereas young adults who are already active may strive to maintain their activity level as they get older.

SUBMITTER: Saint-Maurice PF

PROVIDER: S-EPMC6484624 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Association of Leisure-Time Physical Activity Across the Adult Life Course With All-Cause and Cause-Specific Mortality.

Saint-Maurice Pedro F PF Coughlan Diarmuid D Kelly Scott P SP Keadle Sarah K SK Cook Michael B MB Carlson Susan A SA Fulton Janet E JE Matthews Charles E CE

JAMA network open 20190301 3

<h4>Importance</h4>Although the benefits of leisure-time physical activity (LTPA) in middle age are established, the health effects of long-term participation and changes in LTPA between adolescence and middle age have not been documented.<h4>Objective</h4>To determine whether an association exists between LTPA life course patterns and mortality.<h4>Design, setting, and participants</h4>This prospective cohort study used data from the National Institutes of Health-AARP (formerly American Associa ...[more]

PMID: 30848809

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Project description:BACKGROUND: Physical inactivity is a major public health problem associated with increased mortality risk. It is, however, poorly understood whether vigorous physical activity is more beneficial for reducing mortality risk than activities of lower intensity. The aim of this study was to examine associations of the intensity and volume of leisure-time physical activity with all-cause mortality among middle-aged women and men while considering sociodemographic and health related factors as covariates. METHODS: Questionnaire survey data collected in 2000-02 among 40-60-year-old employees of the City of Helsinki (N = 8960) were linked with register data on mortality (74% gave permission to the linkage) providing a mean follow-up time of 12-years. The analysis included 6429 respondents (79% women). The participants were classified into three groups according to intensity of physical activity: low moderate, high moderate and vigorous. The volume of physical activity was classified into three groups according to tertiles. Cox regression analysis was used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for all-cause mortality. RESULTS: During the follow up 205 participants died. Leisure-time physical activity was associated with reduced risk of mortality. After adjusting for covariates the vigorous group (HR = 0.54, 95% CI 0.34-0.86) showed a reduced risk of mortality compared with the low moderate group whereas for the high moderate group the reductions in mortality risk (HR = 0.72, 95% CI 0.48-1.08) were less clear. Adjusting for the volume of physical activity did not affect the point estimates. Higher volume of leisure-time physical activity was also associated with reduced mortality risk; however, adjusting for the covariates and the intensity of physical activity explained the differences. CONCLUSIONS: For healthy middle-aged women and men who engage in some physical activity vigorous exercise may provide further health benefits preventing premature deaths.

Project description:BackgroundThe 2018 physical activity guidelines for Americans recommend a minimum of 150 to 300 min/wk of moderate physical activity (MPA), 75 to 150 min/wk of vigorous physical activity (VPA), or an equivalent combination of both. However, it remains unclear whether higher levels of long-term VPA and MPA are, independently and jointly, associated with lower mortality.MethodsA total of 116 221 adults from 2 large prospective US cohorts (Nurses' Health Study and Health Professionals Follow-up Study, 1988-2018) were analyzed. Detailed self-reported leisure-time physical activity was assessed with a validated questionnaire, repeated up to 15 times during the follow-up. Cox regression was used to estimate the hazard ratio and 95% CI of the association between long-term leisure-time physical activity intensity and all-cause and cause-specific mortality.ResultsDuring 30 years of follow-up, we identified 47 596 deaths. In analyses mutually adjusted for MPA and VPA, hazard ratios comparing individuals meeting the long-term leisure-time VPA guideline (75-149 min/wk) versus no VPA were 0.81 (95% CI, 0.76-0.87) for all-cause mortality, 0.69 (95% CI, 0.60-0.78) for cardiovascular disease (CVD) mortality, and 0.85 (95% CI, 0.79-0.92) for non-CVD mortality. Meeting the long-term leisure-time MPA guideline (150-299 min/wk) was similarly associated with lower mortality: 19% to 25% lower risk of all-cause, CVD, and non-CVD mortality. Compared with those meeting the long-term leisure-time physical activity guidelines, participants who reported 2 to 4 times above the recommended minimum of long-term leisure-time VPA (150-299 min/wk) or MPA (300-599 min/wk) showed 2% to 4% and 3% to 13% lower mortality, respectively. Higher levels of either long-term leisure-time VPA (≥300 min/wk) or MPA (≥600 min/wk) did not clearly show further lower all-cause, CVD, and non-CVD mortality or harm. In joint analyses, for individuals who reported <300 min/wk of long-term leisure-time MPA, additional leisure-time VPA was associated with lower mortality; however, among those who reported ≥300 min/wk of long-term leisure-time MPA, additional leisure-time VPA did not appear to be associated with lower mortality beyond MPA.ConclusionsThe nearly maximum association with lower mortality was achieved by performing ≈150 to 300 min/wk of long-term leisure-time VPA, 300 to 600 min/wk of long-term leisure-time MPA, or an equivalent combination of both.

Project description:ImportanceFor the first time, the 2020 World Health Organization guidelines on physical activity recommended reducing sedentary behaviors owing to their health consequences. Less is known on the specific association of prolonged occupational sitting with health, especially in the context of low physical activity engagement.ObjectiveTo quantify health risks associated with prolonged occupational sitting and to determine whether there is a certain threshold of physical activity that may attenuate it.Design, setting, and participantsThis prospective cohort study included participants in a health surveillance program in Taiwan who were followed-up between 1996 and 2017. Data on occupational sitting, leisure-time physical activity (LTPA) habits, lifestyle, and metabolic parameters were collected. Data analysis was performed in December 2020.Main outcomes and measuresThe all-cause and cardiovascular disease (CVD) mortality associated with 3 occupational sitting volumes (mostly sitting, alternating sitting and nonsitting, and mostly nonsitting) were analyzed applying multivariable Cox regression models to calculate the hazard ratios (HRs) for all participants and by subgroups, including 5 LTPA levels and a personal activity intelligence (PAI)-oriented metric. Deaths occurring within the initial 2 years of follow-up were excluded to prevent reverse causality.ResultsThe total cohort included 481 688 participants (mean [SD] age, 39.3 [12.8] years; 256 077 women [53.2%]). The study recorded 26 257 deaths during a mean (SD) follow-up period of 12.85 (5.67) years. After adjusting for sex, age, education, smoking, drinking, and body mass index, individuals who mostly sat at work had a 16% higher all-cause mortality risk (HR, 1.16; 95% CI, 1.11-1.20) and a 34% increased mortality risk from CVD (HR, 1.34; 95% CI, 1.22-1.46) compared with those who were mostly nonsitting at work. Individuals alternating sitting and nonsitting at work did not experience increased risk of all-cause mortality compared with individuals mostly nonsitting at work (HR, 1.01; 95% CI, 0.97-1.05). For individuals mostly sitting at work and engaging in low (15-29 minutes per day) or no (<15 minutes per day) LTPA, an increase in LTPA by 15 and 30 minutes per day, respectively, was associated with a reduction in mortality to a level similar to that of inactive individuals who mostly do not sit at work. In addition, individuals with a PAI score exceeding 100 experienced a notable reduction in the elevated mortality risk associated with prolonged occupational sitting.Conclusions and relevanceAs part of modern lifestyles, prolonged occupational sitting is considered normal and has not received due attention, even though its deleterious effect on health outcomes has been demonstrated. In this study, alternating between sitting and nonsitting at work, as well as an extra 15 to 30 minutes per day of LTPA or achieving a PAI score greater than 100, attenuated the harms of prolonged occupational sitting. Emphasizing the associated harms and suggesting workplace system changes may help society to denormalize this common behavior, similar to the process of denormalizing smoking.

Project description:ImportanceHigher amounts of physical activity are associated with increased longevity. However, whether different leisure time physical activity types are differentially associated with mortality risk is not established.ObjectivesTo examine whether participation in equivalent amounts of physical activity (7.5 to <15 metabolic equivalent of task [MET] hours per week) through different activity types is associated with mortality risk and to investigate the shape of the dose-response association.Design, setting, and participantsParticipants in this cohort were respondents from the National Institutes of Health-AARP Diet and Health Study who completed the follow-up questionnaire between 2004 and 2005. This questionnaire collected data on weekly durations of different types of physical activities. Mortality was ascertained through December 31, 2019.ExposuresMET hours per week spent participating in the following activities: running, cycling, swimming, other aerobic exercise, racquet sports, golf, and walking for exercise.Main outcomes and measuresAll-cause, cardiovascular, and cancer mortality. Separate multivariable-adjusted Cox proportional hazards regression models were fitted to estimate hazard ratios (HRs) and 95% CIs of mortality for each of the 7 types of leisure time physical activities, as well as the sum of these activities.ResultsA total of 272 550 participants (157 415 men [58%]; mean [SD] age at baseline, 70.5 [5.4] years [range, 59-82 years]) provided information on types of leisure time activity, and 118 153 (43%) died during a mean (SD) follow-up of 12.4 (3.9) years. In comparison with those who did not participate in each activity, 7.5 to less than 15 MET hours per week of racquet sports (HR, 0.84; 95% CI, 0.75-0.93) and running (HR, 0.85; 95% CI, 0.78-0.92) were associated with the greatest relative risk reductions for all-cause mortality, followed by walking for exercise (HR, 0.91; 95% CI, 0.89-0.93), other aerobic activity (HR, 0.93; 95% CI, 0.90-0.95), golf (HR, 0.93; 95% CI, 0.90-0.97), swimming (HR, 0.95; 95% CI, 0.92-0.98), and cycling (HR, 0.97; 95% CI, 0.95-0.99). Each activity showed a curvilinear dose-response association with mortality risk; low MET hours per week of physical activity for any given activity type were associated with a large reduction in mortality risk, with diminishing returns for each increment in activity thereafter. Associations were similar for cardiovascular and cancer mortality.Conclusions and relevanceThis cohort study of older individuals found differences between different types of leisure time activities and mortality risk, but there were significant associations between participating in 7.5 to less than 15 MET hours per week of any activity and mortality risk.

Project description:BackgroundAdolescence is regarded as formative years for building the foundations for life-long health and well-being, and adolescent determinants of physical activity (PA) development is particularly interesting. Novel approaches for the study of PA development, such as group-based trajectory modelling, opens for the possibility of identifying different patterns in the relationship among several known determinants of PA. This study aimed to explore how demographic, psychological and social factors in early adolescence determine membership in four distinct leisure-time vigorous physical activity (LVPA) trajectories from 13 to 40 years.MethodsThis study is based on data from the Norwegian Longitudinal Health Behaviour Study, following a cohort born in 1977 from Western Norway. Four trajectories identified using latent class growth analysis, based on self-reposted LVPA (n = 1103, 45.5% women) measured ten times from age 13 to age 40 and 17 different adolescent determinants, were used in a multivariate multinomial logistic regression.ResultsWe found that gender (male), VPA intentions the next year and athletic identity associated with belonging to the two trajectories reporting the highest levels of LVPA in adolescence, while VPA intentions in ten years were associated with belonging to the active trajectory compared to the decreasingly active and low active trajectories Enjoyment increased the odds of belonging to the increasingly and decreasingly active trajectories compared to the low active trajectory. In addition, two of the social determinants, mother's PA and emotional support from father, were associated with belonging to the increasingly active trajectory when compared to the low active trajectory. Higher family income increased the odds of belonging to the increasingly active compared to the decreasingly active trajectory.ConclusionsBoth demographic, psychological, and social factors were identified as determinants of LVPA trajectory membership, and the findings support previous research related to the importance of intentions, but also indicate that enjoyment, role modelling and emotional support in PA can be of great importance to LVPA promotion among adolescents.

Dataset Information

Association of Leisure-Time Physical Activity Across the Adult Life Course With All-Cause and Cause-Specific Mortality.

Publications

Association of Leisure-Time Physical Activity Across the Adult Life Course With All-Cause and Cause-Specific Mortality.

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