Changes in the Frequency of Moderate-to-Vigorous Physical Activity and Subsequent Risk of All-Cause and Cardiovascular Disease Mortality.
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SUBMITTER: Choi Y
PROVIDER: S-EPMC8744773 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe 2008 Physical Activity Guidelines for Americans recommends that adults accumulate moderate-to-vigorous physical activity (MVPA) in bouts of ?10 minutes for substantial health benefits. To what extent the same amount of MVPA accumulated in bouts versus sporadically reduces mortality risk remains unclear.Methods and resultsWe analyzed data from the National Health and Nutrition Examination Survey 2003-2006 and death records available through 2011 (follow-up period of ?6.6 years; 700 deaths) to examine the associations between objectively measured physical activity accumulated with and without a bout criteria and all-cause mortality in a representative sample of US adults 40 years and older (n=4840). Physical activity data were processed to generate minutes per day of total and bouted MVPA. Bouted MVPA was defined as MVPA accumulated in bouts of a minimum duration of either 5 or 10 minutes allowing for 1- to 2-minute interruptions. Hazard ratios for all-cause mortality associated with total and bouted MVPA were similar and ranged from 0.24 for the third quartile of total to 0.44 for the second quartile of 10-minute bouts. The examination of jointly classified quartiles of total MVPA and tertiles of proportion of bouted activity revealed that greater amounts of bouted MVPA did not result in additional risk reductions for mortality.ConclusionsThese results provide evidence that mortality risk reductions associated with MVPA are independent of how activity is accumulated and can impact the development of physical activity guidelines and inform clinical practice.
| S-EPMC5907548 | biostudies-literature
Project description:BACKGROUND:It is unclear whether the greater benefits of moderate-to-vigorous physical activity (PA) over light PA are attributed to the higher-intensity PA or simply the greater volume of PA accumulated per unit time for moderate-to-vigorous PA. We examined this question using estimates of the volume of light and moderate-to-vigorous PA in relation to all-cause mortality. METHODS AND RESULTS:We used National Health and Nutrition Examination Survey 2003-2006 accelerometer records in adults (?40 years; n=4840) and mortality data collected through 2011 (n=700 deaths). We estimated intensity-specific PA volume using activity counts (AC) accumulated in light (100-759 AC/min), moderate-to-vigorous PA (?760 AC/min), and total PA (?100 AC/min). We examined quartiles of each exposure using Cox proportional hazard models (hazard ratios [95% confidence interval) adjusted for demographic and behavioral risk factors, health status, and body mass index. Mortality risk was less across increasing quartiles of light PA volume (AC×1000) when compared with the least quartile (AC ?61.8); the least risk occurred in the upper quartile of light PA, AC >98.5 (hazard ratios=0.69, 95% confidence interval: 0.47, 1.00, P trend ?0.05). The benefits for mortality risk were greater across quartiles of moderate-to-vigorous PA and reached a hazard ratio of 0.28 (95% confidence interval: 0.17, 0.46, P trend ?0.05) for AC >187.9, when compared with the referent group (AC ?50.8). Results examining various combinations of light and moderate-to-vigorous intensity-specific volumes demonstrated the strong influence of total activity on mortality risk. CONCLUSIONS:In this population, increasing light PA was associated with less mortality, but at an approximately equal volume of PA, moderate-to-vigorous PA appeared to have greater benefits.
| S-EPMC5907606 | biostudies-literature
Project description:Background:In China, lack of evidence remains a significant challenge for the national initiative to promote physical activity (PA). We aimed to quantify the beneficial effects of meeting or maintaining the recommended PA level [150 minutes per week (min/wk) of moderate PA or 75 min/wk of vigorous PA or an equivalent combination] on incident cardiovascular disease (CVD) among Chinese population. Methods:We included 100,560 participants without history of CVD from three cohorts in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD events and its subtypes, including stroke, coronary heart disease, heart failure, and CVD death. Results:During a median follow-up of 7.3 years (range: 6-15 years), 777,163 person-years and 4693 incident CVD events were observed. Compared with participants who were inactive at baseline, the multivariable adjusted HR (95% CI) of developing CVD was 0.74 (0.69-0.79) for those who met recommended moderate to vigorous physical activity (MVPA) level at baseline. Furthermore, the risk of CVD incidence was reduced with increment of MVPA (P trend < 0.001), and the HR (95% CI) of highly-active versus inactive category was 0.62 (0.56-0.68). Compared with individuals who were inactive both at the baseline and follow-up, those keeping active over the period of follow-up had a substantial lower risk of incident CVD with the HR (95% CI) of 0.57 (0.43-0.77). Conclusions:The findings demonstrated that meeting and maintaining the recommended MVPA level could reduce the cardiovascular risk. Wider adoption of the PA recommendations would have considerable health impacts to the Chinese population.
| S-EPMC7051870 | biostudies-literature
Project description:PurposeConduct a systematic umbrella review to evaluate the relationship of physical activity (PA) with all-cause mortality, cardiovascular mortality, and incident cardiovascular disease (CVD); to evaluate the shape of the dose-response relationships; and to evaluate these relationships relative to the 2008 Physical Activity Guidelines Advisory Committee Report.MethodsPrimary search encompassing 2006 to March, 2018 for existing systematic reviews, meta-analyses, and pooled analyses reporting on these relationships. Graded the strength of evidence using a matrix developed for the Physical Activity Guidelines Advisory Committee.ResultsThe association of self-reported moderate-to-vigorous physical activity (MVPA) on all-cause mortality, CVD mortality, and atherosclerotic CVD-including incident coronary heart disease, ischemic stroke and heart failure-are very similar. Increasing MVPA to guidelines amounts in the inactive US population has the potential to have an important and substantial positive impact on these outcomes in the adult population. The following points are clear: the associations of PA with beneficial health outcomes begin when adopting very modest (one-third of guidelines) amounts; any MVPA is better than none; meeting the 2008 PA guidelines reduces mortality and CVD risk to about 75% of the maximal benefit obtained by physical activity alone; PA amounts beyond guidelines recommendations amount reduces risk even more, but greater amounts of PA are required to obtain smaller health benefits; and there is no evidence of excess risk over the maximal effect observed at about three to five times the amounts associated with current guidelines. When PA is quantified in terms of energy expenditure (MET·h·wk), these relationships hold for walking, running, and biking.ConclusionsTo avoid the risks associated with premature mortality and the development of ischemic heart disease, ischemic stroke, and all-cause heart failure, all adults should strive to reach the 2008 Physical Activity Guidelines for Americans.
| S-EPMC6527136 | biostudies-literature
Project description:Leisure time physical activity reduces the risk of premature mortality, but the years of life expectancy gained at different levels remains unclear. Our objective was to determine the years of life gained after age 40 associated with various levels of physical activity, both overall and according to body mass index (BMI) groups, in a large pooled analysis.We examined the association of leisure time physical activity with mortality during follow-up in pooled data from six prospective cohort studies in the National Cancer Institute Cohort Consortium, comprising 654,827 individuals, 21-90 y of age. Physical activity was categorized by metabolic equivalent hours per week (MET-h/wk). Life expectancies and years of life gained/lost were calculated using direct adjusted survival curves (for participants 40+ years of age), with 95% confidence intervals (CIs) derived by bootstrap. The study includes a median 10 y of follow-up and 82,465 deaths. A physical activity level of 0.1-3.74 MET-h/wk, equivalent to brisk walking for up to 75 min/wk, was associated with a gain of 1.8 (95% CI: 1.6-2.0) y in life expectancy relative to no leisure time activity (0 MET-h/wk). Higher levels of physical activity were associated with greater gains in life expectancy, with a gain of 4.5 (95% CI: 4.3-4.7) y at the highest level (22.5+ MET-h/wk, equivalent to brisk walking for 450+ min/wk). Substantial gains were also observed in each BMI group. In joint analyses, being active (7.5+ MET-h/wk) and normal weight (BMI 18.5-24.9) was associated with a gain of 7.2 (95% CI: 6.5-7.9) y of life compared to being inactive (0 MET-h/wk) and obese (BMI 35.0+). A limitation was that physical activity and BMI were ascertained by self report.More leisure time physical activity was associated with longer life expectancy across a range of activity levels and BMI groups. Please see later in the article for the Editors' Summary.
| S-EPMC3491006 | biostudies-other
Project description:The relative benefits of meeting the current moderate-to-vigorous intensity physical activity (MVPA) and active step count recommendations are unknown. Using robust linear regressions, we compared cardiometabolic marker differences (blood pressure, lipid levels, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), hemoglobin A1C, C-reactive protein (CRP), and body mass index (BMI)) across MVPA (150min/week) and step (10,000 steps/day) thresholds and between step categories (low active: 5000 to 7499, somewhat active: 7500 to 9999, and active: ≥10,000 steps/day vs. inactive: <5000 steps/day) in approximately 6000 Canadian adults (41.5years, SD 14.9). Differences across MVPA and step thresholds were similar but additional benefits were observed for BMI and A1C for the MVPA target (i.e., above vs. below 150min/week MVPA: -1.02kg/m2 (95% Confidence Interval [CI] -1.25 to -0.80) and -0.04% (95% CI -0.06 to -0.02); above vs. below ≥10,000 steps/day: -0.40kg/m2 (95% CI -0.63 to -0.16) and 0.01% (95% CI -0.01 to 0.03)). In terms of steps categories, the greatest incremental improvement was achieved at the somewhat active threshold (e.g., somewhat active vs. inactive: -0.90kg/m2, 95% CI -1.28 to -0.53; low active vs. inactive: -0.36kg/m2, 95% CI -0.73 to 0.02). Additional benefits beyond the 10,000 step/day threshold were limited (e.g., -0.93kg/m2, 95% CI -1.30 to -0.57). Given that most benefits to markers of cardiometabolic health were at the ≥7500 step/day threshold and that there was some additional benefit across the 150min/week MVPA threshold compared to a 10,000 steps/day threshold, we suggest aiming for ≥7500 steps/day and then advancing to a 150min/MVPA goal.
| S-EPMC6625960 | biostudies-literature
Project description:Aims/hypothesisThis work examined the role of physical activity in the course of diabetes using data spanning nearly three decades. Our first aim was to examine the long-term association of moderate and vigorous physical activity with incidence of type 2 diabetes. Our second aim was to investigate the association of moderate-to-vigorous physical activity post-diabetes diagnosis with subsequent risk of all-cause and cardiovascular disease mortality.MethodsA total of 9987 participants from the Whitehall II cohort study free of type 2 diabetes at baseline (1985-1988) were followed for incidence of type 2 diabetes, based on clinical assessments between 1985 and 2016 and linkage to electronic health records up to 31 March 2017. We first examined the association of moderate and vigorous physical activity measured by questionnaire in 1985-1988 (mean age 44.9 [SD 6.0] years; women, 32.7%) with incident type 2 diabetes, using the interval-censored, illness-death model, a competing risk analysis that takes into account both competing risk of death and intermittent ascertainment of diabetes due to reliance on data collection cycles (interval-censored). The second analysis was based on individuals with type 2 diabetes over the follow-up period where we used Cox regression with inverse probability weighting to examine the association of moderate-to-vigorous physical activity after diagnosis of type 2 diabetes with risk of all-cause and cardiovascular disease mortality.ResultsOf the 9987 participants, 1553 developed type 2 diabetes during a mean follow-up of 27.1 (SD 6.3) years. Compared with participants who were inactive in 1985-1988, those who undertook any duration of moderate-to-vigorous physical activity had a lower risk of type 2 diabetes (HR 0.85 [95% CI 0.75, 0.97], p?=?0.02; analysis adjusted for sociodemographic, behavioural and health-related factors). In 1026 participants with a diagnosis of type 2 diabetes over the follow-up period, data on moderate-to-vigorous physical activity after diabetes diagnosis were available; 165 all-cause deaths and 55 cardiovascular disease-related deaths were recorded during a mean follow-up of 8.8 (SD 6.1) years. In these participants with diabetes, any duration of moderate-to-vigorous physical activity was associated with lower all-cause mortality (HR 0.61 [95% CI 0.41, 0.93], p?=?0.02) while the association with cardiovascular mortality was evident only for physical activity undertaken at or above recommendations (?2.5 h per week of moderate-to-vigorous physical activity or ?1.25 h per week of vigorous physical activity; HR 0.40 [95% CI 0.16, 0.96], p?=?0.04) in fully adjusted models.Conclusions/interpretationModerate-to-vigorous physical activity plays an important role in diabetes, influencing both its incidence and prognosis. A protective effect on incidence was seen for durations of activity below recommendations and a marginal additional benefit was observed at higher durations. Among individuals with type 2 diabetes, any duration of moderate-to-vigorous physical activity was associated with reduced all-cause mortality while recommended durations of physical activity were required for protection against cardiovascular disease-related mortality.Data availabilityWhitehall II data, protocols and other metadata are available to the scientific community. Please refer to the Whitehall II data sharing policy at https://www.ucl.ac.uk/epidemiology-health-care/research/epidemiology-and-public-health/research/whitehall-ii/data-sharing.
| S-EPMC6997261 | biostudies-literature
Project description:INTRODUCTION:It is well established that physical activity (PA) protects against mortality and morbidity, but how long-term patterns of PA are associated with mortality and cardiovascular disease (CVD) remains unclear. METHODS:3231 men recruited to the British Regional Heart Study, a prospective cohort study, reported usual PA levels at baseline in 1978-1980 (aged 40-59 years) and at 12-year, 16-year and 20-year follow ups. Twenty-year trajectories of PA, spanning from 1978/1980 to 2000, were identified using group-based trajectory modelling. Men were subsequently followed up until 30 June 2016 for mortality through National Health Service central registers and for non-fatal CVD events through primary and secondary care records. Data analyses were conducted in 2019. RESULTS:Three PA trajectories were identified: low/decreasing (22.7%), light/stable (51.0%) and moderate/increasing (26.3%). Over a median follow-up of 16.4 years, there were 1735 deaths. Compared with the low/decreasing group, membership of the light/stable (HR 0.83, 95%?CI 0.74 to 0.94) and moderate/increasing (HR 0.76, 95%?CI 0.66 to 0.88) groups was associated with a lower risk of all-cause mortality. Similar associations were observed for CVD mortality, major coronary heart disease and all CVD events. Associations were only partially explained by a range of confounders. Sensitivity analyses suggested that survival benefits were largely driven by most recent/current PA. CONCLUSIONS:A dose-response relationship was observed, with higher levels of PA from midlife to old age associated with additional benefits. However, even fairly modest and sustained PA was protective and may be more achievable for the most inactive.
| S-EPMC6993021 | biostudies-literature
Project description:BackgroundAffective responses are posited to be key predictors of the uptake and maintenance of health behaviors. However, few studies have examined how individuals' affective response to physical activity, as well as the degree to which their affect response changes, may predict changes in physical activity and sedentary time during behavioral weight loss treatment.PurposeThe current study examined how baseline momentary affective response (i.e., stress and anxiety) to moderate-to-vigorous physical activity (MVPA) and the degree of pre--post intervention change in this response predicted change in daily sedentary, light, and MVPA time during a three-month internet-based weight loss program.MethodsWomen with overweight/obesity (final N=37) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after the intervention.ResultsWomen who had more reinforcing responses to MVPA (i.e., greater reductions in anxiety and stress response following MVPA bouts) at baseline had greater increases in overall MVPA at the end of the intervention. Those who had greater anxiety reductions after MVPA bouts at baseline also evidenced less sedentary time at the end of the intervention. Changes in affective responses across the intervention were not related to changes in physical activity levels.ConclusionsFindings suggest initial levels of affective reinforcement from MVPA bouts predict future change in MVPA and sedentary time during behavioral weight loss. Future work is needed to examine the utility of more precisely targeting affective responses to physical activity to optimize intervention approaches.
| S-EPMC8562688 | biostudies-literature
Project description:Adults are recommended to engage in 150 min of moderate (MPA) to vigorous (VPA) aerobic physical activity per week, with the public health message of obtaining 3000 steps in 30 min. There is a paucity of research on step rate thresholds that correspond to absolute MVPA (moderate = 3 METs, vigorous = 6 METs) with no research evaluating adult relative MVPA (moderate = 40% VO2max, vigorous = 60% VO2max). Anthropometric differences also influence intensity-related step rate thresholds. The purpose of this study was to identify step rates across a range of walking intensities so that mathematical models incorporating anthropometric factors could be used to identify individualized MVPA step rate thresholds. Forty-three adults (25?; age = 39.4 ± 15.2 years) completed a staged treadmill walking protocol with pedometers and indirect calorimetry: six-minutes at 2.4, 3.2, 4.0, 5.6, 6.4, 7.2 km/h. Mathematical modelling revealed absolute and relative MPA step rate thresholds of ~100 steps/minute (spm) and ~125 spm, respectively. VPA corresponded to step rates of ~133 spm and ~139 spm for absolute and relative thresholds respectively. The current public message of 3000 steps in 30 min is valid for absolute MPA. However, VPA is achieved at higher thresholds than previously reported, more than 130 spm for healthy adults.
| S-EPMC6266480 | biostudies-literature