Leisure time physical activity, sedentary behavior, and risk of cardiovascular disease and mortality among US Veterans.
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ABSTRACT: Background
Cardiovascular disease (CVD) remains the leading cause of death in the US. Although physical activity (PA) has been inversely associated with the risk of CVD, few studies have examined whether sedentary behaviors modify such association. Our goal was to examine associations of leisure time PA with risk of CVD and mortality and the role of sedentary behavior as potential effect modifier among US veterans.Methods
We analyzed self-reported data on leisure time PA, television watching, and time spent on the computer among 438,364 participants of the Veterans Affairs Million Veteran Program from 2011 to 2018. We calculated metabolic equivalent of task-hours per week (MET-h/week) for each person and used electronic health record data to ascertain CVD.Results
Mean age was 64.6 ± 12.6 years and 92% were men. During a mean follow up of 3.3 years, we observed 22,942 new cases of CVD and 48,325 deaths. There was an inverse relation of leisure time PA with CVD and total mortality [HR: 0.96 (0.95-0.97) and 0.91 (0.90-0.92) per 2 MET-h/week increment for CVD and total mortality, respectively]. The associations of PA with both incident CVD and mortality were stronger in participants who spent more time watching television or on computer (all p values for interaction < 0.01). No interaction of PA with time spent on video game was observed (p>0.05).Conclusions
Leisure time PA is inversely associated with risk of CVD and mortality among US veterans and such relations were stronger in participants who spent more time watching television or on computer.
SUBMITTER: Djousse L
PROVIDER: S-EPMC8793724 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveDemanding psychosocial work characteristics, such as high job demands, can have a detrimental impact on leisure-time physical activity (LTPA), with adverse consequences for employee health and well-being. However, the mechanisms and moderators of this crossover effect are still largely unknown. We therefore aimed to identify and test potential mediating and moderating factors from within and outside the work environment. Based on the previous research, we expected job demands to be negatively related to LTPA through fatigue. In addition, we expected that job control and worktime control would attenuate the relationship between job demands and fatigue. Furthermore, we hypothesized that autonomous exercise motivation and spontaneous action planning would attenuate the relationship between fatigue and LTPA. In addition to these cross-sectional hypotheses, we expected the same effects to predict a change in LTPA in the following year.MethodsTo investigate these assumptions, a preregistered longitudinal survey study was conducted among a large sample of Dutch employees in sedentary jobs. Participants reported on the constructs of interest in 2017 and 2018 (N = 1189 and 665 respectively) and the resulting data were analyzed using path analyses.ResultsOur cross-sectional analyses confirm a weak indirect, negative association between job demands and LTPA, via fatigue. However, this finding was not observed in our longitudinal analyses and none of the other hypotheses were confirmed.ConclusionThis study shows that, among employees with relatively healthy psychosocial work characteristics (i.e., high job control), the evidence for an impact of these work characteristics on participation in LTPA is limited.
| S-EPMC8795020 | biostudies-literature
Project description:This study examines leisure time sedentary behavior (LTSB) and usual occupational/domestic activity (UODA) and their relationship with metabolic syndrome and individual cardiovascular disease (CVD) risk factors, independent of physical activity level.National Health and Nutrition Examination Survey (NHANES) 2003-2006 data from men (n = 1868) and women (n = 1688) with fasting measures were classified as having metabolic syndrome by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) definition. LTSB was determined from self-reported television viewing and computer usage. UODA was self-reported daily behavior (sitting, standing, walking, carrying loads).LTSB >or=4 hours/day was associated with odds of having metabolic syndrome of 1.94 (95% confidence interval [CI], 1.24, 3.03) in men compared to <or=1 hour/day. LTSB >or=4 hour/day was also associated with higher odds of elevated waist circumference (1.88, CI, 1.03, 3.41), low high-density lipoprotein cholesterol (HDL-C) (1.84, CI, 1.35, 2.51), and high blood pressure (1.55, CI, 1.07, 2.24) in men. LTSB 2-3 hours/day was associated with higher odds of elevated glucose (1.32, CI, 1.00, 1.75) in men. In women, odds of metabolic syndrome were 1.54 (CI, 1.00, 2.37) with >or=4 hours/day LTSB, but LTSB was not associated with risk of the individual CVD risk factors. Higher LTSB was associated with metabolic syndrome in inactive men (1.50, CI, 1.07, 2.09), active men (1.74, CI, 1.11, 2.71), inactive women (1.69, CI, 1.24, 2.33), but not active women (1.62, CI, 0.87,3.01). UODA was not strongly associated with metabolic syndrome or CVD risk factors in either men or women.In men, high LTSB is associated with higher odds of metabolic syndrome and individual CVD risk factors regardless of meeting physical activity recommendations. In women, high LTSB is associated with higher odds of metabolic syndrome only in those not meeting the physical activity recommendations.
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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.
| S-EPMC4079687 | biostudies-other
Project description:PURPOSE:The objectives of the study were to determine the extent to which trajectories of maternal preconception leisure-time physical activity (LTPA) and leisure-time sedentary behavior (LTSB) during adolescence and young adulthood are associated with offspring birth weight (BW) and to test if these associations differ by offspring sex or maternal pre-pregnancy overweight-obese status. METHODS:Participants with one or more birth (n = 1408) were identified from the National Longitudinal Study of Adolescent to Adult Health. Group-based trajectory modeling was used to characterize trajectories of LTPA (frequency/week) and LTSB (hours/week) which were measured, on average, over 7 years between age 15 and 22 years. Weighted regression and Wald tests were used to estimate and test mean differences and odds ratios for BW, small for gestational age, and large for gestational age (LGA). RESULTS:Three trajectories were identified for LTPA and five for LTSB. Associations differed by offspring sex for continuous BW and LGA (interaction P = .10 and .008, respectively). Among female offspring, participants with high followed by decreasing LTPA delivered offspring with 90 g greater BW (95% confidence interval [CI]: -4 to 184) and 72% greater risk of LGA (95% CI: 0.94-3.14), compared with participants with low LTPA. Among male offspring, LTPA patterns were not associated with BW. A pattern of high then decreasing LTPA among normal weight, but not overweight-obese women, was associated with 2.03 times greater risk of LGA (95% CI: 1.06-3.88). LTSB trajectories were not associated with BW. CONCLUSIONS:Associations of preconception trajectories of LTPA with offspring BW may differ by offspring sex and maternal pre-pregnancy overweight-obese status.
| S-EPMC5705438 | biostudies-literature
Project description:The optimum amounts and types of leisure-time physical activity (LTPA) for cardiovascular disease (CVD) prevention among Chinese retired adults are unclear. The prospective study enrolled 26,584 participants (mean age [SD]: 63.3 [8.4]) without baseline disease from the Dongfeng-Tongji cohort in 2013. Cox-proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a mean 5.0 (1.5) years of follow-up, 5704 incident CVD cases were documented. Compared with less than 7.5 metabolic equivalent of task-hours per week (MET-hours/week) of LTPA, participating LTPA for 22.5-37.5 MET-hours/week, which was equivalent to 3 to 5 times the world health organization (WHO) recommended minimum, was associated with a 18% (95% CI 9 to 25%) lower CVD risk; however, no significant additional benefit was gained when exceeding 37.5 MET-hours/week. Each log10 increment of MET-hours/week in square dancing and cycling was associated with 11% (95% CI 2 to 20%) and 32% (95% CI 21 to 41%), respectively, lower risk of incident CVD. In Chinese retired adults, higher LTPA levels were associated with lower CVD risk, with a benefit threshold at 3 to 5 times the recommended physical activity minimum. Encouraging participation in square dancing and cycling might gain favourable cardiovascular benefits.
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Project description:Background: Maternal leisure time physical activity (LTPA) and sedentary time during pregnancy may influence programming of infant growth in a sex-specific manner. Materials and Methods: Participants (N?=?35,212) from the Danish National Birth Cohort reported moderate/vigorous LTPA (hours/week) in early (conception to mean 16 weeks of gestation) and late pregnancy (mean 31 weeks of gestation to delivery) during interviews at 16 weeks of gestation and 6 months postpartum. Participants reported screen time at work and time spent watching television/videos (hours/day) in early pregnancy. Infant weight at 12 months of age was reported by mothers. Weight-for-length was categorized using sex-specific international standards. Results: Participants reported on average 1 hour per week of early pregnancy moderate/vigorous LTPA, 0.5 hour per week of late pregnancy LTPA, and 3 hours per day of early pregnancy sedentary time. Early pregnancy LTPA category was not associated with infant weight (p for trend?=?0.62). There were suggested associations of early pregnancy sedentary time above the first quartile with greater odds of infant underweight (odds ratio?=?1.15-1.27; p for trend?=?0.27). Associations were similar in male and female infants. Conclusions: There is no clear relationship between early or late pregnancy LTPA and infant weight at 12 months in our study. Maternal early pregnancy sedentary time may be associated with infant underweight at 12 months.
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Project description:IntroductionPhysical activity (PA) plays an important role in the prevention of cardiovascular diseases, especially in children. Previous studies which investigated the role of PA and sedentary time (ST) in cardiovascular disease used different measurements and found inconsistent results. The current study used recommended standardized measures and provides an overview of PA and ST among Dutch primary school children and their associations with cardiovascular risk factors.Methods503 children (55% girls, mean age (± SD) 10 ± 1y) were included. PA (total PA, lightPA and moderate to vigorous PA (MVPA)) and ST were measured with the Actigraph GT3X accelerometer. PA in different domains was measured with the BAECKE questionnaire. Cardiovascular risk factors included BMI z-score, waist circumference, blood pressure (z-score) and estimated cardiorespiratory fitness (CRF) as measured with the 20 meter shuttle run test.ResultsChildren spent 57 ± 20 min/day (8%) on MVPA and 42% of the children reached the MVPA guideline of 60 min/day. Total PA and MVPA (h/day) were negatively associated with BMI z-score (B = -0.452, p = 0.011) and waist circumference (B = -3.553, p = 0.011) and positively associated with CRF (B = 2.527, p = <0.001). ST was positively associated with BMI z-score (B = 0.108, p = 0.048) and waist circumference (B = 0.920, p = 0.033). No significant associations were found between total PA or PA intensities and blood pressure.ConclusionThis study used standardized measures of PA and therefore created an accurate overview of PA, ST and their associations with cardiovascular risk factors. PA and ST were associated with BMI z-score, waist circumference and CRF. The findings emphasize the importance of promoting MVPA in children, but also highlight the potential benefits of reducing ST to improve cardiovascular risk factors.Trial registrationClinicalTrials.gov NCT03440580.
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Project description:Objective: Few studies estimated the effect of leisure-time physical activity (LTPA) on cardiovascular disease (CVD) risk among hypertensive patients in a longitudinal cohort. This study aims to evaluate the association between LTPA and CVD in a longitudinal management cohort of hypertensive patients. Methods: A total of 58,167 hypertensive patients without baseline CVD from a longitudinal cohort were included in this study. LTPA and other covariates were measured at the follow-up four times annually. The primary outcome was CVD events. The association between LTPA and CVD was assessed by the marginal structure model (MSM) and Cox model with adjustment for age, gender, body mass index (BMI), smoking, drinking, diabetes, hyperlipidemia, and antihypertensive medication. The restricted cubic spline and segmented regression were used to assess the dose-response relationship between LTPA and CVD. Results: We recorded 16,332 CVD events; crude incidence of CVD were 89.68, 80.39, 62.64, and 44.04 per 1,000 person-years for baseline 0, 1-150, 151-300, and >300 min/week LTPA, respectively. Compared with inactive LTPA, the adjusted hazard ratios (HRs) estimated by Cox model and MSM-Cox model for CVD associated with 1-150,151-300, and 300 min/week LTPA were 0.85 (95% CI, 0.83-0.88), 0.67 (95% CI, 0.64-0.71), 0.47 (95% CI, 0.44-0.51), and 0.83 (95% CI, 0.76-0.91), 0.58 (95% CI, 0.52-0.63), and 0.39 (95% CI, 0.35-0.44), respectively. Per 60 min/week increase in LTPA was associated with a 13% reduction in CVD risk. LTPA breakpoint was 417 min/week for CVD. Before and after the break-point, the slopes of the piecewise-linear relationship between LTPA and CVD risk were -0.0017 and -0.0003, respectively. Conclusion: LTPA was more strongly associated with the CVD risk than that estimated by conventional analyses based on baseline LTPA; 417 min/week is a breakpoint, after which the incremental health benefits on CVD prevention obtained from the increase in LTPA are much less than before.
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Project description:IntroductionAfrican American women have a life expectancy 2.7 years shorter than that of white women and are less likely than white women to meet national physical activity guidelines. Physical activity has been found to reduce mortality, but evidence concerning African American women is limited.MethodsIn the Black Women's Health Study, a prospective cohort study of African American women begun in 1995, a total of 52,993 participants who were free of cardiovascular disease and cancer at enrollment were followed through 2017. Cox proportional hazards models evaluated the associations of repeated measures of physical activity with mortality, adjusting for demographic, medical, and lifestyle factors. Statistical analyses were last performed in September 2019.ResultsDuring the 22 years of follow-up, 4,719 deaths occurred. Higher levels of physical activity were associated with reduced all-cause, cardiovascular disease, and cancer mortality. Hazard ratios for walking ≥5 hours per week relative to no walking were 0.69 (95% CI=0.62, 0.77), 0.71 (95% CI=0.57, 0.87), and 0.80 (95% CI=0.67, 0.96) for all-cause, cardiovascular disease, and cancer mortality, respectively. The comparable hazard ratios for vigorous exercise for ≥5 hours per week vs none were 0.58 (95% CI=0.50, 0.67), 0.66 (95% CI=0.50, 0.87), and 0.52 (95% CI=0.39, 0.72).ConclusionsBoth walking for exercise and vigorous exercise were associated with reductions in mortality among African American women, including deaths from cardiovascular disease and deaths from cancer, both of which are disproportionately high in the African American population. These findings underline the importance of institutional and individual changes that will lead to increased physical activity.
| S-EPMC7577941 | biostudies-literature
Project description:BackgroundPhysical activity is one of the mainstays of secondary prevention in people with heart disease. It is not well understood, however, how the presence of heart disease or a history of habitual exercise prior to the study modify any mortality-sparing effects of leisure-time physical activity.MethodsWe analyzed data from a well-described cohort of subjects aged 54 years and older at intake (median age, 70 years) from Sonoma, CA, studied between 1993 and 2001 with mortality follow-up until 2003. A history-adjusted marginal structural model was used to obtain counterfactual excess risk estimates that were pooled across the different time points. Additive interaction was examined by comparing these excess risk estimates across strata of age, heart disease, and precohort physical activity.ResultsEstimates of the excess risk for 2-year all-cause mortality comparing Centers for Disease Control and Prevention-recommended levels of current physical activity to lower levels of activity ranged from -0.7% to -4.9% among subjects younger than 75 years of age and from -7.8% to -14.8% among older subjects. Heart disease or precohort physical activity were not found to modify the effect of leisure-time physical activity.ConclusionsOur data are consistent with the view that the mortality-sparing effect of recent physical activity is independent of the presence or absence of underlying cardiac disease and the pattern of past physical activity.
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