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Physical activity trajectories and mortality: population based cohort study

BMJ (Online), 2019-06, Vol.365, p.l2323-l2323 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2019 BMJ This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to 2019 BMJ ;ISSN: 0959-8138 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.l2323 ;PMID: 31243014

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  • Title:
    Physical activity trajectories and mortality: population based cohort study
  • Author: Mok, Alexander ; Khaw, Kay-Tee ; Luben, Robert ; Wareham, Nick ; Brage, Soren
  • Subjects: Adult ; Aged ; Blood pressure ; Body mass index ; Cancer ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - mortality ; Cause of Death ; Cholesterol ; Diabetes ; Energy expenditure ; Energy Metabolism ; Epidemiology ; Exercise ; Family medical history ; Female ; Health risk assessment ; Healthy Lifestyle ; Heart ; Heart rate ; Humans ; Leisure ; Lifestyles ; Longitudinal Studies ; Male ; Middle age ; Middle Aged ; Mortality ; Neoplasms - mortality ; Nutrition research ; Older people ; Physical activity ; Population studies ; Population Surveillance ; Prospective Studies ; Regression analysis ; Risk Factors ; Stroke ; Systematic review ; Triglycerides ; United Kingdom - epidemiology
  • Is Part Of: BMJ (Online), 2019-06, Vol.365, p.l2323-l2323
  • Description: AbstractObjectiveTo assess the prospective associations of baseline and long term trajectories of physical activity on mortality from all causes, cardiovascular disease, and cancer.DesignPopulation based cohort study.SettingAdults from the general population in the UK.Participants14 599 men and women (aged 40 to 79) from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort, assessed at baseline (1993 to 1997) up to 2004 for lifestyle and other risk factors; then followed to 2016 for mortality (median of 12.5 years of follow-up, after the last exposure assessment).Main exposurePhysical activity energy expenditure (PAEE) derived from questionnaires, calibrated against combined movement and heart rate monitoring.Main outcome measuresMortality from all causes, cardiovascular disease, and cancer. Multivariable proportional hazards regression models were adjusted for age, sex, sociodemographics, and changes in medical history, overall diet quality, body mass index, blood pressure, triglycerides, and cholesterol levels.ResultsDuring 171 277 person years of follow-up, 3148 deaths occurred. Long term increases in PAEE were inversely associated with mortality, independent of baseline PAEE. For each 1 kJ/kg/day per year increase in PAEE (equivalent to a trajectory of being inactive at baseline and gradually, over five years, meeting the World Health Organization minimum physical activity guidelines of 150 minutes/week of moderate-intensity physical activity), hazard ratios were: 0.76 (95% confidence interval 0.71 to 0.82) for all cause mortality, 0.71 (0.62 to 0.82) for cardiovascular disease mortality, and 0.89 (0.79 to 0.99) for cancer mortality, adjusted for baseline PAEE, and established risk factors. Similar results were observed when analyses were stratified by medical history of cardiovascular disease and cancer. Joint analyses with baseline and trajectories of physical activity show that, compared with consistently inactive individuals, those with increasing physical activity trajectories over time experienced lower risks of mortality from all causes, with hazard ratios of 0.76 (0.65 to 0.88), 0.62 (0.53 to 0.72), and 0.58 (0.43 to 0.78) at low, medium, and high baseline physical activity, respectively. At the population level, meeting and maintaining at least the minimum physical activity recommendations would potentially prevent 46% of deaths associated with physical inactivity.ConclusionsMiddle aged and older adults, including those with cardiovascular disease and cancer, can gain substantial longevity benefits by becoming more physically active, irrespective of past physical activity levels and established risk factors. Considerable population health impacts can be attained with consistent engagement in physical activity during mid to late life.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0959-8138
    EISSN: 1756-1833
    DOI: 10.1136/bmj.l2323
    PMID: 31243014
  • Source: BMJ Open Access Journals
    MEDLINE
    ProQuest Central
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