4.6 Article

Device-measured physical activity, adiposity and mortality: a harmonised meta-analysis of eight prospective cohort studies

Journal

BRITISH JOURNAL OF SPORTS MEDICINE
Volume 56, Issue 13, Pages 725-+

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bjsports-2021-104827

Keywords

exercise; body mass index; observational study

Categories

Funding

  1. Stockholm County Council
  2. Swedish National Centre for Research in Sports
  3. project ALPHA from European Union
  4. British Heart Foundation [PG/13/86/30546, RG/13/16/30528]
  5. UK Medical Research Council [MC_UU_12015/3, MC_UU_00006/4, MC_UU_12015/3, MR/N003284/1]
  6. Cancer Research UK [C864/A14136]
  7. NIHR Biomedical Research Centre in Cambridge [IS-BRC-1215-20014]
  8. National Health and Medical Research Council of Australia Research Fellowship [1142685]
  9. National Institutes of Health (NIH), National Heart, Lung, and Blood Institute (NHLBI) [N01-HC25195, HHSN268201500001I, 75N92019D00031]
  10. National Institute on Aging [R01AG047645]
  11. Health and Human Services (HHS) [N268201500001I, R01-AG047645, R01-HL131029]
  12. American Heart Association [15GPSGC24800006]
  13. Norwegian Directorate for Public Health
  14. Research Council of Norway [249932/F20]
  15. National Institute of Neurological Disorders and Stroke
  16. National Institute on Aging of the NIH
  17. National Institute of Neurological Disorders and Stroke of the NIH [R01-NS061846]
  18. NIH [CA154647, CA047988, CA182913, HL043851, HL080467, HL099355]
  19. National Institute on Aging
  20. Coca-Cola
  21. Norwegian School of Sport Sciences
  22. Folksam Research Foundation, Sweden
  23. [U01--NS041588]

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The study revealed that higher levels of physical activity were associated with lower risk of mortality regardless of weight status. For normal weight and overweight individuals, higher levels of total and intensity-specific physical activity were related to lower mortality risk, while for those who were obese, only total physical activity was inversely associated with mortality risk.
Background The joint associations of total and intensity-specific physical activity with obesity in relation to all-cause mortality risk are unclear. Methods We included 34 492 adults (72% women, median age 62.1 years, 2034 deaths during follow-up) in a harmonised meta-analysis of eight population-based prospective cohort studies with mean follow-up ranging from 6.0 to 14.5 years. Standard body mass index categories were cross-classified with sample tertiles of device-measured total, light-to-vigorous and moderate-to-vigorous physical activity and sedentary time. In five cohorts with waist circumference available, high and low waist circumference was combined with tertiles of moderate-to-vigorous physical activity. Results There was an inverse dose-response relationship between higher levels of total and intensity-specific physical activity and mortality risk in those who were normal weight and overweight. In individuals with obesity, the inverse dose-response relationship was only observed for total physical activity. Similarly, lower levels of sedentary time were associated with lower mortality risk in normal weight and overweight individuals but there was no association between sedentary time and risk of mortality in those who were obese. Compared with the obese-low total physical activity reference, the HRs were 0.59 (95% CI 0.44 to 0.79) for normal weight-high total activity and 0.67 (95% CI 0.48 to 0.94) for obese-high total activity. In contrast, normal weight-low total physical activity was associated with a higher risk of mortality compared with the obese-low total physical activity reference (1.28; 95% CI 0.99 to 1.67). Conclusions Higher levels of physical activity were associated with lower risk of mortality irrespective of weight status. Compared with obesity-low physical activity, there was no survival benefit of being normal weight if physical activity levels were low.

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