scholarly journals Association of changing physical activity intensity and bout length with mortality: a study of 79,507 participants in UK Biobank

Author(s):  
Louise Amanda Claire Millard ◽  
Kate Tilling ◽  
Tom R Gaunt ◽  
David Carslake ◽  
Deborah A Lawlor

Background Spending more time active (and less time sedentary) is associated with many health benefits such as improved cardiovascular health and lower risk of all-cause mortality. However, it is unclear whether these associations differ depending on whether time spent sedentary or in moderate-vigorous physical activity (MVPA) is accumulated in long or short bouts. In this study we used a novel analytical approach, that accounts for substitution (i.e. more time in MVPA means spending less time sleeping, in light activity or being sedentary), to examine whether length of sedentary and MVPA bouts associates with all-cause mortality. Methods and findings We used data on 79,507 participants from UK Biobank. We derived the total time participants spent in activity categories - sleep, sedentary, light activity and MVPA - on average per day. We also derived the time spent in sedentary and MVPA bouts of short (1-15 minutes), medium (16-40 minutes) and long (41+ minutes) duration. We used Cox proportion hazards regression to estimate the association of spending 10 minutes more average daily time in one activity or bout length category, coupled with spending 10 minutes less time in another, with all-cause mortality. Those spending more time sedentary had higher mortality risk if this replaced time spent in light activity (hazard ratio 1.02 [95% confidence interval (CI): 1.01, 1.03]), and an even higher risk if this replaced time spent in MVPA (hazard ratio 1.08 [95% CI: 1.06, 1.10]). Those spending more time in MVPA had lower mortality risk, irrespective of whether this replaced time spent sleeping, sedentary or in light activity. We found little evidence to suggest that mortality risk differed depending on the length of sedentary or MVPA bouts. A limitation of our study is that we cannot assume that these results are causal, though we adjusted for key confounders. Conclusions Using our novel analytical approach, we uniquely show that time spent in MVPA is associated with reduced mortality, irrespective of whether it replaces time spent sleeping, sedentary or in light activity. This emphasizes the specific importance of MVPA. We found little evidence to suggest that the impact of MVPA differs depending on whether it is obtained from several short bouts or fewer longer bouts, supporting recent policy changes in some countries. Further studies are needed to investigate causality and explore health outcomes beyond mortality.

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Louise Millard ◽  
Kate Tilling ◽  
Tom Gaunt ◽  
David Carslake ◽  
Deborah Lawlor

Abstract Background Spending more time active (and less time sedentary) is associated with many health benefits but it is unclear whether these associations differ depending on whether time spent sedentary or in moderate-vigorous physical activity (MVPA) is accumulated in long or short bouts. We used a novel analytical approach to examine whether length of sedentary and MVPA bouts associates with all-cause mortality. Methods We used data on 79,507 participants from UK Biobank. We derived the total time participants spent in activity categories (sleep, sedentary, light activity and MVPA) and in sedentary and MVPA bouts of short (1-15 minutes), medium (16-40 minutes) and long (41+ minutes) duration, on average per day. We used Cox proportion hazards regression to estimate the association of spending 10 minutes more average daily time in one activity or bout length category, coupled with spending 10 minutes less time in another, with all-cause mortality. Results Those spending more time in MVPA had lower mortality risk, irrespective of whether this replaced time spent sleeping, sedentary or in light activity. We found little evidence to suggest that mortality risk differed depending on the length of sedentary or MVPA bouts. Conclusions We uniquely show that higher total MVPA improves health irrespective of whether it is obtained from several short bouts or fewer longer bouts, supporting recent policy changes in some countries. Key messages Our results suggest that time spent in MVPA associates with lower mortality risk irrespective of whether it is obtained from several short bouts or fewer longer bouts.


PLoS Medicine ◽  
2021 ◽  
Vol 18 (9) ◽  
pp. e1003757
Author(s):  
Lousise A. C. Millard ◽  
Kate Tilling ◽  
Tom R. Gaunt ◽  
David Carslake ◽  
Deborah A. Lawlor

Background Spending more time active (and less sedentary) is associated with health benefits such as improved cardiovascular health and lower risk of all-cause mortality. It is unclear whether these associations differ depending on whether time spent sedentary or in moderate-vigorous physical activity (MVPA) is accumulated in long or short bouts. In this study, we used a novel method that accounts for substitution (i.e., more time in MVPA means less time sleeping, in light activity or sedentary) to examine whether length of sedentary and MVPA bouts associates with all-cause mortality. Methods and findings We used data on 79,503 adult participants from the population-based UK Biobank cohort, which recruited participants between 2006 and 2010 (mean age at accelerometer wear 62.1 years [SD = 7.9], 54.5% women; mean length of follow-up 5.1 years [SD = 0.73]). We derived (1) the total time participants spent in activity categories—sleep, sedentary, light activity, and MVPA—on average per day; (2) time spent in sedentary bouts of short (1 to 15 minutes), medium (16 to 40 minutes), and long (41+ minutes) duration; and (3) MVPA bouts of very short (1 to 9 minutes), short (10 to 15 minutes), medium (16 to 40 minutes), and long (41+ minutes) duration. We used Cox proportion hazards regression to estimate the association of spending 10 minutes more average daily time in one activity or bout length category, coupled with 10 minutes less time in another, with all-cause mortality. Those spending more time in MVPA had lower mortality risk, irrespective of whether this replaced time spent sleeping, sedentary, or in light activity, and these associations were of similar magnitude (e.g., hazard ratio [HR] 0.96 [95% CI: 0.94, 0.97; P < 0.001] per 10 minutes more MVPA, coupled with 10 minutes less light activity per day). Those spending more time sedentary had higher mortality risk if this replaced light activity (HR 1.02 [95% CI: 1.01, 1.02; P < 0.001] per 10 minutes more sedentary time, with 10 minutes less light activity per day) and an even higher risk if this replaced MVPA (HR 1.06 [95% CI: 1.05, 1.08; P < 0.001] per 10 minutes more sedentary time, with 10 minutes less MVPA per day). We found little evidence that mortality risk differed depending on the length of sedentary or MVPA bouts. Key limitations of our study are potential residual confounding, the limited length of follow-up, and use of a select sample of the United Kingdom population. Conclusions We have shown that time spent in MVPA was associated with lower mortality, irrespective of whether it replaced time spent sleeping, sedentary, or in light activity. Time spent sedentary was associated with higher mortality risk, particularly if it replaced MVPA. This emphasises the specific importance of MVPA. Our findings suggest that the impact of MVPA does not differ depending on whether it is obtained from several short bouts or fewer longer bouts, supporting the recent removal of the requirement that MVPA should be accumulated in bouts of 10 minutes or more from the UK and the United States policy. Further studies are needed to investigate causality and explore health outcomes beyond mortality.


2012 ◽  
Vol 24 (4) ◽  
pp. 507-518 ◽  
Author(s):  
Virginie Nicaise ◽  
David Kahan ◽  
Karen Reuben ◽  
James F. Sallis

This study investigated the impact of renovation and redesign of a university preschool’s outdoor space on children’s sedentary behavior, light activity, and moderate-to-vigorous-physical-activity (MVPA) during unstructured recess. Physical activity was measured by accelerometry and direct observation in two independent samples of 50 (baseline) and 57 (postintervention) children (Mage=4.4 yrs ± 0.5). Controlling for gender, age, BMI and recess length, observational data, but not accelerometry, revealed a significant decrease in intervals spent sedentary (-26.5%) and increases in light physical activity (+11.6%) and MVPA (+14.9%). Higher levels of MVPA were associated with specific environmental changes (new looping cycle path, OR = 2.18; increased playground open space, OR = 7.62; and new grass hill, OR = 3.27). Decreased sedentary behavior and increased light activity and MVPA may be realized with environmental changes that promote continuous and novel movement experiences in more expansive spaces.


2016 ◽  
Vol 31 (4) ◽  
pp. 340-342 ◽  
Author(s):  
Paul D. Loprinzi

Purpose. Research demonstrates that moderate-to-vigorous physical activity (MVPA) is associated with a reduced risk of all-cause mortality. Few studies have examined the effects of light-intensity physical activity on mortality. Therefore, the purpose of this study was to examine the association between objectively measured light-intensity physical activity and all-cause mortality risk. Design. Longitudinal. Setting. National Health and Nutrition Examination Survey 2003–2006 with follow-up through December 31, 2011. Subjects. Five thousand five hundred seventy-five U.S. adults. Measures. Participants wore an accelerometer for at least 4 days and completed questionnaires to assess sociodemographics and chronic disease information, with blood samples taken to assess biological markers. Follow-up mortality status was assessed via death certificate data from the National Death Index. Analysis. Cox proportional hazard model. Results. After adjusting for accelerometer-determined MVPA, age, gender, race-ethnicity, cotinine, weight status, poverty level, C-reactive protein, and comorbid illness, for every 60-minute increase in accelerometer-determined light-intensity physical activity, participants had a 16% reduced hazard of all-cause mortality (hazard ratio = .84; 95% confidence interval: .78–.91; p < .001). Conclusion. In this national sample of U.S. adults, light-intensity physical activity was inversely associated with all-cause mortality risk, independent of age, MVPA, and other potential confounders. In addition to MVPA, promotion of light-intensity physical activity is warranted.


2020 ◽  
Vol 76 (1) ◽  
pp. 77-84
Author(s):  
Purva Jain ◽  
John Bellettiere ◽  
Nicole Glass ◽  
Michael J LaMonte ◽  
Chongzhi Di ◽  
...  

Abstract Background Self-reported time spent standing has been associated with lower risk of mortality. No previous studies have examined this association using device-measured standing. Method This was a prospective cohort study of 5878 older (median age = 80 years), racial/ethnically diverse, community-dwelling women in the WHI Objective Physical Activity and Cardiovascular Health Study (OPACH). Women wore accelerometers for 1 week and were followed for mortality. The study applied previously validated machine learning algorithms to ActiGraph GT3X+ accelerometer data to separately measure time spent standing with and without ambulation. Cox proportional hazards models were used to estimate mortality risk adjusting for potential confounders. Effect modification by age, body mass index, moderate-to-vigorous physical activity, sedentary time, physical functioning, and race/ethnicity was evaluated. Results There were 691 deaths during 26 649 person-years of follow-up through March 31, 2018 (mean follow-up = 4.8 years). In fully adjusted models, all-cause mortality risk was lower among those with more standing without ambulation (quartile [Q] 4 vs Q1 HR = 0.63; 95% CI = 0.49–0.81, p-trend = .003) and more standing with ambulation (Q4 vs Q1 HR = 0.50; 95% CI = 0.35–0.71, p-trend &lt; .001). Associations of standing with ambulation and mortality were stronger among women with above-median sedentary time (HR = 0.51; 95% CI = 0.38–0.68) compared to women with below-median sedentary time (HR = 0.80; 95% CI = 0.59–1.07; p-interaction = .02). Conclusions In this prospective study among older women, higher levels of accelerometer-measured standing were associated with lower risks of all-cause mortality. Standing is an achievable approach to interrupting prolonged sedentary time, and if not contraindicated, is a safe and feasible behavior that appears to benefit health in older ages.


2020 ◽  
Vol 7 ◽  
Author(s):  
Xiaoyao Li ◽  
Xiaodi Xue ◽  
Xuerong Sun ◽  
Shuang Zhao ◽  
Keping Chen ◽  
...  

Objective: To clarify the impact of sex on physical activity (PA) levels among patients with implantable cardioverter-defibrillators/cardiac resynchronization therapy defibrillators (ICD/CRT-D) and its association with cardiac death and all-cause mortality.Methods: Overall, data of 820 patients with ICD/CRT-D from the SUMMIT registry were retrospectively analyzed. Baseline PA from 30 to 60 days after device implantation was measured using Biotronik accelerometer sensors. The primary and secondary endpoints were cardiac death and all-cause mortality, respectively.Results: Baseline PA levels were significantly higher in male patients than in female patients (11.40 ± 5.83% vs. 9.93 ± 5.49%, P = 0.001). Males had higher predictive PA cut-off values for cardiac death (11.16 vs. 7.15%) and all-cause mortality (11.33 vs. 7.17%). During the median follow-up time of 75.7 ± 29.1 months, patients with baseline PA&lt;cut-off values had higher cumulative incidence of cardiac death and all-cause mortality in both males and females. At a PA level between the cut-off values of males and females, males had a higher risk of cardiac death (hazard ratio = 4.952; 95%CI = 1.055-23.245, P = 0.043) and all-cause mortality (hazard ratio = 2.432; 95%CI = 1.095-5.402, P = 0.029).Conclusions: Males had higher predictive PA cut-off values for cardiac death and all-cause mortality in patients with ICD/CRT-D. Sex should be considered as an important contributing factor when deciding for PA targets.


2020 ◽  
Vol 28 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Judith Godin ◽  
Joanna M. Blodgett ◽  
Kenneth Rockwood ◽  
Olga Theou

The authors sought to examine how much sedentary time needs to be replaced by light or moderate–vigorous physical activity in order to reduce frailty and protect against mortality. The authors built isotemporal substitution models to assess the theoretical effect of replacing sedentary behavior with an equal amount of light or moderate–vigorous activity on frailty and mortality in community-based adults aged 50 years and older. Controlling for age, sex, body mass index, marital status, race, education, employment status, and National Health and Nutrition Examination Study cycle, replacing 1 hr of sedentary time with moderate–vigorous or light physical activity daily was associated with a lower frailty index. For mortality, results varied based on frailty level. Replacing sedentary behavior with moderate–vigorous exercise was associated with lower mortality risk in vulnerable individuals; however, replacing sedentary behavior with light activity was associated with lower mortality risk in frailer individuals.


2018 ◽  
Vol 15 (1) ◽  
pp. 30-39 ◽  
Author(s):  
Zakkoyya H. Lewis ◽  
Kyriakos S. Markides ◽  
Kenneth J. Ottenbacher ◽  
Soham Al Snih

Background: We investigated the association between 10 years of change in physical activity (PA) levels and 7-year all-cause mortality. Methods: Mexican American adults aged 67 and older (N = 803) participating in the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/1996–2012/2013) were included. All-cause mortality was our outcome. Participants were divided into 4 groups based on their difference in overall PA between 1995/1996 and 2005/2006 measured by the Physical Activity Scale for the Elderly. Participants were classified as having unchanged low PA (n = 339), decreased activity (n = 233), unchanged high activity (n = 166), and increased activity (n = 65). Change in the frequency of PA domains was also investigated. PA domains included leisure, household, sedentary, and walking activities. Results:After controlling for all covariates, results from the Cox proportional hazards regression found a 43% lower mortality risk in the increased PA group (hazards ratio = 0.57; 95% confidence interval, 0.34–0.97) compared with the unchanged low PA group. In the entire sample, a significantly lower mortality risk was also present among walking (hazards ratio = 0.88) and household (hazards ratio = 0.88) activities. Conclusion:Our results suggest that, independent of other factors, increasing PA is most protective of mortality among older Mexican Americans.


Author(s):  
Anna E Clarke ◽  
Valerie Carson ◽  
Jean-Philippe Chaput ◽  
Rachel C Colley ◽  
Karen C Roberts ◽  
...  

This study determined if meeting the Canadian 24-Hour Movement Guidelines recommendations are associated with all-cause mortality. Participants were 3,471 adults from the 2005-2006 U.S. National Health and Nutrition Examination Survey followed for mortality over 11 years. They were classified as meeting or not meeting recommendations for sleep duration, sedentary behaviour, and moderate-to-vigorous physical activity (MVPA). A total of 63.8%, 35.3%, and 41.5% of participants met recommendations for sleep, sedentary behavior, and physical activity while 12.3% met all three recommendations. The hazard ratio (HR) for all-cause mortality in participants meeting the recommendations relative to those not meeting the recommendations were 0.91 (0.72, 1.16) for sleep, 0.92 (0.61, 1.40) for sedentary behavior, and 0.42 (0.24, 0.74) for MVPA. The HR for meeting none, any one, any two, and all three recommendations were 1.00, 0.86 (0.65, 1.14), 0.49 (0.28, 0.86), and 0.72 (0.34, 1.50). When the cut-point used to denote acceptable sedentary time was changed from ≤8 to ≤10 hours/day, the HR for meeting none, any one, any two, and all three recommendations were 1.00, 0.83 (0.59, 1.15), 0.57 (0.34, 0.96), and 0.43 (0.20, 0.93). These findings provide some support for the ability of the 24-hour movement guidelines to predict mortality risk. NOVELTY - The 24-Hour Movement Guidelines provide recommendations for sleep, sedentary behavior, and physical activity. - The findings of this study provide some support of the ability of these new guidelines to predict mortality risk.


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