Associations of vigorous physical activity with all-cause, cardiovascular and cancer mortality among 64 913 adults

BackgroundPhysical activity recommendations state that for the same energy expenditure, moderate-to-vigorous physical activities (MVPAs) produce similar health benefits. However, few epidemiological studies have tested this hypothesis.DesignWe examined whether, compared with moderate, vigorous activity was associated with larger mortality risk reductions.MethodsData from 11 cohorts of the Health Survey for England and the Scottish Health Survey, collected from 1994 to 2011 (mean (SD) follow-up, 9.0 (3.6) years). Adults aged ≥30 years reported MVPA and linkage to mortality records. Exposure was the proportion of self-reported weighted MVPA through vigorous activity. Outcomes were all-cause, cardiovascular disease (CVD) and cancer mortality.ResultsAmong 64 913 adult respondents (44% men, 56% women, mean (SD) age, 49.8 (13.6) years), there were 5064 deaths from all-causes, 1393 from CVD and 1602 from cancer during 435 743 person-years of follow-up. Compared with those who reported no vigorous physical activity, and holding constant the volume of weighted MVPA, vigorous activity was associated with additional reductions in mortality risk. For all-cause mortality, the adjusted HR was HR=0.84 (95% CI 0.71, 0.99) and HR=0.84 (95% CI 0.76, 0.94) among those who reported between >0% and<30%, or ≥30% of their activity as vigorous, respectively. For CVD and cancer mortality, point estimates showed similar beneficial associations yet CIs were wider and crossed unity.ConclusionVigorous activities were associated with larger reductions in mortality risk than activities of moderate intensity, but no evidence of dose–response effects was found.

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Intensity-Weighted Physical Activity Volume and Risk of All-Cause and Cardiovascular Mortality: Does the Use of Absolute or Corrected Intensity Matter?

Journal of Physical Activity and Health ◽

10.1123/jpah.2019-0117 ◽

2019 ◽

Vol 16 (11) ◽

pp. 1054-1059

Author(s):

Jordan Andre Martenstyn ◽

Lauren Powell ◽

Natasha Nassar ◽

Mark Hamer ◽

Emmanuel Stamatakis

Keyword(s):

Physical Activity ◽

Health Survey ◽

Mortality Risk ◽

Cardiovascular Mortality ◽

Cox Regression ◽

Resting Metabolic Rate ◽

Epidemiological Studies ◽

Metabolic Equivalent ◽

Risk Of Mortality ◽

Scottish Health Survey

Background: Previous epidemiological studies examining the association between physical activity (PA) and mortality risk have measured absolute PA intensity using standard resting metabolic rate reference values that fail to consider individual differences. This study compared the risk of all-cause and cardiovascular mortality between absolute and corrected estimates of PA volume. Methods: 49,982 adults aged ≥40 years who participated in the Health Survey for England and Scottish Health Survey in 1994–2008 were included in our study. PA was classified as absolute or corrected metabolic equivalent (MET)-hours per week, taking participant’s weight, height, age, and sex into account. Cox regression models were used to examine the association between absolute and corrected PA volumes and all-cause and cardiovascular mortality. Results: The authors found no difference in the association between levels of PA and risk of all-cause and cardiovascular mortality for absolute and corrected MET-hours per week, although there was a consistent decrease in mortality risk with increasing PA. There was no difference in mortality when analyses were stratified by sex, age, and body mass index. Conclusions: The association between PA volume and risk of mortality was similar regardless of whether PA volume was estimated using absolute or corrected METs. There is no empirical justification against the use of absolute METs to estimate PA volume from questionnaires.

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Light-Intensity Physical Activity and All-Cause Mortality

American Journal of Health Promotion ◽

10.4278/ajhp.150515-arb-882 ◽

2016 ◽

Vol 31 (4) ◽

pp. 340-342 ◽

Cited By ~ 35

Author(s):

Paul D. Loprinzi

Keyword(s):

Physical Activity ◽

Light Intensity ◽

Mortality Risk ◽

Weight Status ◽

Vigorous Physical Activity ◽

National Sample ◽

Poverty Level ◽

All Cause Mortality ◽

Intensity Physical Activity

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.

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Can a simple measure of vigorous physical activity predict future mortality? Results from the OXCHECK study

Public Health Nutrition ◽

10.1079/phn2003548 ◽

2004 ◽

Vol 7 (4) ◽

pp. 557-562 ◽

Cited By ~ 14

Author(s):

Melvyn Hillsdon ◽

Margaret Thorogood ◽

Mike Murphy ◽

Lesley Jones

Keyword(s):

Physical Activity ◽

Cox Regression ◽

Vigorous Physical Activity ◽

Previous History ◽

Self Report ◽

Moderate Intensity ◽

Risk Of Death ◽

All Cause Mortality ◽

Intensity Physical Activity

AbstractBackground:As epidemiological studies have become more complex, demands for short, easily administered measures of risk factors have increased. This study investigates whether such a measure of physical activity is associated with the risk of death from all causes and death from specific causes.Methods:A prospective follow-up study of 11 090 men and women, aged 35–64 years, recruited from five UK general practices who responded to a postal questionnaire in 1989. Self-reported frequency of vigorous-intensity physical activity and data on confounding factors were collected at baseline survey. Death notifications up to 31 December 2001 were provided by the Office for National Statistics. The relative risk (and 95% confidence interval) of dying associated with each level of exposure to physical activity was estimated by the hazard ratio in a series of Cox regression models.Results:After > 10 years' follow-up there were 825 deaths among the 10 522 subjects with no previous history of angina or myocardial infarction. Participation in vigorous exercise was associated with a significantly lower risk of all-cause mortality. Similar associations were found for ischaemic heart disease and cancer mortality, although the relationships were not significant at the 5% level.Conclusions:Simple measures of self-reported vigorous physical activity are associated with the risk of future mortality, at least all-cause mortality in a somewhat selected group. Interpretation of the finding should be treated with caution due to the reliance on self-report and the possibility that residual confounding may underlie the associations. Because moderate-intensity physical activity is also beneficial to health, short physical activity questionnaires should include measures of such physical activity in the future.

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

British Journal of Sports Medicine ◽

10.1136/bjsports-2021-104827 ◽

2021 ◽

pp. bjsports-2021-104827

Author(s):

Jakob Tarp ◽

Morten W Fagerland ◽

Knut Eirik Dalene ◽

Jostein Steene Johannessen ◽

Bjørge H Hansen ◽

...

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Sedentary Time ◽

Meta Analysis ◽

Vigorous Physical Activity ◽

Total Activity ◽

Normal Weight ◽

Total Physical Activity ◽

Risk Of Mortality

BackgroundThe joint associations of total and intensity-specific physical activity with obesity in relation to all-cause mortality risk are unclear.MethodsWe 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.ResultsThere 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).ConclusionsHigher 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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The Relationship of Accelerometer-Assessed Standing Time With and Without Ambulation and Mortality: The WHI OPACH Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa227 ◽

2020 ◽

Vol 76 (1) ◽

pp. 77-84

Author(s):

Purva Jain ◽

John Bellettiere ◽

Nicole Glass ◽

Michael J LaMonte ◽

Chongzhi Di ◽

...

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Community Dwelling ◽

Machine Learning Algorithms ◽

Cardiovascular Health Study ◽

Accelerometer Data ◽

All Cause Mortality

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 < .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.

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An empirical example of analysis using a two-stage modeling approach: within-subject association of outdoor context and physical activity predicts future daily physical activity levels

Translational Behavioral Medicine ◽

10.1093/tbm/ibaa107 ◽

2020 ◽

Author(s):

Chih-Hsiang Yang ◽

Jaclyn P Maher ◽

Aditya Ponnada ◽

Eldin Dzubur ◽

Rachel Nordgren ◽

...

Keyword(s):

Physical Activity ◽

Vigorous Physical Activity ◽

Wearable Sensors ◽

Activity Levels ◽

Two Stage ◽

Modeling Approach ◽

Source Program ◽

Modeling Strategy ◽

Stage Modeling

Abstract People differ from each other to the extent to which momentary factors, such as context, mood, and cognitions, influence momentary health behaviors. However, statistical models to date are limited in their ability to test whether the association between two momentary variables (i.e., subject-level slopes) predicts a subject-level outcome. This study demonstrates a novel two-stage statistical modeling strategy that is capable of testing whether subject-level slopes between two momentary variables predict subject-level outcomes. An empirical case study application is presented to examine whether there are differences in momentary moderate-to-vigorous physical activity (MVPA) levels between the outdoor and indoor context in adults and whether these momentary differences predict mean daily MVPA levels 6 months later. One hundred and eight adults from a multiwave longitudinal study provided 4 days of ecological momentary assessment (during baseline) and accelerometry data (both at baseline and 6 month follow-up). Multilevel data were analyzed using an open-source program (MixWILD) to test whether momentary strength between outdoor context and MVPA during baseline was associated with average daily MVPA levels measured 6 months later. During baseline, momentary MVPA levels were higher in outdoor contexts as compared to indoor contexts (b = 0.07, p < .001). Participants who had more momentary MVPA when outdoors (vs. indoors) during baseline (i.e., a greater subject-level slope) had higher daily MVPA at the 6 month follow-up (b = 0.09, p < .05). This empirical example shows that the subject-level momentary association between specific context (i.e., outdoors) and health behavior (i.e., physical activity) may contribute to overall engagement in that behavior in the future. The demonstrated two-stage modeling approach has extensive applications in behavioral medicine to analyze intensive longitudinal data collected from wearable sensors and mobile devices.

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Determinants of student’s physical activity: a 12-month follow-up study in Ningxia province

BMC Public Health ◽

10.1186/s12889-021-10525-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Huang ◽

Xiangrong Shi ◽

Yujie Wang ◽

Xiaoling Li ◽

Pengpeng Gao ◽

...

Keyword(s):

Physical Activity ◽

Children And Adolescents ◽

Vigorous Physical Activity ◽

Skill Training ◽

Critical Role ◽

School Factors ◽

Factors Associated ◽

Students Attitudes ◽

Sport Events

Abstract Background Physical activity has many health benefits for children and adolescents. However, the prevalence of physical inactivity in school-aged children and adolescents remains high in China. Many factors impact the levels of moderate and vigorous physical activity (MVPA) among students. This study investigated the factors associated with students’ MVPA levels and the determinants of changes in their MVPA behaviour. Methods This is a longitudinal study with a 12-month follow-up. The study samples were obtained from 2016 and 2017 Physical Activity and Fitness in China—The Youth Study, and they included 1597 students (aged 9–18 years) from 31 primary, junior high, and high schools in Ningxia Province. Factors related to the individual (Age, Sex, BMI and attitude to PA), school (school exercise facility, PE class, teacher support, PA time and PA environment) and neighbourhood (free skill training, sport events, sport organization, sport facility) factors were measured via questionnaire at baseline and after 12 months. Multiple logistic regression was performed to examine the factors that impact students’ MVPA level and the determinants of changes in students’ MVPA behaviour. Results There was no difference in students’ MVPA levels between 2016 and 2017. Boys were more physically active than girls at baseline (RR 1.55, 95% CI 1.10, 2.20). Neighbourhood factors associated students’ MVPA levels were significant, but all of these factors (neighbourhood sport events, organizations, facilities, etc.) were removed from the longitudinal model. Individual and school factors were important for students’ MVPA maintenance and positive development (e.g., gender, attitude, school PE class and PA time). Conclusions In conclusion, both neighbourhood and school factors may affect students’ MVPA, but school appears to plays a more critical role in maintaining and promoting students’ MVPA levels. In addition, individual factors may be more important than school and neighbourhood factors in influencing students’ MVPA levels. Our research demonstrates that students’ attitudes towards PA and school factors should be considered targets for future intervention programmes to promote MVPA. More education programmes may help enhance students’ attitudes towards PA, but more studies with large samples and objective assessments are needed to explore the determinants of MVPA.

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Accelerometry and Self-Report Are Congruent for Children’s Moderate-to-Vigorous and Higher Intensity Physical Activity

Journal for the Measurement of Physical Behaviour ◽

10.1123/jmpb.2020-0017 ◽

2021 ◽

pp. 1-8

Author(s):

Claudio R. Nigg ◽

Xanna Burg ◽

Barbara Lohse ◽

Leslie Cunningham-Sabo

Keyword(s):

Physical Activity ◽

Repeated Measures ◽

Vigorous Physical Activity ◽

Fourth Grade ◽

Assessment Method ◽

Self Report ◽

Upper Elementary ◽

Upper Elementary School ◽

Intensity Physical Activity

Purpose: This study used different analytic approaches to compare physical activity (PA) metrics from accelerometers (ACC) and a self-report questionnaire in upper elementary youth participating in the Fuel for Fun intervention. Methods: The PA questionnaire and ACC were assessed at baseline/preintervention (fall fourth grade), Follow-up 1/postintervention (spring fourth grade), and Follow-up 2 (fall fifth grade) of 564 fourth grade students from three elementary schools (50% females, 78% White, and 28% overweight or obese). Different analytic approaches identified similarities and differences between the two methods. Results: On average, self-report was higher than ACC for vigorous PA (range = 9–15 min/day), but lower than ACC for moderate PA (range = 24–30 min/day), light PA (range = 30–36 min/day), and moderate-to-vigorous physical activity (MVPA; range = 9–21 min/day). Spearman’s correlations for vigorous PA (.30, .26, and .32); moderate PA (.12, .13, and .14); and MVPA (.25, .25, and .24) were significant at each time point (all ps ≤ .01), whereas correlations for light PA were not significant (.06, .04, and .07; all ps > .05). In repeated-measures analyses, ACC and questionnaire measures were significantly different from each other across the three time points; however, change difference of the two measures over time was only 5.5 MVPA min/day. Conclusions: The PA questionnaire and ACC validated each other and can be used to assess MVPA in upper elementary school children in a similar population to the current study. However, each assessment method captures unique information, especially for light-intensity PA. Multiple PA measurement methods are recommended to be used in research and application to provide a more comprehensive understanding of children’s activity.

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Abstract MP35: Physical Activity Before and After Cancer Diagnosis and Total and Cause-Specific Mortality

Circulation ◽

10.1161/circ.137.suppl_1.mp35 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Paulette D Chandler ◽

Deirdre Tobias ◽

Jule E Buring ◽

I-Min Lee ◽

Daniel Chasman ◽

...

Keyword(s):

Physical Activity ◽

Cancer Diagnosis ◽

Cancer Mortality ◽

Total Mortality ◽

Health Study ◽

Specific Mortality ◽

Before And After ◽

After Cancer ◽

Cvd Mortality

Background: Given the increased prevalence of cancer survivors in the United States, it is imperative to define risk factors for potential reductions in total and cause-specific mortality. Physical activity (PA) represents a promising target for intervention. Design: We prospectively evaluated PA from questionnaires before and after cancer diagnosis with total and cause-specific mortality among 13,297 subjects diagnosed with invasive cancer combined from the Physicians’ Health Study (PHS) (n=6328), Physicians’ Health Study II (PHS II) (n=912), and Women's Health Study (WHS) (n=6057). WHS and PHS participants were free of baseline cancer; PHS II participants reported no active cancer at baseline. We ascertained PA before and after an incident cancer diagnosis based on reports on repeated follow-up questionnaires. Death was ascertained by medical records and death certificates. Cox regression estimated combined hazard ratios (HRs) of mortality by PA adjusted for age, randomized treatments, BMI, and other lifestyle/demographic factors. We evaluated the interaction between PA before and after cancer diagnosis by comparing PA ≤1 versus ≥2 times/wk. Results: The mean follow-up after cancer diagnosis was 8.0, 7.5, and 5.2 y for WHS, PHS, and PHS II, respectively, during which there were 5623 deaths (WHS, 2164; PHS, 3269; PHS II; 190). Higher PA before cancer diagnosis was associated with significantly lower mortality. Compared with PA ≤ once/wk, the HRs (95% CIs) associated with PA 2-4 and >4 times/wk were 0.87 (0.82-0.93) and 0.88 (0.82-0.94) for total mortality; 0.77 (0.63-0.95) and 0.79 (0.62-0.997) for CVD mortality, and 0.90 (0.83-0.98) and 0.90 (0.83-0.98) for cancer mortality. Higher PA after cancer diagnosis was associated with significantly lower total and cancer mortality and non-significantly lower CVD mortality, with HRs (95% CIs) of 0.65 (0.58-0.72) and 0.66 (0.59-0.73) for total mortality; 0.78 (0.59-1.03) and 0.82 (0.61-1.10) for CVD mortality, and 0.66 (0.57-0.77) and 0.64 (0.55-0.74) for cancer mortality. There was a significant interaction of PA before and after cancer diagnosis for total (p int =0.02) and cancer (p int =0.007) mortality, but not CVD mortality (p int =0.38). Conclusions: Greater PA both before and after cancer diagnosis were significantly associated with lower total and cancer mortality. Higher PA before cancer diagnosis was also associated with lower CVD mortality. PA may be an important target for lower mortality after cancer diagnosis.

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Evaluation of a Walking-Track Intervention to Increase Children’s Physical Activity during Primary School Break Times

Children ◽

10.3390/children5100135 ◽

2018 ◽

Vol 5 (10) ◽

pp. 135

Author(s):

Emma Powell ◽

Lorayne Woodfield ◽

Alexander Powell ◽

Alan Nevill ◽

Tony Myers

Keyword(s):

Physical Activity ◽

Vigorous Physical Activity ◽

Structured Interview ◽

Systematic Observation ◽

Daily Routines ◽

Mixed Method Design ◽

School Playgrounds ◽

Recommended Guidelines ◽

Children’S Physical Activity

Despite the known benefits of engaging in daily moderate to vigorous physical activity (MVPA), only 22% of children in England are meeting the recommended guidelines. School break times have been advocated as a key part of children’s daily routines in which their MVPA can be increased. The main aim of this study was to evaluate the effect of installing a walking-track on children’s MVPA during school break times. A mixed method design was employed which allowed for the quantitative measurement of children’s PA at three time points (baseline, mid-intervention (1–5 weeks) and follow-up (6–9 weeks)), using pedometers (n = 81, 5–9 years) and systematic observation (n = 23, 7–9 years). A semi-structured interview (n = 1) was also conducted at 10 weeks’ follow-up. The installation of the walking-track was grounded in a unique set of theoretical constructs to aid the behaviour change of the teachers. Short term positive increases in girls’ and boys’ MVPA and longer term increases in boys’ vigorous PA (VPA) were found. Qualitative data highlighted that boys dominated the walking-track and the inconsistent behaviour of school staff negatively impacted upon children’s MVPA. A set of principles to guide the installment of walking-tracks in school playgrounds are recommended.

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