Association of physical activity intensity and bout length with mortality: An observational study of 79,503 UK Biobank participants

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.

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221Association of physical activity bout length and changing intensity with mortality in UK Biobank

International Journal of Epidemiology ◽

10.1093/ije/dyab168.443 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Louise Millard ◽

Kate Tilling ◽

Tom Gaunt ◽

David Carslake ◽

Deborah Lawlor

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Vigorous Physical Activity ◽

Lower Mortality ◽

Uk Biobank ◽

Bout Length ◽

All Cause Mortality ◽

Light Activity ◽

Activity Bout ◽

Lower Mortality Risk

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.

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

10.1101/2020.05.22.20108795 ◽

2020 ◽

Author(s):

Louise Amanda Claire Millard ◽

Kate Tilling ◽

Tom R Gaunt ◽

David Carslake ◽

Deborah A Lawlor

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Analytical Approach ◽

Vigorous Physical Activity ◽

Hazard Ratio ◽

Uk Biobank ◽

Bout Length ◽

All Cause Mortality ◽

Light Activity ◽

The Impact

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.

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Low serum klotho associated with all-cause mortality among a nationally representative sample of American adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glab308 ◽

2021 ◽

Author(s):

Jacob K Kresovich ◽

Catherine M Bulka

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Representative Sample ◽

Cox Regression ◽

The United States ◽

Risk Of Death ◽

All Cause Mortality ◽

Nationally Representative ◽

Low Serum

Abstract α-Klotho (klotho) is a protein involved in suppressing oxidative stress and inflammation. In animal models, it is reported to underlie numerous aging phenotypes and longevity. Among a nationally representative sample of adults aged 40 to 79 in the United States, we investigated whether circulating concentrations of klotho is a marker of mortality risk. Serum klotho was measured by ELISA on 10,069 individuals enrolled in the National Health and Nutrition Examination Survey between 2007-2014. Mortality follow-up data based on the National Death Index were available through December 31, 2015. After a mean follow-up of 58 months (range: 1-108), 616 incident deaths occurred. Using survey-weighted Cox regression models adjusted for age, sex and survey cycle, low serum klotho concentration (< 666 pg/mL) was associated with a 31% higher risk of death (compared to klotho concentration > 985 pg/mL, HR: 1.31, 95% CI: 1.00, 1.71, P= 0.05). Associations were consistent for mortality caused by heart disease or cancer. Associations of klotho with all-cause mortality did not appear to differ by most participant characteristics. However, we observed effect modification by physical activity, such that low levels of serum klotho were more strongly associated with mortality among individuals who did not meet recommendation-based physical activity guidelines. Our findings suggest that, among the general population of American adults, circulating levels of klotho may serve as a marker of mortality risk.

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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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Replacing Sedentary Time With Light or Moderate–Vigorous Physical Activity Across Levels of Frailty

Journal of Aging and Physical Activity ◽

10.1123/japa.2018-0361 ◽

2020 ◽

Vol 28 (1) ◽

pp. 18-23 ◽

Cited By ~ 1

Author(s):

Judith Godin ◽

Joanna M. Blodgett ◽

Kenneth Rockwood ◽

Olga Theou

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Mortality Risk ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Frailty Index ◽

Lower Mortality ◽

Vigorous Exercise ◽

Light Activity ◽

Lower Mortality Risk

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.

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Association of Different Physical Activity Domains on All-Cause Mortality in Adults Participating in Primary Care in the Brazilian National Health System: 4-Year Follow-up

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0067 ◽

2017 ◽

Vol 14 (1) ◽

pp. 45-51 ◽

Cited By ~ 3

Author(s):

Bruna C. Turi ◽

Jamile S. Codogno ◽

Romulo A. Fernandes ◽

Xuemei Sui ◽

Carl J. Lavie ◽

...

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Cox Regression ◽

National Health System ◽

Circulatory System ◽

Cox Regression Analysis ◽

Circulatory System Diseases ◽

All Cause Mortality ◽

Males And Females

Background:Evidence has shown that physical activity (PA) is associated with low mortality risk. However, data about reduced mortality due to PA are scarce in developing countries and the dose–response relationship between PA from different domains and all-cause mortality remains unclear. Thus, the aim of this study is to investigate the association of PA from different domains on all-cause mortality among Brazilian adults.Methods:679 males and females composed the study sample. Participants were divided into quartile groups according to PA from different domains (occupational, sports, and leisure-time). Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of PA from different domains and all-cause mortality.Results:During the follow-up period, 59 participants died. The most prevalent cause of death was circulatory system diseases (n = 20; 33.9% [21.8%–45.9%]). Higher scores of occupational (HR= 0.45 [95% CI: 0.20–0.97]), sports (HR= 0.44 [95% CI: 0.20–0.95]) and overall PA (HR= 0.40 [95% CI: 0.17–0.90]) were associated with lower mortality, even after adjustment for confounders.Conclusions:The findings in this study showed the importance of being active in different domains to reduce mortality risk.

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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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Multimorbidity, mortality, and physical activity

Chronic Illness ◽

10.1177/1742395316644306 ◽

2016 ◽

Vol 12 (4) ◽

pp. 272-280 ◽

Cited By ~ 12

Author(s):

Paul D Loprinzi ◽

Ovuokerie Addoh ◽

Chelsea Joyner

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Physical Inactivity ◽

Self Report ◽

Minimal Effect ◽

Increased Risk ◽

All Cause Mortality ◽

The Government ◽

Physician Diagnosis

Objectives Multimorbidity and physical inactivity are individually associated with increased mortality risk, but the possibility for physical activity to moderate the multimorbidity–mortality relationship has yet to be investigated. Methods Data from the 1999–2006 NHANES were employed, with 16,091 participants constituting the analytic sample. Participants were followed through 2011, including a median follow-up of 99 months. Physical activity was assessed via self-report with multimorbidity assessed from physician diagnosis. Results After adjustment, for every 1 morbidity increase, participants had a 23% increased risk of all-cause mortality (HR = 1.23; 95% CI: 1.19–1.28; p < 0.001). Multimorbidity mostly remained associated with all-cause mortality across all levels of physical activity, with the exception of those achieving four times the dose of the government guidelines. Discussion With the exception of those who engaged in high levels of self-reported physical activity, physical activity had a minimal effect on the multimorbidity–mortality relationship.

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Personality Pathways to Mortality: Interleukin-6 Links Conscientiousness to Mortality Risk

10.31234/osf.io/b42ya ◽

2020 ◽

Author(s):

Páraic S O'Súilleabháin ◽

Nick Turiano ◽

Denis Gerstorf ◽

Martina Luchetti ◽

stephen gallagher ◽

...

Keyword(s):

Mortality Risk ◽

Interleukin 6 ◽

The United States ◽

Lower Mortality ◽

Reactive Protein ◽

Age Related ◽

Physiological Pathways ◽

Adjusted Model ◽

Lower Mortality Risk

Personality is associated consistently with mortality hazards, but the physiological pathways are not yet clear. Immune system dysregulation may be one such pathway due to its role in age-related morbidity and mortality. In this preregistered study, we tested whether interleukin-6 (IL-6) and C-reactive protein (CRP) mediated the associations between personality traits and mortality hazards. The sample included 957 participants (M ± SD = 58.65 ± 11.51 years; range = 35 – 86 years) from the Midlife in the United States Survey that had 14 years of follow-up. Higher conscientiousness was associated with lower mortality hazards, with each one standard deviation higher conscientiousness associated with a 35% lower mortality risk. IL-6, but not CRP, partially mediated this association, with IL-6 accounting for 18% of this association in the fully adjusted model. While there was initial evidence that the biomarkers mediated both neuroticism and agreeableness and mortality risk, the indirect effects were not significant when controlling for the sociodemographic variables. Taken together, higher conscientiousness may lead to a longer life partially as a result of lower IL-6. This work highlights the importance of biological pathways that link personality to future mortality risk.

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Effects of Physical Inactivity on All-Cause Mortality Risk in Upper Bavaria

Perceptual and Motor Skills ◽

10.2466/pms.1993.77.2.499 ◽

1993 ◽

Vol 77 (2) ◽

pp. 499-505 ◽

Cited By ~ 8

Author(s):

Siegfried Weyerer

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Reference Group ◽

Physical And Mental Health ◽

Crude Mortality ◽

Confounding Variables ◽

All Cause Mortality ◽

Representative Random Sample ◽

Physically Inactive

The effect of physical activity on all-cause mortality was examined using a representative random sample of 1,536 persons (15 years and older) in three communities in Upper Bavaria. 27.0% of the respondents reported regular and 26.2% occasional physical exercise. During the 5-year follow-up 5.1% ( n = 79) of the original sample died. Using a logistic regression model, the relation between physical activity and mortality was measured by the odds ratio, with subjects reporting regular physical activity as the reference group. Crude mortality risk was significantly higher among the physically inactive (men: 3.97; women: 4.36) but not among respondents practising occasionally (men: 1.67; women: 1.24). After adjustment for potential confounding variables (age, social class, physical and mental health), the mortality risk was elevated but not statistically significant for the physically inactive (men: 1.76; women: 1.51) and for the group practising occasionally (men: 1.50; women: 1.14).

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