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  • Joint association between accelerometry-measured daily combination of time spent in physical activity, sedentary behaviour and sleep and all-cause mortality: a pooled analysis of six prospective cohorts using compositional analysis

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Original research
Joint association between accelerometry-measured daily combination of time spent in physical activity, sedentary behaviour and sleep and all-cause mortality: a pooled analysis of six prospective cohorts using compositional analysis
  1. Sebastien Chastin1,2,
  2. Duncan McGregor1,3,
  3. Javier Palarea-Albaladejo3,
  4. Keith M Diaz4,
  5. Maria Hagströmer5,6,7,
  6. Pedro Curi Hallal8,
  7. Vincent T van Hees9,
  8. Steven Hooker10,
  9. Virginia J Howard11,
  10. I-Min Lee12,
  11. Philip von Rosen5,
  12. Séverine Sabia13,14,
  13. Eric J Shiroma15,
  14. Manasa S Yerramalla13,
  15. Philippa Dall1
  1. 1 School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
  2. 2 Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
  3. 3 Biomathematics and Statistics Scotland, Edinburgh, UK
  4. 4 Department of Medicine, Columbia University Medical Center, New York, New York, USA
  5. 5 Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institute, Stockholm, Sweden
  6. 6 Department of Health Promoting Science, Sophiahemmet University College, Stockholm, Sweden
  7. 7 Academic Primary Health Care Center, Stockholm, Region Stockholm, Sweden
  8. 8 Federal University of Pelotas, Pelotas, Brazil
  9. 9 Accelting, Almere, The Netherlands
  10. 10 Exercise Science and Health Promotion Program, College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
  11. 11 University of Alabama School of Medicine, Birmingham, Alabama, USA
  12. 12 Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  13. 13 Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Université de Paris, Paris, France
  14. 14 Department of Epidemiology and Public Health, University College London, London, UK
  15. 15 Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland, USA
  1. Correspondence to Prof Sebastien Chastin, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK; Sebastien.Chastin{at}gcu.ac.uk

Abstract

Objective To examine the joint associations of daily time spent in different intensities of physical activity, sedentary behaviour and sleep with all-cause mortality.

Methods Federated pooled analysis of six prospective cohorts with device-measured time spent in different intensities of physical activity, sedentary behaviour and sleep following a standardised compositional Cox regression analysis.

Participants 130 239 people from general population samples of adults (average age 54 years) from the UK, USA and Sweden.

Main outcome All-cause mortality (follow-up 4.3–14.5 years).

Results Studies using wrist and hip accelerometer provided statistically different results (I2=92.2%, Q-test p<0.001). There was no association between duration of sleep and all-cause mortality, HR=0.96 (95% CI 0.67 to 1.12). The proportion of time spent in moderate to vigorous physical activity was significantly associated with lower risk of all-cause mortality (HR=0.63 (95% CI 0.55 to 0.71) wrist; HR=0.93 (95% CI 0.87 to 0.98) hip). A significant association for the ratio of time spent in light physical activity and sedentary time was only found in hip accelerometer-based studies (HR=0.5, 95% CI 0.42 to 0.62). In studies based on hip accelerometer, the association between moderate to vigorous physical activity and mortality was modified by the balance of time spent in light physical activity and sedentary time.

Conclusion This federated analysis shows a joint dose–response association between the daily balance of time spent in physical activity of different intensities and sedentary behaviour with all-cause mortality, while sleep duration does not appear to be significant. The strongest association is with time spent in moderate to vigorous physical activity, but it is modified by the balance of time spent in light physical activity relative to sedentary behaviour.

  • physical activity
  • sleep
  • health

Data availability statement

Data are available in a public, open-access repository. Data may be obtained from a third party and are not publicly available. Some of the data sets included in this study are open access and others are curated by the studies. This is detailed in the manuscript and supplemental material.

https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bjsports-2020-102345

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    Data availability statement

    Data are available in a public, open-access repository. Data may be obtained from a third party and are not publicly available. Some of the data sets included in this study are open access and others are curated by the studies. This is detailed in the manuscript and supplemental material.

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    Footnotes

    • Twitter @SebChastin, @epiAgeing

    • SC and DM contributed equally.

    • Contributors SC conceived the study. DM, SC, PD and JPA contributed to the design of the study. DM and SC did the literature search. JPA provided guidance on the statistical elements of the study and compositional data analysis expertise. DM performed the federated analysis. DM, SC and PD wrote the first draft of the report. All authors analysed the data. All authors contributed to analysis and interpretation of the data, and critically reviewed the report.

    • Funding This work was supported by the Scottish Government’s Rural and Environment Science and Analytical Services Division (to DM and JPA) and the Spanish Ministry of Science, Innovation and Universities (CODAMET RTI2018-095518-B-C21, 2019-2021) (to JPA). The ABC study was supported by Stockholm County Council, Swedish National Centre for Research in Sports, and project ALPHA, which received funding from the European Union in the framework of the Public Health Programme and Folksam Research Foundation, Sweden (to MH and PvR). The REGARDS study was supported by a cooperative agreement U01 NS041588 cofunded by the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute on Aging (NIA), National Institutes of Health (NIH), Department of Health and Human Service. Additional funding was provided by an investigator-initiated grant R01-NS061846 from the NINDS/NIH (to SH) and an unrestricted research grant from The Coca-Cola Company. The Whitehall II study was supported by grants from the UK Medical Research Council (K013351, R024227, S011676); the British Heart Foundation (PG/11/63/29011 and RG/13/2/30098); the British Health and Safety Executive; the British Department of Health; the National Heart, Lung, and Blood Institute (R01HL036310); the NIA, NIH (R01AG056477, R01AG034454); and the Economic and Social Research Council (ES/J023299/1). MSY and SS were supported by the French National Research Agency (ANR-19-CE36-0004-01). The Women’s Health Study was supported by the NIH grants: CA154647, CA047988, CA182913, HL043851, HL080467 and HL099355 (to EJS and IML).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.