PT  - JOURNAL ARTICLE
AU  - Ulf Ekelund
AU  - Jakob Tarp
AU  - Morten W Fagerland
AU  - Jostein Steene Johannessen
AU  - Bjørge H Hansen
AU  - Barbara J Jefferis
AU  - Peter H Whincup
AU  - Keith M Diaz
AU  - Steven Hooker
AU  - Virginia J Howard
AU  - Ariel Chernofsky
AU  - Martin G Larson
AU  - Nicole Spartano
AU  - Ramachandran S Vasan
AU  - Ing-Mari Dohrn
AU  - Maria Hagströmer
AU  - Charlotte Edwardson
AU  - Thomas Yates
AU  - Eric J Shiroma
AU  - Paddy Dempsey
AU  - Katrien Wijndaele
AU  - Sigmund A Anderssen
AU  - I-Min Lee
TI  - Joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality: a harmonised meta-analysis in more than 44 000 middle-aged and older individuals
AID  - 10.1136/bjsports-2020-103270
DP  - 2020 Dec 01
TA  - British Journal of Sports Medicine
PG  - 1499--1506
VI  - 54
IP  - 24
4099  - http://bjsm.bmj.com/content/54/24/1499.short
4100  - http://bjsm.bmj.com/content/54/24/1499.full
SO  - Br J Sports Med2020 Dec 01; 54
AB  - Objectives To examine the joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality.Methods We conducted a harmonised meta-analysis including nine prospective cohort studies from four countries. 44 370 men and women were followed for 4.0 to 14.5 years during which 3451 participants died (7.8% mortality rate). Associations between different combinations of moderate-to-vigorous intensity physical activity (MVPA) and sedentary time were analysed at study level using Cox proportional hazards regression analysis and summarised using random effects meta-analysis.Results Across cohorts, the average time spent sedentary ranged from 8.5 hours/day to 10.5 hours/day and 8 min/day to 35 min/day for MVPA. Compared with the referent group (highest physical activity/lowest sedentary time), the risk of death increased with lower levels of MVPA and greater amounts of sedentary time. Among those in the highest third of MVPA, the risk of death was not statistically different from the referent for those in the middle (16%; 95% CI 0.87% to 1.54%) and highest (40%; 95% CI 0.87% to 2.26%) thirds of sedentary time. Those in the lowest third of MVPA had a greater risk of death in all combinations with sedentary time; 65% (95% CI 1.25% to 2.19%), 65% (95% CI 1.24% to 2.21%) and 263% (95% CI 1.93% to 3.57%), respectively.Conclusion Higher sedentary time is associated with higher mortality in less active individuals when measured by accelerometry. About 30–40 min of MVPA per day attenuate the association between sedentary time and risk of death, which is lower than previous estimates from self-reported data.