RT Journal Article
SR Electronic
T1 Device-measured physical activity, adiposity and mortality: a harmonised meta-analysis of eight prospective cohort studies
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP bjsports-2021-104827
DO 10.1136/bjsports-2021-104827
A1 Jakob Tarp
A1 Morten W Fagerland
A1 Knut Eirik Dalene
A1 Jostein Steene Johannessen
A1 Bjørge H Hansen
A1 Barbara J Jefferis
A1 Peter H Whincup
A1 Keith M Diaz
A1 Steven Hooker
A1 Virginia J Howard
A1 Ariel Chernofsky
A1 Martin G Larson
A1 Nicole L Spartano
A1 Ramachandran S Vasan
A1 Ing-Mari Dohrn
A1 Maria Hagströmer
A1 Charlotte Edwardson
A1 Thomas Yates
A1 Eric J Shiroma
A1 Paddy C Dempsey
A1 Katrien Wijndaele
A1 Sigmund A Anderssen
A1 I-Min Lee
A1 Ulf Ekelund
YR 2021
UL http://bjsm.bmj.com/content/early/2021/12/06/bjsports-2021-104827.abstract
AB Background The joint associations of total and intensity-specific physical activity with obesity in relation to all-cause mortality risk are unclear.Methods We 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.Results There 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).Conclusions Higher 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.Data ara available on reasonable request. The study-specific summary data included in the meta-analyses can be obtained from the corresponding authors; jtarp@clin.au.dk.