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

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journal contribution
posted on 14.01.2022, 13:50 by Jakob Tarp, Morten W Fagerland, Knut Eirik Dalene, Jostein Steene Johannessen, Bjorge H Hansen, Barbara J Jefferis, Peter H Whincup, Keith M Diaz, Steven Hooker, Virginia J Howard, Ariel Chernofsky, Martin G Larson, Nicole L Spartano, Ramachandran S Vasan, Ing-Mari Dohrn, Maria Hagstromer, Charlotte Edwardson, Thomas Yates, Eric J Shiroma, Paddy C Dempsey, Katrien Wijndaele, Sigmund A Anderssen, I-Min Lee, Ulf Ekelund

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.

Funding

British Heart Foundation (PG/13/86/30546, RG/13/16/30528). UK Medical Research Council (MR/N003284/1). Cancer Research UK (C864/A14136). NIHR Biomedical Research Centre in Cambridge (IS-BRC-1215-20014).

History

Citation

Tarp J, Fagerland MW, Dalene KE, et al., 'Device-measured physical activity, adiposity and mortality: a harmonised meta-analysis of eight prospective cohort studies', British Journal of Sports Medicine. Published Online First: 07 December 2021. doi: 10.1136/bjsports-2021-104827

Author affiliation

Diabetes Research Centre; NIHR Leicester Biomedical Research Centre

Version

VoR (Version of Record)

Published in

BRITISH JOURNAL OF SPORTS MEDICINE

Pagination

1-9

Publisher

BMJ PUBLISHING GROUP

issn

0306-3674

eissn

1473-0480

Acceptance date

17/11/2021

Copyright date

2021

Available date

07/12/2021

Language

English