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
Ekelund, Ulf; Tarp, Jakob; Fagerland, Morten Wang; Steene-Johannessen, Jostein; Hansen, Bjørge Herman; Jefferis, Barbara; Whincup, Peter H.; Diaz, Keith M.; Hooker, Steven; Howard, Virginia J.; Chernofsky, Ariel; Larson, Martin G.; Spartano, Nicole; Vasan, Ramachandran S.; Dohrn, Ing-Mari; Hagströmer, Maria; Edwardson, Charlotte; Yates, Thomas; Shiroma, Eric; Dempsey, Paddy; Wijndaele, Katrien; Anderssen, Sigmund Alfred; Lee, I-Min
Peer reviewed, Journal article
MetadataVis full innførsel
OriginalversjonBritish Journal of Sports Medicine. 2020, 54(24), 1499-1507. 10.1136/bjsports-2020-103270
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.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.