TY - JOUR
T1 - Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes
T2 - A dose-response meta-analysis of large prospective studies
AU - Garcia, Leandro
AU - Pearce, Matthew
AU - Abbas, Ali
AU - Mok, Alexander
AU - Strain, Tessa
AU - Ali, Sara
AU - Crippa, Alessio
AU - Dempsey, Paddy C
AU - Golubic, Rajna
AU - Kelly, Paul
AU - Laird, Yvonne
AU - McNamara, Eoin
AU - Moore, Samuel
AU - de Sa, Thiago Herick
AU - Smith, Andrea D
AU - Wijndaele, Katrien
AU - Woodcock, James
AU - Brage, Soren
N1 - Funding Information:
LG, AA and JW were supported by METAHIT, an MRC Methodology Panel project (MR/P02663X/1). AA, MP and JW have received funding from the European Research Council (ERC) under the Horizon 2020 Research and Innovation Programme (grant agreement 817754) (this material reflects only the authors’ views and the Commission is not liable for any use that may be made of the information contained therein). LG, AA and JW were supported by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence funded by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research (NIHR) and the Wellcome Trust (MR/K023187/1). PCD was supported by a National Health and Medical Research Council of Australia Research Fellowship (no: 1142685). RG was supported by a Gates Cambridge Scholarship. MP and SB were supported by the NIHR Biomedical Research Centre, Cambridge (IS-BRC-1215-20014). AM was supported by the National Science Scholarship from Singapore, A*STAR. THdS was supported by the São Paulo Research Foundation (2012/08565-4 and 2013/25624-7) and the National Council for Scientific and Technological Development (200358/2014-6 and 402648/2015-3). MP, TS, PCD, KW and SB were supported by UK Medical Research Council (MC_UU_12015/3, MC_UU_00006/4).
Publisher Copyright:
© Author(s) (or their employer(s)) 2023.
PY - 2023/7/20
Y1 - 2023/7/20
N2 - OBJECTIVE: To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population.DESIGN: Systematic review and cohort-level dose-response meta-analysis.DATA SOURCES: PubMed, Scopus, Web of Science and reference lists of published studies.ELIGIBILITY CRITERIA: Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney).RESULTS: 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted.CONCLUSIONS: Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
AB - OBJECTIVE: To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population.DESIGN: Systematic review and cohort-level dose-response meta-analysis.DATA SOURCES: PubMed, Scopus, Web of Science and reference lists of published studies.ELIGIBILITY CRITERIA: Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney).RESULTS: 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted.CONCLUSIONS: Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
KW - epidemiology
KW - health
KW - meta-Analysis
KW - noncommunicable diseases
KW - physical activity
U2 - 10.1136/bjsports-2022-105669
DO - 10.1136/bjsports-2022-105669
M3 - Review article
C2 - 36854652
SN - 0306-3674
VL - 57
SP - 979
EP - 989
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
IS - 15
M1 - bjsports-2022-105669
ER -