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JAMA Jul 2023Guidelines recommend 150 minutes or more of moderate to vigorous physical activity (MVPA) per week for overall health benefit, but the relative effects of concentrated...
IMPORTANCE
Guidelines recommend 150 minutes or more of moderate to vigorous physical activity (MVPA) per week for overall health benefit, but the relative effects of concentrated vs more evenly distributed activity are unclear.
OBJECTIVE
To examine associations between an accelerometer-derived "weekend warrior" pattern (ie, most MVPA achieved over 1-2 days) vs MVPA spread more evenly with risk of incident cardiovascular events.
DESIGN, SETTING, AND PARTICIPANTS
Retrospective analysis of UK Biobank cohort study participants providing a full week of accelerometer-based physical activity data between June 8, 2013, and December 30, 2015.
EXPOSURES
Three MVPA patterns were compared: active weekend warrior (active WW, ≥150 minutes with ≥50% of total MVPA achieved in 1-2 days), active regular (≥150 minutes and not meeting active WW status), and inactive (<150 minutes). The same patterns were assessed using the sample median threshold of 230.4 minutes or more of MVPA per week.
MAIN OUTCOMES AND MEASURES
Associations between activity pattern and incident atrial fibrillation, myocardial infarction, heart failure, and stroke were assessed using Cox proportional hazards regression, adjusted for age, sex, racial and ethnic background, tobacco use, alcohol intake, Townsend Deprivation Index, employment status, self-reported health, and diet quality.
RESULTS
A total of 89 573 individuals (mean [SD] age, 62 [7.8] years; 56% women) who underwent accelerometry were included. When stratified at the threshold of 150 minutes or more of MVPA per week, a total of 37 872 were in the active WW group (42.2%), 21 473 were in the active regular group (24.0%), and 30 228 were in the inactive group (33.7%). In multivariable-adjusted models, both activity patterns were associated with similarly lower risks of incident atrial fibrillation (active WW: hazard ratio [HR], 0.78 [95% CI, 0.74-0.83]; active regular: 0.81 [95% CI, 0.74-0.88; inactive: HR, 1.00 [95% CI, 0.94-1.07]), myocardial infarction (active WW: 0.73 [95% CI, 0.67-0.80]; active regular: 0.65 [95% CI, 0.57-0.74]; and inactive: 1.00 [95% CI, 0.91-1.10]), heart failure (active WW: 0.62 [95% CI, 0.56-0.68]; active regular: 0.64 [95% CI, 0.56-0.73]; and inactive: 1.00 [95% CI, 0.92-1.09]), and stroke (active WW: 0.79 [95% CI, 0.71-0.88]; active regular: 0.83 [95% CI, 0.72-0.97]; and inactive: 1.00 [95% CI, 0.90-1.11]). Findings were consistent at the median threshold of 230.4 minutes or more of MVPA per week, although associations with stroke were no longer significant (active WW: 0.89 [95% CI, 0.79-1.02]; active regular: 0.87 [95% CI, 0.74-1.02]; and inactive: 1.00 [95% CI, 0.90-1.11]).
CONCLUSIONS AND RELEVANCE
Physical activity concentrated within 1 to 2 days was associated with similarly lower risk of cardiovascular outcomes to more evenly distributed activity.
Topics: Female; Humans; Male; Middle Aged; Accelerometry; Atrial Fibrillation; Cardiovascular Diseases; Cohort Studies; Exercise; Heart Failure; Myocardial Infarction; Retrospective Studies; Aged
PubMed: 37462704
DOI: 10.1001/jama.2023.10875 -
JAMA Oncology Sep 2023Vigorous physical activity (VPA) is a time-efficient way to achieve recommended physical activity (PA) for cancer prevention, although structured longer bouts of VPA...
IMPORTANCE
Vigorous physical activity (VPA) is a time-efficient way to achieve recommended physical activity (PA) for cancer prevention, although structured longer bouts of VPA (via traditional exercise) are unappealing or inaccessible to many individuals.
OBJECTIVES
To evaluate the dose-response association of device-measured daily vigorous intermittent lifestyle physical activity (VILPA) with incident cancer, and to estimate the minimal dose required for a risk reduction of 50% of the maximum reduction.
DESIGN, SETTING, AND PARTICIPANTS
This was a prospective cohort analysis of 22 398 self-reported nonexercising adults from the UK Biobank accelerometry subsample. Participants were followed up through October 30, 2021 (mortality and hospitalizations), or June 30, 2021 (cancer registrations).
EXPOSURES
Daily VILPA of up to 1 and up to 2 minutes, assessed by accelerometers worn on participants' dominant wrist.
MAIN OUTCOMES AND MEASURES
Incidence of total cancer and PA-related cancer (a composite outcome of 13 cancer sites associated with low PA levels). Hazard ratios and 95% CIs were estimated using cubic splines adjusted for age, sex, education level, smoking status, alcohol consumption, sleep duration, fruit and vegetable consumption, parental cancer history, light- and moderate-intensity PA, and VPA from bouts of more than 1 or 2 minute(s), as appropriate.
RESULTS
The study sample comprised 22 398 participants (mean [SD] age, 62.0 [7.6] years; 10 122 [45.2%] men and 12 276 [54.8%] women; 21 509 [96.0%] White individuals). During a mean (SD) follow-up of 6.7 (1.2) years (149 650 person-years), 2356 total incident cancer events occurred, 1084 owing to PA-related cancer. Almost all (92.3%) of VILPA was accrued in bouts of up to 1 minute. Daily VILPA duration was associated with outcomes in a near-linear manner, with steeper dose-response curves for PA-related cancer than total cancer incidence. Compared with no VILPA, the median daily VILPA duration of bouts up to 1 minute (4.5 minutes per day) was associated with an HR of 0.80 (95% CI, 0.69-0.92) for total cancer and 0.69 (95% CI, 0.55-0.86) for PA-related cancer. The minimal dose was 3.4 minutes per day for total (HR, 0.83; 95% CI, 0.73-0.93) and 3.7 minutes for PA-related (HR, 0.72; 95% CI, 0.59-0.88) cancer incidence. Findings were similar for VILPA bout of up to 2 minutes.
CONCLUSIONS AND RELEVANCE
The findings of this prospective cohort study indicate that small amounts of VILPA were associated with lower incident cancer risk. Daily VILPA may be a promising intervention for cancer prevention in populations not able or motivated to exercise in leisure time.
Topics: Male; Humans; Adult; Female; Middle Aged; Prospective Studies; Incidence; Biological Specimen Banks; Exercise; Accelerometry; Life Style; Neoplasms; United Kingdom
PubMed: 37498576
DOI: 10.1001/jamaoncol.2023.1830 -
British Journal of Sports Medicine Nov 2023To examine whether moderate-to-vigorous physical activity (MVPA) modifies the association between sedentary time and mortality and vice versa, and estimate the joint... (Review)
Review
OBJECTIVES
To examine whether moderate-to-vigorous physical activity (MVPA) modifies the association between sedentary time and mortality and vice versa, and estimate the joint associations of MVPA and sedentary time on mortality risk.
METHODS
This study involved individual participant data analysis of four prospective cohort studies (Norway, Sweden, USA, baseline: 2003-2016, 11 989 participants ≥50 years, 50.5% women) with hip-accelerometry-measured physical activity and sedentary time. Associations were examined using restricted cubic splines and fractional polynomials in Cox regressions adjusted for sex, education, body mass index, smoking, alcohol, study cohort, cardiovascular disease, cancer, and/or diabetes, accelerometry wear time and age.
RESULTS
6.7% (n=805) died during follow-up (median 5.2 years, IQR 4.2 years). More than 12 daily sedentary hours (reference 8 hours) was associated with mortality risk only among those accumulating <22 min of MVPA per day (HR 1.38, 95% CI 1.10 to 1.74). Higher MVPA levels were associated with lower mortality risk irrespective of sedentary time, for example, HR for 10 versus 0 daily min of MVPA was 0.85 (95% CI 0.74 to 0.96) in those accumulating <10.5 daily sedentary hours and 0.65 (95% CI 0.53 to 0.79) in those accumulating ≥10.5 daily sedentary hours. Joint association analyses confirmed that higher MVPA was superior to lower sedentary time in lowering mortality risk, for example, 10 versus 0 daily min of MVPA was associated with 28-55% lower mortality risk across the sedentary time spectrum (lowest risk, 10 daily sedentary hours: HR 0.45, 95% CI 0.31 to 0.65).
CONCLUSIONS
Sedentary time was associated with higher mortality risk but only in individuals accumulating less than 22 min of MVPA per day. Higher MVPA levels were associated with lower mortality risk irrespective of the amount of sedentary time.
Topics: Humans; Female; Male; Prospective Studies; Sedentary Behavior; Exercise; Risk; Accelerometry
PubMed: 37875329
DOI: 10.1136/bjsports-2022-106568 -
European Journal of Preventive... Jul 2023To investigate the joint association of accelerometer-measured physical activity (PA) and sleep duration with mortality risk.
AIMS
To investigate the joint association of accelerometer-measured physical activity (PA) and sleep duration with mortality risk.
METHODS AND RESULTS
A 7-day accelerometer recording was performed on 92 221 participants (age 62.4 ± 7.8 years; 56.4% women) from the UK Biobank between February 2013 and December 2015. We divided sleep duration into three groups (short, normal, and long), total volume of PA into three levels according to tertiles (high, intermediate, low), and moderate-to-vigorous PA (MVPA) into two groups based on the World Health Organization guidelines. The mortality outcomes were prospectively collected through the death registry. Over a median follow-up of 7.0 years, 3080 adults died, of which 1074 died from cardiovascular disease (CVD) and 1871 from cancer. The associations of PA and sleep duration with mortality risk were all in a curvilinear dose-response pattern (Pnonlinearity <0.001). PA and sleep duration had additive and multiplicative interactions on mortality risk (Pinteraction <0.05). Compared with the participants with guideline-recommended MVPA and normal sleep duration, those without recommended MVPA but having short or long sleep duration were at a higher risk for all-cause mortality [short sleep: hazard ratio (HR) = 1.88; 95% confidence interval (CI), 1.61-2.20; long sleep: HR = 1.69; 95% CI, 1.49-1.90]. A higher volume of PA or recommended MVPA attenuated the detrimental effects of short or long sleep duration on all-cause and CVD mortality risks.
CONCLUSION
MVPA meeting recommendations or a higher volume of PA at any intensity potentially diminished the adverse effects on all-cause and cause-specific mortality associated with short and long sleep duration.
Topics: Adult; Humans; Female; Middle Aged; Aged; Male; Cohort Studies; Cause of Death; Sleep Duration; Exercise; Cardiovascular Diseases; Accelerometry
PubMed: 36990109
DOI: 10.1093/eurjpc/zwad060 -
Sleep Jan 2024Abnormally short and long sleep are associated with premature mortality, and achieving optimal sleep duration has been the focus of sleep health guidelines. Emerging...
Abnormally short and long sleep are associated with premature mortality, and achieving optimal sleep duration has been the focus of sleep health guidelines. Emerging research demonstrates that sleep regularity, the day-to-day consistency of sleep-wake timing, can be a stronger predictor for some health outcomes than sleep duration. The role of sleep regularity in mortality, however, has not been investigated in a large cohort with objective data. We therefore aimed to compare how sleep regularity and duration predicted risk for all-cause and cause-specific mortality. We calculated Sleep Regularity Index (SRI) scores from > 10 million hours of accelerometer data in 60 977 UK Biobank participants (62.8 ± 7.8 years, 55.0% female, median[IQR] SRI: 81.0[73.8-86.3]). Mortality was reported up to 7.8 years after accelerometer recording in 1859 participants (4.84 deaths per 1000 person-years, mean (±SD) follow-up of 6.30 ± 0.83 years). Higher sleep regularity was associated with a 20%-48% lower risk of all-cause mortality (p < .001 to p = 0.004), a 16%-39% lower risk of cancer mortality (p < 0.001 to p = 0.017), and a 22%-57% lower risk of cardiometabolic mortality (p < 0.001 to p = 0.048), across the top four SRI quintiles compared to the least regular quintile. Results were adjusted for age, sex, ethnicity, and sociodemographic, lifestyle, and health factors. Sleep regularity was a stronger predictor of all-cause mortality than sleep duration, by comparing equivalent mortality models, and by comparing nested SRI-mortality models with and without sleep duration (p = 0.14-0.20). These findings indicate that sleep regularity is an important predictor of mortality risk and is a stronger predictor than sleep duration. Sleep regularity may be a simple, effective target for improving general health and survival.
Topics: Humans; Female; Male; Prospective Studies; Sleep; Life Style; Actigraphy; Time Factors
PubMed: 37738616
DOI: 10.1093/sleep/zsad253 -
ELife Dec 2023A large observational study has found that irregular sleep-wake patterns are associated with a higher risk of overall mortality, and also mortality from cancers and... (Observational Study)
Observational Study
A large observational study has found that irregular sleep-wake patterns are associated with a higher risk of overall mortality, and also mortality from cancers and cardiovascular disease.
Topics: Humans; Circadian Rhythm; Actigraphy; Sleep; Cardiovascular Diseases
PubMed: 38038345
DOI: 10.7554/eLife.94131 -
Lancet (London, England) Nov 2023Cancer is an age-related condition, but changes to modifiable lifestyle-related behaviours, including physical activity, could impact risk. While step count is an...
BACKGROUND
Cancer is an age-related condition, but changes to modifiable lifestyle-related behaviours, including physical activity, could impact risk. While step count is an accessible metric of activity for older adults, its association with cancer risk remains poorly understood. We investigated the association between accelerometer-measured total activity, step count, and cancer risk.
METHODS
We analysed data from a prospective UK Biobank cohort of consenting participants who wore wrist-based Axivity AX3 accelerometer devices for 7 days between June 1, 2013 and Dec 23, 2015, had valid accelerometer data, and no previous cancer diagnosis at baseline. Machine learning models estimated total physical activity (vector magnitude) and step count. The primary outcome, a composite of 13 cancers previously associated with physical activity, was obtained from national registries. Hazard ratios (HR) and were calculated using Cox proportional hazard models, with attained age as the underlying timescale and adjustment for sex, ethnicity, smoking status, alcohol consumption, education, and Townsend Deprivation Index. The impact of reallocating time between behaviours was evaluated using compositional data analyses. Dose-response associations were assessed with restricted cubic splines.
FINDINGS
We analysed data from 86 556 participants, who were followed up during an average of 6·1 years (age range 43-78; 48 478 [56%] female and 38 078 [44%] male; 83 830 [97%] white). 5577 incident malignant cancers occurred among these 86 556 participants. Greater total physical activity was associated with a lower risk of physical-activity-related cancer (HR per 1 SD [+8·33 milligravity per day] 0·85, 95% CI 0·81-0·89). Reallocating 30 min/day from other activities to moderate-to-vigorous physical activity behaviour was associated with lower cancer risk (HR 0·96, 0·94-0·98), as was reallocating 1 h/day to light intensity activity (HR 0·94, 0·92-0·96), compared with the mean behaviour composition among included participants. Compared with taking 5000 steps per day, taking 10 000 daily steps was associated with a significantly lower risk of physical-activity-related cancer (HR 0·81, 0·73-0·90).
INTERPRETATION
In this sample from the UK Biobank, higher total physical activity and daily step count were associated with lower risk of physical-activity-related cancers. Findings suggest additional physical activity time, irrespective of intensity, may be beneficial. Increasing low intensity activity time and increasing daily step counts could be practical public health interventions to lower cancer risk, especially for aging adults.
FUNDING
National Institute of Health Oxford Cambridge Scholars Program, Wellcome Trust, Swiss Re, Health Data Research UK, and Cancer Research UK.
Topics: Humans; Male; Female; Aged; Adult; Middle Aged; Prospective Studies; Biological Specimen Banks; Exercise; Accelerometry; United Kingdom; Neoplasms
PubMed: 37997129
DOI: 10.1016/S0140-6736(23)02147-5 -
Diabetes Care May 2024To assess the association between timing of aerobic moderate to vigorous physical activity (MVPA) and risk of cardiovascular disease (CVD), microvascular disease (MVD),...
OBJECTIVE
To assess the association between timing of aerobic moderate to vigorous physical activity (MVPA) and risk of cardiovascular disease (CVD), microvascular disease (MVD), and all-cause mortality in adults with obesity and a subset with obesity and type 2 diabetes (T2D).
RESEARCH DESIGN AND METHODS
Participants included adults with obesity (BMI ≥30 kg/m2) and a subset of those with T2D from the UK Biobank accelerometry substudy. Aerobic MVPA was defined as bouts of MVPA lasting ≥3 continuous minutes. Participants were categorized into morning, afternoon, or evening MVPA based on when they undertook the majority of their aerobic MVPA. The reference group included participants with an average of less than one aerobic MVPA bout per day. Analyses were adjusted for established and potential confounders.
RESULTS
The core sample included 29,836 adults with obesity, with a mean age of 62.2 (SD 7.7) years. Over a mean follow-up period of 7.9 (SD 0.8) years, 1,425 deaths, 3,980 CVD events, and 2,162 MVD events occurred. Compared with activity in the reference group, evening MVPA was associated with the lowest risk of mortality (hazard ratio [HR] 0.39; 95% CI 0.27, 0.55), whereas afternoon (HR 0.60; 95% CI 0.51, 0.71) and morning MVPA (HR 0.67; 95% CI 0.56, 0.79) demonstrated significant but weaker associations. Similar patterns were observed for CVD and MVD incidence, with evening MVPA associated with the lowest risk of CVD (HR 0.64; 95% CI 0.54, 0.75) and MVD (HR 0.76; 95% CI 0.63, 0.92). Findings were similar in the T2D subset (n = 2,995).
CONCLUSIONS
Aerobic MVPA bouts undertaken in the evening were associated with the lowest risk of mortality, CVD, and MVD. Timing of physical activity may play a role in the future of obesity and T2D management.
Topics: Adult; Humans; Middle Aged; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Obesity; Exercise; Accelerometry
PubMed: 38592034
DOI: 10.2337/dc23-2448 -
Journal of Sport and Health Science Sep 2024Skeletal muscle energetics decline with age, and physical activity (PA) has been shown to offset these declines in older adults. Yet, many studies reporting these...
Associations of accelerometry-measured and self-reported physical activity and sedentary behavior with skeletal muscle energetics: The Study of Muscle, Mobility and Aging (SOMMA).
BACKGROUND
Skeletal muscle energetics decline with age, and physical activity (PA) has been shown to offset these declines in older adults. Yet, many studies reporting these effects were based on self-reported PA or structured exercise interventions. Therefore, we examined the associations of accelerometry-measured and self-reported PA and sedentary behavior (SB) with skeletal muscle energetics and explored the extent to which PA and sedentary behavior would attenuate the associations of age with muscle energetics.
METHODS
As part of the Study of Muscle, Mobility and Aging, enrolled older adults (n = 879), 810 (age = 76.4 ± 5.0 years old, mean ± SD; 58% women) had maximal muscle oxidative capacity measured ex vivo via high-resolution respirometry of permeabilized myofibers (maximal oxidative phosphorylation (maxOXPHOS)) and in vivo by phosphorus magnetic resonance spectroscopy (maximal adenosine triphosphate (ATP)). Accelerometry-measured sedentary behavior, light activity, and moderate-to-vigorous PA (MVPA) were assessed using a wrist-worn ActiGraph GT9X over 7 days. Self-reported sedentary behavior, MVPA, and all PA were assessed with the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Linear regression models with progressive covariate adjustments evaluated the associations of sedentary behavior and PA with muscle energetics, as well as the attenuation of the age/muscle energetics association by MVPA and sedentary behavior. As a sensitivity analysis, we also examined activPAL-measured daily step count and time spent in sedentary behavior and their associations with muscle energetics.
RESULTS
Every 30 min/day more of ActiGraph-measured MVPA was associated with 0.65 pmol/(s × mg) higher maxOXPHOS and 0.012 mM/s higher ATP after adjusting for age, site/technician, and sex (p < 0.05). Light activity was not associated with maxOXPHOS or ATP. Meanwhile, every 30 min/day spent in ActiGraph-measured sedentary behavior was associated with 0.39 pmol/s × mg lower maxOXPHOS and 0.006 mM/s lower ATP (p < 0.05). Only associations with ATP held after further adjusting for socioeconomic status, body mass index, lifestyle factors, and multimorbidity. CHAMPS MVPA and all PA yielded similar associations with maxOXPHOS and ATP (p < 0.05), but sedentary behavior did not. Higher activPAL step count was associated with higher maxOXHPOS and ATP (p < 0.05), but time spent in sedentary behavior was not. Additionally, age was significantly associated with muscle energetics for men only (p < 0.05); adjusting for time spent in ActiGraph-measured MVPA attenuated the age association with ATP by 58% in men.
CONCLUSION
More time spent in accelerometry-measured or self-reported daily PA, especially MVPA, was associated with higher skeletal muscle energetics. Interventions aimed specifically at increasing higher intensity activity might offer potential therapeutic interventions to slow age-related decline in muscle energetics. Our work also emphasizes the importance of taking PA into consideration when evaluating associations related to skeletal muscle energetics.
Topics: Humans; Sedentary Behavior; Aged; Female; Male; Accelerometry; Self Report; Exercise; Muscle, Skeletal; Energy Metabolism; Aged, 80 and over; Aging; Oxidative Phosphorylation; Adenosine Triphosphate
PubMed: 38341136
DOI: 10.1016/j.jshs.2024.02.001 -
Clinical Oral Investigations Aug 2023Observational studies suggested an inverse association between physical activity and periodontitis. However, observational studies might be subject to unobserved...
OBJECTIVES
Observational studies suggested an inverse association between physical activity and periodontitis. However, observational studies might be subject to unobserved confounding and reverse causation bias. We conducted an instrumental variable study to strengthen the evidence on the relationship between physical activity and periodontitis.
MATERIALS AND METHODS
We used genetic variants associated with self-reported and accelerometer-assessed physical activity in 377,234 and 91,084 UK Biobank participants, respectively, as instruments. For these instruments, genetic associations with periodontitis were obtained from 17,353 cases and 28,210 controls in the GeneLifestyle Interactions in Dental Endpoints consortium.
RESULTS
We found no evidence for effects of self-reported moderate-to-vigorous physical activity, self-reported vigorous physical activity, accelerometry "average accelerations," and "fraction of accelerations > 425 milli-gravities" on periodontitis. For example, the odds ratio for self-reported moderate-to-vigorous physical activity was 1.07 (95% credible interval: 0.87; 1.34) in Causal Analysis using Summary Effect Estimates. We conducted sensitivity analyses to rule out weak instrument bias and correlated horizontal pleiotropy.
CONCLUSIONS
The study does not support an effect of physical activity on the risk of periodontitis.
CLINICAL RELEVANCE
This study provides little evidence that recommending physical activity would help prevent periodontitis.
Topics: Humans; Mendelian Randomization Analysis; Self Report; Exercise; Periodontitis; Accelerometry; Genome-Wide Association Study; Polymorphism, Single Nucleotide
PubMed: 37310512
DOI: 10.1007/s00784-023-05109-9