Association between domains of physical activity and all-cause, cardiovascular and cancer mortality

Abstract

International audienceFew studies have investigated the independent effects of domain-specific physical activity on mortality. We sought to investigate the association of physical activity performed in different domains of daily living on all-cause, cardiovascular (CVD) and cancer mortality. Using a prospective cohort design, 4,672 men and women, aged 25-74 years, who participated in the baseline examination of the MONICA/KORA Augsburg Survey 1989/1990 were classified according to their activity level (no, light, moderate, vigorous). Domains of self-reported physical activity (work, transportation, household, leisure time) and total activity were assessed by the validated MOSPA (MONICA Optional Study on Physical Activity) questionnaire. After a median follow-up of 17.8 years, a total of 995 deaths occurred, with 452 from CVD and 326 from cancer. For all-cause mortality, hazard ratios and 95% confidence interval (HR, 95% CI) of the highly active versus the inactive reference group were 0.69 (0.48-1.00) for work, 0.48 (0.36-0.65) for leisure time, and 0.73 (0.59-0.90) for total activity after multivariable adjustments. Reduced risks of CVD mortality were observed for high levels of work (0.54, 0.31-0.93), household (0.80, 0.54-1.19), leisure time (0.50, 0.31-0.79) and total activity (0.75, 0.55-1.03). Leisure time (0.36, 0.23-0.59) and total activity (0.62, 0.43-0.88) were associated with reduced risks of cancer mortality. Light household activity was related to lower all-cause (0.82, 0.71-0.95) and CVD (0.72, 0.58-0.89) mortality. No clear effects were found for transportation activities. Our findings suggest that work, household, leisure time and total physical activity, but not transportation activity, may protect from premature mortality

Impact of different domains of physical activity on cause-specific mortality: A longitudinal study

“…Analyses of the association between work-related physical activity and mortality provided conflicting results. They range from a protective effect (Autenrieth et al, 2011;Barengo et al, 2004;Samitz et al, 2011) to no effects (Besson et al, 2008) (in line with our results) to deleterious effects, at least in men (Herzig et al, 2012). Null findings between occupational physical activity and mortality may be due to residual confounding or the broad physical activity categorisation due to job type only.…”

“…Interestingly, some effects were as strong as or even stronger for cancer mortality than for CVD mortality, as has been reported in other studies, e.g. In line with (Autenrieth et al, 2011;Besson et al, 2008) and in contrast to (Andersen et al, 2000;Samitz et al, 2011) others, we found no significant association between walking or cycling to work and all-cause mortality. This inconsistency may be explained by country-specific physical environments present for active commuting or by different measurement instruments.…”

“…The relationship between leisure-time physical activity and all-cause (Lee and Skerrett, 2001;Samitz et al, 2011) and cause-specific mortality (Autenrieth et al, 2011;Laukkanen et al, 2011) has been reported previously. According to a metaanalysis, risk reductions for all-cause mortality per additional unit of time were largest for vigorous exercise (not separately reported for men and women) (Samitz et al, 2011); highest risk reductions for all-cause and CVD mortality for sport and exercise were also found by others (Besson et al, 2008).…”

“…This is also supported by the fact that studies using more accurate measures reported lower HR (Autenrieth et al, 2011;Zhao et al, 2013). A further limitation was that we had information only on mortality, not on morbidity.…”

“…However, only few studies have investigated the association between different domains of physical activity and allcause as well as cause-specific mortality, and the evidence is inconsistent (Andersen et al, 2000;Arrieta and Russell, 2008;Autenrieth et al, 2011;Barengo et al, 2004;Besson et al, 2008). Only few of the large cohort studies with data on physical activity and mortality have included women and relatively few deaths were observed, leaving uncertainty about the benefit of physical activity in women (Andersen et al, 2000).…”