Independent and joint association of physical activity and sedentary behavior on all-cause mortality

Zhou, Wei; Wei, Yan; Wang, Tao; Zhu, Lingjuan; Yan, Xu; Zhao, Jun; Yu, Lingling; Bao, Huihui; Cheng, Xiaoshu

doi:10.1097/cm9.0000000000001730

Cited by 11 publications

(18 citation statements)

References 50 publications

(82 reference statements)

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“…Overall, our study demonstrates a positive association of self-reported sitting time with all-cause mortality and major CVD, which is in line with previous meta-analyses (including studies using self-reported measurements from HICs) and recent prospective cohorts from China . Moreover, we found that the risk of composite outcome associated with sitting time increased in a linear manner, which was similar to a prospective cohort among 5638 older women from the US, demonstrating a linear relationship between objectively measured sedentary time and CVD .…”

Section: Discussionsupporting

confidence: 90%

“…Thus far, current evidence has been almost exclusively in high-income countries (HICs) and China . Previous studies suggested that the contextual patterns in which sedentary behavior occurs might vary substantially by socioeconomic status and social class .…”

Section: Introductionmentioning

confidence: 99%

“…3 Thus far, current evidence has been almost exclusively in high-income countries (HICs) 4,5 and China. [6][7][8] Previous studies suggested that the contextual patterns in which sedentary behavior occurs might vary substantially by socioeconomic status and social class. 9,10 The health effects of sedentary behavior are not well documented for populations from lowand middle-income countries (LICs and MICs), where the patterns of activity are much different from HICs and the prevalence of a sedentary lifestyle has increased dramatically along with rapid urbanization.…”

mentioning

confidence: 99%

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Association of Sitting Time With Mortality and Cardiovascular Events in High-Income, Middle-Income, and Low-Income Countries

Lear

Rangarajan

et al. 2022

JAMA Cardiol

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High amounts of sitting time are associated with increased risks of cardiovascular disease (CVD) and mortality in high-income countries, but it is unknown whether risks also increase in low-and middle-income countries.OBJECTIVE To investigate the association of sitting time with mortality and major CVD in countries at different economic levels using data from the Prospective Urban Rural Epidemiology study. DESIGN, SETTING, AND PARTICIPANTSThis population-based cohort study included participants aged 35 to 70 years recruited from January 1, 2003, and followed up until August 31, 2021, in 21 high-income, middle-income, and low-income countries with a median follow-up of 11.1 years.EXPOSURES Daily sitting time measured using the International Physical Activity Questionnaire. MAIN OUTCOMES AND MEASURESThe composite of all-cause mortality and major CVD (defined as cardiovascular death, myocardial infarction, stroke, or heart failure). RESULTSOf 105 677 participants, 61 925 (58.6%) were women, and the mean (SD) age was 50.4 (9.6) years. During a median follow-up of 11.1 (IQR, 8.6-12.2) years, 6233 deaths and 5696 major cardiovascular events (2349 myocardial infarctions, 2966 strokes, 671 heart failure, and 1792 cardiovascular deaths) were documented. Compared with the reference group (<4 hours per day of sitting), higher sitting time (Ն8 hours per day) was associated with an increased risk of the composite outcome (hazard ratio [HR], 1.19; 95% CI, 1.11-1.28; P for trend < .001), all-cause mortality (HR, 1.20; 95% CI, 1.10-1.31; P for trend < .001), and major CVD (HR, 1.21; 95% CI, 1.10-1.34; P for trend < .001). When stratified by country income levels, the association of sitting time with the composite outcome was stronger in low-income and lower-middle-income countries (Ն8 hours per day: HR, 1.29; 95% CI, 1.16-1.44) compared with high-income and upper-middle-income countries (HR, 1.08; 95% CI, 0.98-1.19; P for interaction = .02). Compared with those who reported sitting time less than 4 hours per day and high physical activity level, participants who sat for 8 or more hours per day experienced a 17% to 50% higher associated risk of the composite outcome across physical activity levels; and the risk was attenuated along with increased physical activity levels.CONCLUSIONS AND RELEVANCE High amounts of sitting time were associated with increased risk of all-cause mortality and CVD in economically diverse settings, especially in low-income and lower-middle-income countries. Reducing sedentary time along with increasing physical activity might be an important strategy for easing the global burden of premature deaths and CVD.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Association of Sitting Time With Mortality and Cardiovascular Events in High-Income, Middle-Income, and Low-Income Countries

Lear

Rangarajan

et al. 2022

JAMA Cardiol

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“…However, the currently available data suggest that the elderly do not engage in physical activity [ 25 ] and this lifestyle choice can lead to health implications [ 26 ] and higher mortality rates [ 27 , 28 ]. In fact, physical activity can improve depressive symptoms and quality of life in institutionalized elderly persons [ 29 ], and it can be used to prevent falls in this age group [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

Nutritional Status Is Associated with Health-Related Quality of Life, Physical Activity, and Sleep Quality: A Cross-Sectional Study in an Elderly Greek Population

et al. 2023

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This study aims to explore the associations between nutritional status and health-related quality of life, physical activity, and sleep quality in older exclusively Caucasian adults from Greec who were free of any severe disease. This is a cross-sectional study. Mini Nutritional Assessment was used to assess nutritional status, health-related quality of life was assessed using the Short Form Healthy Survey questionnaire, sleep quality was assessed using the Pittsburgh Sleep Quality Index, and physical activity levels were assessed via the International Physical Activity Questionnaire3405 community-dwelling men and women, over 65 years old from14 different Greek regions were enrolled. Ten-point four percent (10.4%) of the participants were classified as malnourished, while 35.6% were “at risk of malnutrition”. A better nutritional status was significantly and independently associated with higher physical activity levels (p = 0.0011) and better quality of life (p = 0.0135), as well as better sleep quality (p = 0.0202). In conclusion, our study highlights the interrelationships between a good nutritional status, a high-quality sleep, active lifestyle, and good quality of life. Further interventional studies are needed to clarify the associations, and test the feasibility of improving the nutritional status, physical activity levels and sleep quality of the elderly, and the impact of these changes on quality of life, and healthy ageing in races beyond Caucasian populations. Public health strategies and policies should be recommended to inform older adults for the necessity to improve their nutritional status and lifestyle habits to improve their health status and to obtain better life expectancy.

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“…Compared with SB<6h per day with a high PA, SB≥6h with inadequate PA would increase the risk of all-cause mortality. The negative effect of SB on mortality risk cannot be fully offset by increasing PA. For people with high PA, the risk of death remains higher for SB≥6h than for SB<6h [20]. Replacing sedentary time with PA would reduce the risk of death from CVD.…”

Section: Risk Factorsmentioning

confidence: 99%

Stroke in China: disease burden and attributable risk factors

Tian

2023

Second International Conference on Biological Engineering and Medical Science (ICBioMed 2022)

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Stroke is one of major challenge in healthcare systems. A comprehensive overview of trends in stroke prevalence can provide a better understanding of the burden of stroke disease. This paper summarizes the results of national wide epidemiological surveys of stroke and attributable risk factors in China. According to the analysis, the disease burden of stroke in China is increasing, with an increasing trend in incidence, prevalence, and mortality. In China, the stroke burden showed significant age differences, gender differences, geographical differences and urban-rural differences. The north-eastern and central parts of China are the regions with a higher stroke burden. Hypertension, metabolic disturbances, smoking, alcohol consumption, physical inactivity and a sedentary lifestyle are all risk factors for stroke, with hypertension being the most prevalent risk factor in many epidemiological surveys. Recent data on the burden of disease in China are scarce. It is necessary to investigate more comprehensively the burden of disease and the control of associated risk factors for stroke. There are still relatively few national surveys in China and the available data are insufficient to show changes in the burden of stroke disease over the last five years. Due to the methodological limitation in collecting epidemiological survey data, timely, accurate, high-return rate survey data is urgently needed. These results shed light on the characteristics of stroke burden and attributable risk factors, providing a valid basis for stroke prevention strategies in China.

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Independent and joint association of physical activity and sedentary behavior on all-cause mortality

Cited by 11 publications

References 50 publications

Association of Sitting Time With Mortality and Cardiovascular Events in High-Income, Middle-Income, and Low-Income Countries

Association of Sitting Time With Mortality and Cardiovascular Events in High-Income, Middle-Income, and Low-Income Countries

Nutritional Status Is Associated with Health-Related Quality of Life, Physical Activity, and Sleep Quality: A Cross-Sectional Study in an Elderly Greek Population

Stroke in China: disease burden and attributable risk factors

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