Influence of Exercise, Walking, Cycling, and Overall Nonexercise Physical Activity on Mortality in Chinese Women

Abstract

This investigation described the effects of exercise, walking, and cycling for transportation, as well as the effect of overall nonexercise physical activity, on mortality in the Shanghai Women's Health Study (1997-2004). Women without heart disease, stroke, or cancer were followed for an average of 5.7 years (n = 67,143), and there were 1,091 deaths from all causes, 537 deaths from cancer, and 251 deaths from cardiovascular diseases. Information about physical activity and relevant covariates was obtained by interview. Proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals. Exercise and cycling for transportation were both inversely and independently associated with all-cause mortality (p(trend) < 0.05), but walking for transportation was less strongly associated with reduced risk (p(trend) = 0.07). Women reporting no regular exercise but who reported 10 or more metabolic equivalent (MET)-hours/day of nonexercise activity were at 25-50% reduced risk (p(trend) < 0.01) relative to less active women (0-9.9 MET-hours/day). Among women reporting the least nonexercise activity (0-9.9 MET-hours/day) but reporting regular exercise participation, exercise was associated with reduced mortality (hazard ratio = 0.78, 95% confidence interval: 0.62, 0.99). These findings add new evidence that overall physical activity levels are an important determinant of longevity, and that health benefit can be obtained through an active lifestyle, exercise, or combinations of both.

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

“…With regard to the beneficial impact of leisure time physical activity or total activity, our results are consistent with a previous study which showed a dose-response relationship, predominantly in the leisure time domain, with all-cause mortality [24]. In contrast, the significant results for walking or biking as a means of transportation detected by Andersen et al [9] and Matthews et al [11] were not observed in the present study which may be explained by the use of different instruments.…”

“…In addition to total and sports/exercise activities being inversely associated with all-cause and CVD mortality, the authors also found evidence for the benefits of domestic activities, but none for work and transportation-related physical activity [12]. Two other studies have investigated several different forms of physical activity independently in relation to all-cause mortality [9,11]. With regard to the beneficial impact of leisure time physical activity or total activity, our results are consistent with a previous study which showed a dose-response relationship, predominantly in the leisure time domain, with all-cause mortality [24].…”

“…Some population studies and reviews detected a reduced risk of cancer mortality through enhanced physical activity among men [25], women [11] or both sexes [16,17,26,27], but none of them has independently examined work, transportation, household and leisure time physical activity. A large prospective follow-up study from Finland [16] reported a 21% and 27% lower risk of cancer mortality for men and women, respectively, when comparing high versus low occupational and leisure time physical activity.…”

“…Recent recommendations advocate a minimum of 30 minutes of at least moderate-intensity activities on most days of the week [5]. Although the association between physical activity and mortality has been examined extensively in the past several years [6][7][8], few studies have focused on domain-specific activities performed during daily routines [9][10][11]. Specifically, analyses of the four most common domains (domestic, transportation, work, leisure time) of physical activity on mortality are sparse [12].…”

“…Especially household physical activity in relation to mortality has not been given sufficient attention; the distinct effect of regular housework in terms of all-cause and CVD mortality has only recently been investigated [12,15]. In addition, few population-based data exist on different types and intensities of activity undertaken during daily routines and their relation to cause-specific mortality [11,16,17]. These considerations, and the insufficient prior systematic investigation of physical activity, subdivided into different domains, on all-cause, CVD and cancer mortality in a population-based cohort, were the motivation for this study.…”