Joint association between accelerometry-measured daily combination of time spent in physical activity, sedentary behaviour and sleep and all-cause mortality: a pooled analysis of six prospective cohorts using compositional analysis

Abstract

ObjectiveTo examine the joint associations of daily time spent in different intensities of physical activity, sedentary behaviour and sleep with all-cause mortality.MethodsFederated pooled analysis of six prospective cohorts with device-measured time spent in different intensities of physical activity, sedentary behaviour and sleep following a standardised compositional Cox regression analysis.Participants130 239 people from general population samples of adults (average age 54 years) from the UK, USA and Sweden.Main outcomeAll-cause mortality (follow-up 4.3–14.5 years).ResultsStudies using wrist and hip accelerometer provided statistically different results (I2=92.2%, Q-test p<0.001). There was no association between duration of sleep and all-cause mortality, HR=0.96 (95% CI 0.67 to 1.12). The proportion of time spent in moderate to vigorous physical activity was significantly associated with lower risk of all-cause mortality (HR=0.63 (95% CI 0.55 to 0.71) wrist; HR=0.93 (95% CI 0.87 to 0.98) hip). A significant association for the ratio of time spent in light physical activity and sedentary time was only found in hip accelerometer-based studies (HR=0.5, 95% CI 0.42 to 0.62). In studies based on hip accelerometer, the association between moderate to vigorous physical activity and mortality was modified by the balance of time spent in light physical activity and sedentary time.ConclusionThis federated analysis shows a joint dose–response association between the daily balance of time spent in physical activity of different intensities and sedentary behaviour with all-cause mortality, while sleep duration does not appear to be significant. The strongest association is with time spent in moderate to vigorous physical activity, but it is modified by the balance of time spent in light physical activity relative to sedentary behaviour.

Reallocation of time between device-measured movement behaviours and risk of incident cardiovascular disease

“…9 These methods can only distinguish behaviours based on intensity, and are prone to substantial misclassification, [9][10][11] which may materially impact research findings. 12 As they use only a single metric of intensity to classify the behaviour, there may be substantial unused information in the accelerometer signal. Emerging machine-learning methods could, therefore, allow a wider range of behaviours to be classified accurately: these methods use many features of the data, capture non-linear relationships and can learn relationships from training data beyond what a researcher might hypothesise.…”

Measurement of Physical Fitness and 24/7 Physical Activity, Standing, Sedentary Behavior, and Time in Bed in Working-Age Finns: Study Protocol for FINFIT 2021

“…Strong evidence shows that physical inactivity, i.e., not meeting the current physical activity (PA) recommendation for health [ 2 ], increases the risk of many adverse health conditions, including coronary heart disease, type 2 diabetes, several cancers, anxiety and depression, and cognitive impairments, and shortens life expectancy [ 3 ]. According to a recent report, there is a curvilinear dose–response between the time spent in moderate-to-vigorous PA (MVPA) and the risk of all-cause mortality, with a lower risk associated with a higher time spent in MVPA [ 4 ]. Despite these established benefits of PA, a significant proportion of adults do not adhere to MVPA recommendations [ 5 , 6 , 7 ].…”

“…Replacing SB with PA of any intensity will produce health benefits, but the greatest benefits will occur when SB is replaced with MVPA [ 11 ]. Moreover, when SB is replaced with MVPA instead of LPA, the comparable health benefits will be achieved within less time [ 4 ].…”

Modeling the Development of Local Health-Enhancing Physical Activity Policies from Empirical Data and Policy Science Theories

“…Insufficient physical activity is associated with major consequences on health, such as an increased risk of developing a non-communicable disease, or a lower quality of life and mental health [1][2][3]. Its prevalence was estimated at 27.5% of the worldwide population [4,5].…”

“…Data from the National Institute of Statistics and Economic Studies-INSEE (2018) 2. Data from INSEE (2018); at national level the annual median income is 22,077 € 3.…”