Wearable accelerometer-derived physical activity and incident disease

Abstract

Physical activity is regarded as favorable to health but effects across the spectrum of human disease are poorly quantified. In contrast to self-reported measures, wearable accelerometers can provide more precise and reproducible activity quantification. Using wrist-worn accelerometry data from the UK Biobank prospective cohort study, we test associations between moderate-to-vigorous physical activity (MVPA) – both total MVPA minutes and whether MVPA is above a guideline-based threshold of ≥150 min/week—and incidence of 697 diseases using Cox proportional hazards models adjusted for age, sex, body mass index, smoking, Townsend Deprivation Index, educational attainment, diet quality, alcohol use, blood pressure, anti-hypertensive use. We correct for multiplicity at a false discovery rate of 1%. We perform analogous testing using self-reported MVPA. Among 96,244 adults wearing accelerometers for one week (age 62 ± 8 years), MVPA is associated with 373 (54%) tested diseases over a median 6.3 years of follow-up. Greater MVPA is overwhelmingly associated with lower disease risk (98% of associations) with hazard ratios (HRs) ranging 0.70–0.98 per 150 min increase in weekly MVPA, and associations spanning all 16 disease categories tested. Overall, associations with lower disease risk are enriched for cardiac (16%), digestive (14%), endocrine/metabolic (10%), and respiratory conditions (8%) (chi-square p < 0.01). Similar patterns are observed using the guideline-based threshold of ≥150 MVPA min/week. Some of the strongest associations with guideline-adherent activity include lower risks of incident heart failure (HR 0.65, 95% CI 0.55–0.77), type 2 diabetes (HR 0.64, 95% CI 0.58–0.71), cholelithiasis (HR 0.61, 95% CI 0.54–0.70), and chronic bronchitis (HR 0.42, 95% CI 0.33–0.54). When assessed within 456,374 individuals providing self-reported MVPA, effect sizes for guideline-adherent activity are substantially smaller (e.g., heart failure HR 0.84, 95% CI 0.80–0.88). Greater wearable device-based physical activity is robustly associated with lower disease incidence. Future studies are warranted to identify potential mechanisms linking physical activity and disease, and assess whether optimization of measured activity can reduce disease risk.

The associations of “weekend warrior” and regularly active physical activity with abdominal and general adiposity in US adults

“…Third, given that varying activity patterns may affect muscle condition, we assessed associations between PA patterns and prevalence of muscle pain or soreness in the past 3 days in a subsample since it was only collected in the 2011–2012 and 2013–2014 cycles. Fourth, we assessed alternative definitions of the WW pattern and RA pattern [24]. WW was total PA at or above 150 min/week and ≥50% of total PA over one or two sessions.…”

Associations of between‐ and within‐day patterns of physical activity accumulation with arterial stiffness and indices of microvascular health—Evidence from The Maastricht study

“…They found that compared to those who were inactive, participants who were insufficiently active, regularly active or "weekend warriors" all had a more favorable vascular health, with no difference between the regularly active or the "weekend warriors." When looking at downstream cardiovascular events in the UK Biobank study, Kurshid et al 7 similarly found that those who completed ≥150 min/week through being "active regularly" or "weekend warriors" both had lower risk of cardiovascular events compared to those who were inactive. 7 However, grouping people based on combinations of duration, intensity and frequency of PA makes it difficult to isolate the effect of PA pattern from overall PA volume, of which we know is beneficially associated with vascular health.…”

Development and Validation of a Machine Learning Wrist-worn Step Detection Algorithm with Deployment in the UK Biobank

“…Physical activity has been associated with lower risk of a wide range of non-communicable diseases and is a key feature of public health guidelines for cardiovascular health [1][2][3] . While researchers most commonly report device-measured activity in terms of overall acceleration or time-use behaviours derived from intensity thresholds 4 , the reporting of steps is a more intuitive measure of physical activity intrinsically linked to the key biomechanical feature of human gait 5 .…”