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. 2012;9(11):e1001335.
doi: 10.1371/journal.pmed.1001335. Epub 2012 Nov 6.

Leisure Time Physical Activity of Moderate to Vigorous Intensity and Mortality: A Large Pooled Cohort Analysis

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Free PMC article

Leisure Time Physical Activity of Moderate to Vigorous Intensity and Mortality: A Large Pooled Cohort Analysis

Steven C Moore et al. PLoS Med. .
Free PMC article

Abstract

Background: Leisure time physical activity reduces the risk of premature mortality, but the years of life expectancy gained at different levels remains unclear. Our objective was to determine the years of life gained after age 40 associated with various levels of physical activity, both overall and according to body mass index (BMI) groups, in a large pooled analysis.

Methods and findings: We examined the association of leisure time physical activity with mortality during follow-up in pooled data from six prospective cohort studies in the National Cancer Institute Cohort Consortium, comprising 654,827 individuals, 21-90 y of age. Physical activity was categorized by metabolic equivalent hours per week (MET-h/wk). Life expectancies and years of life gained/lost were calculated using direct adjusted survival curves (for participants 40+ years of age), with 95% confidence intervals (CIs) derived by bootstrap. The study includes a median 10 y of follow-up and 82,465 deaths. A physical activity level of 0.1-3.74 MET-h/wk, equivalent to brisk walking for up to 75 min/wk, was associated with a gain of 1.8 (95% CI: 1.6-2.0) y in life expectancy relative to no leisure time activity (0 MET-h/wk). Higher levels of physical activity were associated with greater gains in life expectancy, with a gain of 4.5 (95% CI: 4.3-4.7) y at the highest level (22.5+ MET-h/wk, equivalent to brisk walking for 450+ min/wk). Substantial gains were also observed in each BMI group. In joint analyses, being active (7.5+ MET-h/wk) and normal weight (BMI 18.5-24.9) was associated with a gain of 7.2 (95% CI: 6.5-7.9) y of life compared to being inactive (0 MET-h/wk) and obese (BMI 35.0+). A limitation was that physical activity and BMI were ascertained by self report.

Conclusions: More leisure time physical activity was associated with longer life expectancy across a range of activity levels and BMI groups. Please see later in the article for the Editors' Summary.

Conflict of interest statement

I-Min Lee served as a consultant to Virgin HealthMiles and served on their Scientific Advisory Board (2007–2010). The authors have declared that no other competing interests exist.

Figures

Figure 1
Figure 1. Leisure time physical activity level and hazard ratios for mortality and gains in life expectancy after age 40.
The points shown represent the HR (A) or years of life gained (B) for each of the physical activity categories examined, and the vertical lines represent the 95% CIs for that physical activity category. The reference category for both (A) and (B) is 0.0 MET-h/wk of leisure time physical activity. The lines connecting the points help to illustrate the dose–response relationship between physical activity and risk of mortality; the shape of the association shown here is similar to that obtained using spline modeling (Figure S1). HRs were calculated in models stratified by study that used age as the underlying time scale. Multivariable models were adjusted for gender, alcohol consumption (0, 0.1–14.9, 15.0–29.9, 30.0+ g/d), education (did not complete high school, completed high school, post-high-school training, some college, completed college), marital status (married, divorced, widowed, unmarried), history of heart disease, history of cancer, BMI (<18.5, 18.5–19.9, 20–22.4, 22.5–24.9, 25–27.4, 27.5–29.9, 30+ kg/m2), and smoking status (never, former, current). Years of life expectancy gained after age 40 were derived using direct adjusted survival curves , for participants who were 40+ y of age at baseline (97.5% of participants).
Figure 2
Figure 2. Years of life expectancy lost after age 40 in relation to joint categories of physical activity level and body mass index.
The bars indicate the number of years of life lost for each category, and the vertical lines are the 95% CIs. The reference category is normal weight and 7.5+ MET-h/wk of physical activity (i.e., meeting US recommended physical activity levels). Normal weight is a BMI of 18.5–24.9 kg/m2, overweight is a BMI of 25.0–29.9 kg/m2, obese class I is a BMI of 30.0–34.9 kg/m2, and obese class II+ is a BMI of 35.0 kg/m2 or greater. Years of life expectancy lost after age 40 were derived using direct adjusted survival curves , for participants who were 40+ y of age at baseline and not underweight (96.5% of participants). Life expectancy models used age as the underlying time scale and were adjusted for gender, alcohol consumption (0, 0.1–14.9, 15.0–29.9, 30.0+ g/d), education (did not complete high school, completed high school, post-high-school training, some college, completed college), marital status (married, divorced, widowed, unmarried), history of heart disease, history of cancer, and smoking status (never, former, current).

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