It is never too late to start: adherence to physical activity recommendations for 11-22 years and risk of all-cause and cardiovascular disease mortality. The HUNT Study

Trine Moholdt; Eivind Schjelderup Skarpsno; Børge Moe; Tom Ivar Lund Nilsen

doi:10.1136/bjsports-2020-102350

It is never too late to start: adherence to physical activity recommendations for 11-22 years and risk of all-cause and cardiovascular disease mortality. The HUNT Study

Br J Sports Med. 2020 Sep 28:bjsports-2020-102350. doi: 10.1136/bjsports-2020-102350. Online ahead of print.

Authors

Trine Moholdt^{1

2}, Eivind Schjelderup Skarpsno³, Børge Moe⁴, Tom Ivar Lund Nilsen^{3

5}

Affiliations

¹ Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway trine.moholdt@ntnu.no.
² Women's Clinic, St. Olavs Hospital, Trondheim, Norway.
³ Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway.
⁴ Department of Physical Activity and Health, Queen Maud University College of Early Childhood Education, Trondheim, Norway.
⁵ Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim, Norway.

PMID: 32988932
DOI: 10.1136/bjsports-2020-102350

Abstract

Objectives: To examine associations between long-term (11-22 years) adherence to physical activity recommendations and mortality from all causes and from cardiovascular disease.

Design: Prospective population-based study with repeated assessments of self-reported physical activity (1984-86, 1995-97 and 2006-08) and follow-up until the end of 2013.

Setting: County of Nord-Trøndelag, Norway.

Participants: Men and women aged ≥20 years; 32 811 who participated in 1984-86 and 1995-97; 22 058 in 1984-86 and 2006-08; 31 948 in 1995-97 and 2006-09 and 19 349 in all three examinations (1984-1986, 1995-95 and 2006-08).

Main outcome measures: All-cause mortality and cardiovascular disease mortality from the national Cause of Death Registry.

Results: Compared with the reference category comprising individuals who adhered to the physical activity recommendations (≥150 min of moderate intensity or ≥60 min of vigorous intensity physical activity per week) over time, individuals who remained inactive (reporting no or very little physical activity) from 1984-86 to 1995-97 had HRs (95% CI) of 1.56 (1.40 to 1.73) for all-cause mortality and 1.94 (1.62 to 2.32) for cardiovascular disease mortality. Individuals who were inactive in 1984-86 and then adhered to recommendations in 2006-08 had HRs of 1.07 (0.85 to 1.35) for all-cause mortality and 1.31 (0.87 to 1.98) for cardiovascular disease mortality. In a subsample of individuals who participated at all three time points, those who were inactive or physically active below the recommended level across three decades (1984-86, 1995-97 and 2006-2008) had an HR of 1.57 (1.22 to 2.03) for all-cause mortality and 1.72 (1.08 to 2.73) for cardiovascular disease mortality.

Conclusion: Individuals who remained, or became, physically inactive had substantially greater risk of all-cause and cardiovascular disease mortality compared with those who met the physical activity recommendations throughout the lifespan.

Keywords: epidemiology; exercise; health; sedentary; survival.