Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies
- PMID: 36854652
- PMCID: PMC10423495
- DOI: 10.1136/bjsports-2022-105669
Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies
Abstract
Objective: To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population.
Design: Systematic review and cohort-level dose-response meta-analysis.
Data sources: PubMed, Scopus, Web of Science and reference lists of published studies.
Eligibility criteria: Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney).
Results: 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted.
Conclusions: Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
Keywords: epidemiology; health; meta-analysis; noncommunicable diseases; physical activity.
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
Conflict of interest statement
Competing interests: None declared.
Figures
Similar articles
-
The effect of exposure to long working hours on stroke: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury.Environ Int. 2020 Sep;142:105746. doi: 10.1016/j.envint.2020.105746. Epub 2020 Jun 3. Environ Int. 2020. PMID: 32505015
-
Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis.JAMA Psychiatry. 2022 Jun 1;79(6):550-559. doi: 10.1001/jamapsychiatry.2022.0609. JAMA Psychiatry. 2022. PMID: 35416941 Free PMC article.
-
The effect of exposure to long working hours on ischaemic heart disease: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury.Environ Int. 2020 Sep;142:105739. doi: 10.1016/j.envint.2020.105739. Epub 2020 Jun 5. Environ Int. 2020. PMID: 32505014 Free PMC article.
-
Physical activity and incident type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of prospective cohort studies.Diabetologia. 2016 Dec;59(12):2527-2545. doi: 10.1007/s00125-016-4079-0. Epub 2016 Oct 17. Diabetologia. 2016. PMID: 27747395 Free PMC article. Review.
-
Aspirin Use in Adults: Cancer, All-Cause Mortality, and Harms: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet].Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Sep. Report No.: 13-05193-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Sep. Report No.: 13-05193-EF-1. PMID: 26491756 Free Books & Documents. Review.
Cited by
-
Combined associations of physical activity, diet quality and their changes over time with mortality: findings from the EPIC-Norfolk study, United Kingdom.BMC Med. 2024 Oct 14;22(1):464. doi: 10.1186/s12916-024-03668-6. BMC Med. 2024. PMID: 39402526 Free PMC article.
-
Association between physical activity and mortality in patients with osteoporosis: a cohort study of NHANES.Osteoporos Int. 2024 Oct 10. doi: 10.1007/s00198-024-07280-5. Online ahead of print. Osteoporos Int. 2024. PMID: 39387876
-
Does sedentary time and physical activity predict chronic back pain and morphological brain changes? A UK biobank cohort study in 33,402 participants.BMC Public Health. 2024 Oct 1;24(1):2685. doi: 10.1186/s12889-024-20188-3. BMC Public Health. 2024. PMID: 39354455 Free PMC article.
-
Disparities in adherence to physical activity guidelines among US adults: A population-based study.Medicine (Baltimore). 2024 Sep 6;103(36):e39539. doi: 10.1097/MD.0000000000039539. Medicine (Baltimore). 2024. PMID: 39252263 Free PMC article.
-
Active longevity and aging: dissecting the impacts of physical and sedentary behaviors on longevity and age acceleration.Geroscience. 2024 Sep 4. doi: 10.1007/s11357-024-01329-3. Online ahead of print. Geroscience. 2024. PMID: 39230773
References
-
- Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Allen C, et al. . Global, regional, and National cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol 2017;3:524–48. 10.1001/jamaoncol.2016.5688 - DOI - PMC - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources