Abstract 11597: Voluntary and Occupational Physical Activity Have Different Effects on Mortality

Abstract

Introduction: Animal studies suggest oppositional effects for voluntary and involuntary physical activity (PA). To assess this in humans, we used distinct domains of PA (sports, leisure time, work) as well as physical fitness and associated these variables with all-cause, cardiovascular (CVD) and cancer mortality in a large population-based cohort. Methods: Data of 2,925 participants from the Study of Health in Pomerania (SHIP-1) were used [median age: 48 (interquartile range (IQR): 35, 62) years (y), 52% [[female symbol]]]. All-cause and cause-specific mortality was determined after a median follow-up of 7.0 y (IQR: 5.6 - 6.2). A Sports index (SI), Leisure Time index (LTI) and Work index (WI) were assessed using a modified Baecke questionnaire. Maximal oxygen consumption (VO2peak), oxygen consumption at the anaerobic threshold (VO2@AT), and maximal work load (Wmax) were measured on a bicycle ergometer during symptom-limited cardiopulmonary exercise testing (CPET). Cox models were adjusted for sex, age, smoking, alcohol consumption, years of schooling, income, and body mass index. Results: A total of 156 subjects died due to all-cause, 53 due to CVD and 50 due to cancer after follow-up. After adjustment, SI [hazard ratio (HR) per SD: 0.27; 95%-confidence interval (CI): 0.13; 0.55] and LTI (HR per SD: 0.34; 95%-CI: 0.15; 0.77) were associated with a reduced risk of all-cause mortality. WI was not associated with all-cause mortality. SI was associated with reduced risk of CVD mortality (HR: 0.26; 95%-CI: 0.07; 0.96). All CPET measures were significantly related to reduced risk of all-cause and cancer mortality (VO2peak - all-cause HR per SD: 0.007; 95%-CI: 0.001; 0.057 and cancer HR per SD: 0.011; 95%-CI: 0.005; 0.210; VO2@AT - all-cause HR per SD: 0.047; 95%-CI: 0.001; 0.028 and cancer HR per SD: 0.052; 95%-CI: 0.004; 0.073; Wmax - all-cause HR per SD: 0.012; 95%-CI: 0.002; 0.074 and cancer HR per SD: 0.01; 95%-CI: 0.0007; 0.166). Conclusion: Voluntary PA was associated with a reduced risk for all-cause and CVD mortality, while occupational PA was not. Exercise capacity was inversely related to all-cause and cancer mortality. Our results indicate that the benefits of PA may be limited to voluntary PA. Thus, questionnaires need to differentiate between voluntary and occupational PA.