Abstract
BackgroundModerate-to-vigorous physical activity (MVPA) is proposed as key for cardiovascular diseases (CVD) prevention. At older ages, the role of sedentary behaviour (SB) and light intensity physical activity (LIPA) remains unclear. Evidence so far is based on studies examining movement behaviours as independent entities ignoring their co-dependency. This study examines the association between daily composition of objectively-assessed movement behaviours (MVPA, LIPA, SB) and incident CVD in older adults.MethodsWhitehall II accelerometer sub-study participants free of CVD at baseline (N = 3319, 26.7% women, mean age = 68.9 years in 2012–2013) wore a wrist-accelerometer from which times in SB, LIPA, and MVPA during waking period were extracted over 7 days. Compositional Cox regression was used to estimate the hazard ratio (HR) for incident CVD for daily compositions of movement behaviours characterized by 10 (20 or 30) minutes greater duration in one movement behaviour accompanied by decrease in another behaviour, while keeping the third behaviour constant, compared to reference composition. Analyses were adjusted for sociodemographic, lifestyle, cardiometabolic risk factors and multimorbidity index.ResultsOf the 3319 participants, 299 had an incident CVD over a mean (SD) follow-up of 6.2 (1.3) years. Compared to daily movement behaviour composition with MVPA at recommended 21 min per day (150 min/week), composition with additional 10 min of MVPA and 10 min less SB was associated with smaller risk reduction – 8% (HR, 0.92; 95% CI, 0.87–0.99) – than the 14% increase in risk associated with a composition of similarly reduced time in MVPA and more time in SB (HR, 1.14; 95% CI, 1.02–1.27). For a given MVPA duration, the CVD risk did not differ as a function of LIPA and SB durations.ConclusionsAmong older adults, an increase in MVPA duration at the expense of time in either SB or LIPA was found associated with lower incidence of CVD. This study lends support to public health guidelines encouraging increase in MVPA or at least maintain MVPA at current duration.
Highlights
Moderate-to-vigorous physical activity (MVPA) is proposed as key for cardiovascular diseases (CVD) prevention
We defined a set of reference movement behaviour compositions to which we compared compositions with 10 (20- and 30-) minutes more time spent in one movement behaviour at the expense of time spent in another movement behaviour, keeping time spent in the third behaviour fixed at the reference composition
First to assess the impact of MVPA duration, we defined three separate reference movement behaviour compositions corresponding to individuals with daily MVPA duration set at 10 min, 21 min [39], and the recommended 30 min per day [39]
Summary
Moderate-to-vigorous physical activity (MVPA) is proposed as key for cardiovascular diseases (CVD) prevention. Physical activity is a modifiable risk factor for cardiovascular diseases (CVD) [1, 2], with 17 to 25% lower CVD risk among those following the current recommended 150 min per week of moderate-to-vigorous physical activity (MVPA) [3] These recommendations are not met by the majority of the population, older adults [4] in part due to declining physiological ability to perform higher intensity activity [5]. The evidence on the association between multiple movement behaviours during the day (i.e. SB, LIPA, MVPA) and CVD is primarily based on self-reported physical activity [12], which are subject to recall and response bias [13] Further limitations of such data include their inability to capture incidental, short periods of movements and light intensity activities that are spread over the day and less easy to report with accuracy [12,13,14]. These studies have found higher duration of MVPA to be associated with reduced risk of CVD [16,17,18, 20], while results on the impact of LIPA [11, 16,17,18, 20] and SB [16,17,18,19,20] are inconsistent
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