Cardiovascular disease risk and all-cause mortality associated with accelerometer-measured physical activity and sedentary time ‒ a prospective population-based study in older adults

ObjectiveTo examine the associations of accelerometer-measured physical activity and sedentary time with all-cause mortality in older Japanese adults.MethodsA total of 1723 independent Japanese adults aged ≥65 years were followed from...

Joint associations of accelerometer-measured physical activity and sedentary time with cardiometabolic risk in older adults: A cross-sectional study.

BackgroundThe COPD guidelines recommend engaging in regular physical activity and reducing sedentary time (ST), but little is known about the optimal or minimal dose of physical activity and ST. This study aimed to quantify the prospective dose-response relationships between daily time spent in moderate to vigorous physical activity (MVPA), light physical activity (LPA), ST and mortality, and examine the theoretical consequences of replacing ST with equal time of MVPA or LPA.MethodsA population-based cohort study of 1,551 individuals with COPD enrolled in the UK Biobank. MVPA, LPA, ST were measured with the wrist-worn Axivity AX3 accelerometer. All-cause mortality was obtained through the linkage to death registries. Restricted cubic splines were used to assess the dose response associations of MVPA, LPA, ST and all-cause mortality. Isotemporal substitution models were used to estimate the theoretical effect of replacing ST with MVPA or LPA.Results54% were male, and the mean (SD) age was 66.31 (6.52) years. Over a mean (SD) follow-up of 7.44 (1.67) years, 244 (15.7%) died. We observed a significant L-shaped association between MVPA and all-cause mortality, with an optimal amount at 60 min/day (HR = 0.27, 95% CI: 0.18–0.41). For LPA, we observed a significant U-shaped association, with an optimal amount at 5.2 h/day (HR = 0.15, 95% CI: 0.10–0.25). The threshold for ST was 12.43 h/day, above which a significant increase in mortality was observed. Replacing 30 min/day of ST was associated with 34% decreased risk in mortality for MVPA (HR = 0.66, 95%CI: 0.55–0.81, P < .001) and 10% lower mortality for LPA (HR = 0.90, 95% CI: 0.86–0.94, P < .001).ConclusionsThe findings of this study suggest non-linear associations of MVPA, LPA, ST and all-cause mortality. Replacing ST with either MVPA or LPA is associated with decreased risk of mortality.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12890-025-03969-3.

To develop healthy ageing interventions, longitudinal associations between objectively assessed physical behaviours and physical function need to be better understood. We assessed associations between accelerometer-assessed total physical activity (PA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary time and prolonged sedentary bout time, and clinically assessed physical function (grip strength, usual walking speed (UWS), chair stand speed) at two time-points in 3188 participants (≥ 60 years) of the EPIC-Norfolk study. Bidirectional associations were assessed using multivariable linear regression. Over an average of 6.1 years, baseline physical behaviours (greater total PA, MVPA and LPA, and less sedentary time) were associated with better subsequent walking and chair stand speed. Better baseline physical function was associated with better follow-up physical behaviours. There were no bidirectional associations between changes in physical behaviours and grip strength. Improvements in UWS were associated with improvements in all physical behaviours. Improvements in chair stand speed were associated with improvements in total PA, MVPA, and sedentary bout time. Improvements in physical behaviours were associated with improvements in UWS (3.1 cm/s/yr per 100 cpm/yr total PA, 3.6 cm/s/yr per hr/day/yr MVPA, 2.5 cm/s/yr per hr/day/yr LPA, − 2.9 cm/s/yr per hour/day/yr sedentary time, and − 1.6 cm/s/yr per hr/day/yr prolonged sedentary bout time). Only improvements in total PA, MVPA and sedentary bout time were associated with improvements in chair stand speed. In conclusion, we found bidirectional associations between changes in some physical behaviours and physical function and between baseline physical behaviours and subsequent physical function, highlighting the importance of considering the full range of physical behaviours to promote healthy ageing.

Introduction: High neighborhood walkability, defined as presence of crosswalks, sidewalks, and parks, is associated with higher physical activity (PA) and lower sedentary time (ST) among United States (US) adults. The associations between neighborhood walkability, PA, and ST have not been studied among US South Asians adults, a group which experiences significantly higher cardiovascular disease (CVD) mortality compared to other race-ethnic groups. Methods: The SAHELI clinical trial randomized South Asian adults from the Chicago, IL metro area (18-65 years with CVD risk factors) to a 16-week lifestyle intervention versus a control group between 2018-2023. Baseline PA and ST were measured by an Actigraph worn by participants for 7 consecutive days. Moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and ST were defined by Troiano cut points. Neighborhood was defined by a 500-meter radius around participants’ home address. Neighborhood walkability measures included: the National Walkability Index (measured at the US Census block level), total number of crosswalks, total number of sidewalks, and percentage of neighborhood which contained a park, all measured by Google Street View. In separate models, multivariate linear regression evaluated the association between each neighborhood walkability measure and baseline MVPA, LPA, and ST, adjusting for age, sex, country-of-origin, years in US, and Actigraph wear time. Results: Participants from SAHELI with valid Actigraph data (defined as at least 600 min/day of wear time for &gt;3 days) and geocoded neighborhood walkability data were included (N=432; 59% female, 98% immigrant, 79% Indian origin). Mean±SD MVPA was 24±19 min/day, LPA was 299±95 min/day, and ST was 564±136 min/day. Distribution of neighborhood walkability variables are shown in Figure . Neighborhood walkability exposures were not associated with MVPA. The National Walkability Index, total number of crosswalks, and total number of sidewalks were significantly associated with higher LPA and lower ST in maximally-adjusted models ( Figure ). The percentage of neighborhood containing a park was not associated with LPA or ST. Conclusion: National Walkability Index, number of neighborhood crosswalks and sidewalks were significantly associated with higher LPA and lower ST, but not with MVPA. Neighborhood walkability may be important to consider when designing CVD prevention interventions that promote PA and minimize ST among US South Asians.

Evidence regarding the association between physical activity and Parkinson’s disease (PD) risk is generally limited due to the use of self-report questionnaires. We aimed to quantify the separate and combined effects of accelerometer-measured light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time and exercise timing with incident PD. 96,422 participants without prior PD and with usable accelerometer data were included from UK Biobank. Time spent in sedentary activity, LPA, MVPA, and exercise timing were estimated using machine learning models. The study outcome was incident PD. Over a median follow-up duration of 6.8 years, 313 participants developed PD. There was a L-shaped association for LPA and MVPA, and a reversed L-shaped association for sedentary time, with the risk of incident PD (all P for nonlinearity < 0.001). Similar trends were found across three time-windows (morning, midday-afternoon, and evening). Compared with those with both low LPA (<3.89 h/day) and low MVPA (<0.27 h/day), the adjusted HR (95% CI) of PD risk was 0.49 (0.36–0.66), 0.19 (0.36–0.66) and 0.13 (0.09–0.18), respectively, for participants with high MVPA only, high LPA only, and both high LPA and high MVPA. Moreover, participants with both low LPA and high sedentary time (≥9.41 h/day) (adjusted HR, 5.59; 95% CI: 4.10–7.61), and those with both low MVPA and high sedentary time (adjusted HR, 3.93; 95% CI: 2.82–5.49) had the highest risk of incident PD. In conclusion, regardless of exercise timing (morning, midday-afternoon, and evening), there was an inverse association for accelerometer-measured MVPA and LPA, and a positive association for sedentary time, with incident PD.

We examined the longitudinal associations of accelerometer-measured physical activity and sedentary time with leg muscle strength (LMS), balance, and falls in middle-aged women. This was a 5-year cohort study among 308 women aged 36–56 years. We used linear mixed-effects models to examine associations of baseline and change in accelerometer-measured sedentary time, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) with baseline and 5-year change in LMS and balance (timed up and go test [TUG], functional reach test [FRT], lateral reach test [LRT], and step test [ST]), and negative binomial/Poisson and log-binomial regression as appropriate to assess associations with falls after 5-year follow-up. Greater baseline MVPA was associated with better baseline LMS (β = 4.65 kg/SD, 95% CI: 1.37, 7.93) and TUG (β = −0.09 s/SD, 95% CI: –0.18, –0.01) but not with change in them over 5 years. Baseline MVPA was not associated with FRT at baseline but associated with a greater decrease in FRT (β = −0.87 cm/SD, 95% CI: –1.57, –0.17). Increased MVPA over 5 years was associated with less deterioration in FRT (β = 0.88 cm/SD, 95% CI: 0.14, 1.61). Increased sedentary time over 5 years was associated with a larger decrease in FRT (β = −0.82 cm/SD, 95% CI: –1.58, –0.07). Higher baseline LPA was associated with higher falls risk (IRR = 1.27, 95% CI: 1.02, 1.57). Higher baseline MVPA may benefit LMS and balance, while increasing MVPA in the medium term has little effect on change in these outcomes in mid-life. Detrimental association of LPA with falls may be due to greater exposures to environmental hazards. Highlights Our study for the first time examined the longitudinal associations of objectively measured physical activity and sedentary time with leg muscle strength, balance and falls in middle-aged women. Higher baseline moderate-to-vigorous physical activity (MVPA) may be beneficial for muscle strength and balance at baseline but increasing MVPA in the medium term has little effect on change in LMS or balance outcomes in middle-aged women. Higher baseline light physical activity (LPA) was associated with an increased risk of falls. The detrimental association of LPA with falls may be due to a greater exposure to environmental hazards in midlife, which needs to be clarified in future research.

Sedentary time (ST) and lack of physical activity increase the risk of adverse outcomes for those living with coronary artery disease (CAD). Little is known about how much ST, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) that CAD participants not attending cardiac rehabilitation engage in, the locations where they engage in these behaviors, and how far from home the locations are. Participants completed a survey and wore an accelerometer and global positioning system receiver for 7 d at baseline and 6 mo later. Accelerometer analyses (n = 318) showed that participants averaged 468.4 ± 102.7 of ST, 316.1 ± 86.5 of LPA, and 32.9 ± 28.9 of MVPA min/d at baseline. ST and LPA remained stable at 6 mo, whereas MVPA significantly declined. The global positioning system (GPS) analyses (n = 315) showed that most of participant ST, LPA, and MVPA time was spent at home followed by other residential, retail/hospitality, and work locations at baseline and 6 mo. When not at home, the average distance to a given location ranged from approximately 9 to 18 km. Participants with CAD spent the majority of their time being sedentary. Home was the location used the most to engage in ST, LPA, and MVPA. When not home, ST, LPA, and MVPA were distributed across a variety of locations. The average distance from home to a given location suggests that proximity to home may not be a barrier from an intervention perspective.

The aim of this study was to examine the prevalence of metabolic health across weight statuses and the associations of physical activity and sedentary time within and across metabolic health-weight status groups. Six studies (n = 4,581) from the International Children's Accelerometry Database were used. Sedentary time, light physical activity, and moderate to vigorous physical activity (MVPA) were accelerometer derived. Individuals were classified with normal weight (NW), overweight, or obesity. Strict and lenient composite definitions of metabolic health were created. Binomial and multinomial logistic regressions controlling for age, sex, study, and accelerometer wear time were conducted. The metabolically unhealthy (MU) prevalence was 26.4% and 45.6% based on two definitions. Across definitions, more sedentary time was associated with higher odds of MU classification compared with metabolically healthy (MH) classification for the NW group. More MVPA was associated with lower odds of MU classification than MH classification for NW and overweight groups. For multinomial logistic regressions, more MVPA was associated with lower odds of MH-obesity classification, as well as MU-NW, -overweight, and -obesity classifications, compared with the MH-NW group. Furthermore, more sedentary time was associated with higher odds of MU-NW classification compared with the MH-NW group. More MVPA was beneficial for metabolic health and weight status, whereas lower sedentary time was beneficial for metabolic health alone, although associations were weak.

This study adopted a compositional framework to cross-sectionally examine the associations between physical activity (PA) and sedentary time (ST) with vascular structure and function and clustered cardiovascular disease (CVD) risk factors in 4277 children (2,226 girls), aged 10.6±0.2 years. Cardiovascular outcomes included flow mediated dilation, distensibility coefficient, pulse wave velocity and a clustered CVD risk factor score. Time spent in light PA (LPA) and moderate to vigorous PA (MVPA) and ST were determined using accelerometers. Multiple linear regression analyses were adjusted for key covariates with LPA, MVPA and ST entered as compositional exposure variables. Neither LPA, MVPA or ST were significantly associated with the vascular outcomes. The proportion of time spent in MVPA and ST were inversely (unstandardised b=−0.126; P=0.001) and positively (b=0.136; P=0.016) associated with clustered CVD risk in the whole group analysis, respectively. MVPA was negatively associated with clustered CVD risk in boys (b=−0.144; P=0.011) and girls (b=−0.110; P=0.032). Only girls had a positive association between ST and clustered CVD risk (b=0.199; P=0.005). Although no associations were observed for PA and ST with vascular outcomes, these data provide further support for interventions that promote MVPA and minimise ST for reducing risk factors for CVD in children.

During the postpartum period, 150 minutes of moderate-intensity physical activity (PA) per week is recommended. However, little is known about how many women are meeting these guidelines and if racial differences exist. PURPOSE: The purpose of this study was to examine the time spent being sedentary, time in light PA (LPA), and time in moderate-to-vigorous PA (MVPA), while also examining the percentage of women meeting the recommended PA guidelines during the first year postpartum. METHODS: Participants were white (n = 85) and African American (n = 49) women (18-43 years), who gave birth to a singleton at ≥37 weeks gestation. At 6-8 weeks, 4 months, 6 months, 9 months, and 12 months postpartum, PA was measured by a hip worn accelerometer. Participants wore the accelerometer for at least 5 days and were told to maintain their normal daily routine. Data was analyzed to determine time spent in sedentary bouts, LPA, and MVPA. Mean daily MVPA was used to determine if participants met the guidelines of 150 minutes of MVPA per week. RESULTS: Daily average sedentary, LPA, and MVPA time are included in the table below (means and standard deviations). The percentage of women who did not meet recommended guidelines at each timepoint are as follows: 18.8% at 6-8 weeks, 12.4% at 4 months, 6.9% at 6 months, 6.7% at 9 months, and 5.2% at 12 months. For African American women, 32.7% at 6-8 weeks, 25.0% at 4 months, 7.4% at 6 months, 17.7% at 9 months, and 17.7% at 12 months did not meet the recommendations. For white women at the same timepoints, 10.7%, 6.4%, 6.7%, 3.5%, and 1.7% (respectively) did not meet recommended guidelines. CONCLUSION: During the first year postpartum, sedentary time appeared higher at 6-8 weeks than later timepoints. Time in LPA was higher at 9 and 12 months than earlier timepoints. Time in MVPA showed an increasing trend across the timepoints. There was a higher percentage of African American than white women not meeting the guidelines at each timepoint.Supported by: NIH Grant R21MD012740

BackgroundExisting research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites.MethodsThis multinational, cross-sectional study included 6228 children aged 9–11 years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2 days/week [rare], 3 to 5 days/week [occasional] or 6 to 7 days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200 h) and afternoon (1200 h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time.ResultsParticipants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated with a higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4 min/day and 1.3%) than rare breakfast consumption (all p ≤ 0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found.ConclusionsIn this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance.Trial registrationThe International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is registered at (Identifier NCT01722500).

Relationships between movement-related behaviours and metabolic health remain underexplored in adolescents with obesity. To compare profiles of sedentary time (more sedentary, SED+ vs. less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs. less active, MVPA-) and combinations of behaviours (SED-/MVPA+, SED-/MVPA-, SED+/MVPA+, SED+/MVPA-) in regard to metabolic health. One hundred and thirty-four subjects (mean age 13.4± 2.2 yrs, mean body mass index [BMI] 98.9± 0.7 percentile, 48.5% females) underwent 24 h/7 day accelerometry, anthropometric, body composition, blood pressure (BP), lipid profile and insulin resistance (IR) assessments. Metabolic health was better in SED- [lower fat mass (FM) percentage (p < 0.05), blood pressure (BP) (p < 0.05), homeostasis model assessment of insulin resistance (HOMA-IR) (p < 0.001) and metabolic syndrome risk score (MetScore) (p < 0.001), higher high-density lipoprotein-cholesterol (HDL-c) (p=0.001)] vs. SED+ group and in MVPA+ [lower triglyceridemia (TG), (p < 0.05), HOMA-IR (p < 0.01) and MetScore (p < 0.001), higher HDL-c (p < 0.01)] vs. MVPA- group after adjustment with age, gender, maturation and BMI. SED-/MVPA+ group had the best metabolic health. While sedentary (p < 0.001) but also MVPA times (p < 0.001) were lower in SED-/MVPA- vs. SED+/MVPA+, SED-/MVPA- had lower FM percentage (p < 0.05), HOMA-IR (p < 0.01) and MetScore (p < 0.05) and higher HDL-c (p < 0.05), independently of BMI. Sedentary time was positively correlated with HOMA-IR and Metscore and negatively correlated with HDL-c after adjustment with MVPA (p < 0.05). MVPA was negatively correlated with HOMA-IR, BP and MetScore and positively correlated with HDL-c after adjustment with sedentary time (p < 0.05). Lower sedentary time is associated with a better metabolic health independently of MVPA and might be a first step in the management of pediatric obesity when increasing MVPA is not possible.

BackgroundNo previous studies have examined the associations between changes in objectively-measured physical behaviours with follow-up QoL in older adults. Based on cross-sectional evidence, it is biologically plausible that such associations exist. If so, this bolsters the case for the commissioning of activity interventions and for including QoL as an outcome in trials of such interventions.MethodsWe assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers at baseline (2006–2011) and follow-up (2012–2016) and health-related quality-of-life (QoL) using EQ-5D questionnaires at follow-up in 1433 participants (≥ 60 years) of the EPIC (European Prospective Investigation into Cancer)-Norfolk study. The EQ-5D summary score was used, with 0 as the worst to 1 as best perceived quality-of-life. We evaluated the prospective associations of baseline physical behaviours with follow-up QoL, and of changes in behaviours with follow-up QoL using multi-level regression.ResultsOn average, MVPA decreased by 4.0 min/day/year (SD 8.3) for men and 4.0 min/day/year for women (SD 12.0) between baseline and follow-up. Total sedentary time increased by an average 5.5 min/day/yr (SD 16.0) for men and 6.4 min/day/yr (SD 15.0) for women between baseline and follow-up. Mean (SD) follow-up time was 5.8 (1.8) years.We found that higher baseline MVPA and lower sedentary time was associated with higher subsequent QoL (e.g. 1 h/day greater baseline MVPA was associated with 0.02 higher EQ-5D score, 95% CI 0.06, 0.36). More pronounced declines in activity were associated with worse Hr-QoL (0.005 (95% CI 0.003, 0.008) lower EQ-5D per min/day/yr decrease in MVPA). Increases in sedentary behaviours were also associated with poorer QoL (0.002 lower EQ-5D, 95% CI -0.003, -0.0007 per hour/day/yr increase in total sedentary time).ConclusionsPromotion of physical activity and limiting sedentary time among older adults may improve quality-of-life, and therefore this relationship ought to be included in future cost effectiveness analyses so that greater commissioning of activity interventions can be considered.

Introduction: Habitual physical activity (PA) and less sedentary behavior have been associated with a lower risk of mortality in middle-aged adults. However, little is known about the associations of objectively-assessed PA of varying levels and sedentary time with mortality in community-dwelling older adults. Hypothesis: We hypothesized that higher overall PA and less sedentary time will be associated with a lower risk of all-cause mortality in older adults. Methods: We evaluated 1,262 Framingham Offspring Study participants (mean age 69 yrs, 54% women) with accelerometry-derived PA data (wear time ≥10 hours/day for at least 4 days using an Actical device) at their ninth examination (2011-2014). Multivariable Cox proportional hazards regression models were used to relate PA and sedentary time (separate model for each) with all-cause mortality adjusting for potential confounders. In sensitivity analysis to mitigate the potential impact of frailty on the associations evaluated, we excluded those with frailty at baseline. Results: Overall, 67 participants died during a median follow-up of 4.8 years (25 th -75 th percentiles: 4.3 - 5.3 [years]). Higher total PA, light intensity PA (LIPA), adherence to PA guidelines, and lower sedentary time were associated with a lower risk of all-cause mortality ( Table ). The results remained statistically significant even after excluding those with frailty. Higher LIPA and lower sedentary time were associated with a lower risk of all-cause mortality regardless of MVPA in both models including all participants and excluding those with frailty. Conclusions: In our investigation of a moderate-size sample of community-dwelling older adults, we confirmed that being physically active substantially lowered mortality risk. Additionally, our findings suggest that reducing sedentary time and increasing LIPA (regardless of MVPA) may be sufficient to reduce mortality risk in older adults. Additional studies of larger multi-ethnic samples of older adults are warranted to confirm our findings.