Abstract
BackgroundMost previous studies have relied on single measurements of body weight and physical activity and have not considered the interplay between long-term changes in body weight and physical activity in relation to mortality. The aim of the current study was therefore to examine the joint effect of changes in body weight and leisure-time physical activity over a period of ~ 10 years on all-cause and cardiovascular mortality.MethodsThe study population comprised 34,257 individuals who participated in the first (1984–86) and second (1995–97) waves of the HUNT Study, and were followed up through the Norwegian Cause of Death Registry until December 31st, 2013. We used Cox regression to estimate hazard ratios (HR) with 95% confidence intervals (CI) of death associated with changes in body weight and leisure-time physical activity.ResultsCompared to the reference group with stable weight who were long-term physically active, people who gained ≥5% of their weight had a HR for all-cause mortality of 1.54 (95% CI: 1.28–1.85) if they were long-term physically inactive; a HR of 1.23 (1.09–1.40) if they became physically active, and a HR of 1.00 (95% CI 0.94–1.06) if they were long-term physically active. The corresponding HRs for cardiovascular mortality were 1.57 (95% CI 1.17–2.12), 1.28 (95% CI 1.04–1.58) and 1.06 (95% CI 0.96–1.16), respectively. Long-term physical inactivity was associated with increased all-cause (HR 1.29; 95% CI 1.08–1.53) and cardiovascular (HR 1.37; 95% CI 1.05–1.79) mortality among those who were weight stable.ConclusionsThe risk of all-cause and cardiovascular mortality is particularly evident among people who gain weight while remaining inactive during a ~ 10 year period. However, participants who remained physically active had the lowest risk of premature mortality, regardless of maintenance or increase in weight. These findings suggest that there is an interplay between long-term changes in body weight and physical activity that should receive particular attention in the prevention of premature mortality.
Highlights
Most previous studies have relied on single measurements of body weight and physical activity and have not considered the interplay between long-term changes in body weight and physical activity in relation to mortality
Compared to the reference group of participants with stable weight who remained active, participants who remained inactive had a hazard ratios (HR) for all-cause mortality of 1.54 if they gained weight and 1.29 if they
Exclusion of participants with a history of cardiovascular disease partly attenuated the unfavorable association with cardiovascular mortality in those who gained weight and remained inactive, compared to persons who had stable weight and the same level of physical activity (Additional file 1: Table S4). This large prospective study showed that the risk of all-cause and cardiovascular mortality is evident among people who gain weight while remaining inactive during a 10–12 year period
Summary
Most previous studies have relied on single measurements of body weight and physical activity and have not considered the interplay between long-term changes in body weight and physical activity in relation to mortality. The aim of the current study was to examine the joint effect of changes in body weight and leisure-time physical activity over a period of ~ 10 years on all-cause and cardiovascular mortality. Previous studies have shown that increasing the level of physical activity may reduce both all-cause and cardiovascular mortality considerably [6, 7]. Most previous studies have relied on single measurements of weight status and physical activity and have not considered the influence of long-term lifestyle changes on mortality. Increased knowledge about the potential interplay between concurrent changes in body weight and leisure-time physical activity are necessary to guide public health recommendations aimed at preventing premature mortality
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