Optimum Amount and Mode of Physical Activity in Association with All-Cause and Cause-Specific Mortality: A Large Prospective Cohort Study

Abstract

Background: Evidence on amount and mode of physical activity (PA) is optimum for human health is limited. We aimed to determine the optimum amount and mode of PA in association with mortality. Methods: The data of this study was from the US National Institutes of Health–AARP Diet and Health Study from 1995 to 2011. PA was acquired using a self-report questionnaire. We used restricted cubic splines to fit PA time and amount for Cox proportional hazards of mortality. Cox proportional hazards regression was used to generate multivariable-adjusted hazard ratio (HR) and 95%CI of mortality. Results: 266,072 participants were included in this study. During a median follow-up of 7.12 years, there were 36,006 deaths from all cause. Anyway, compared with participants without PA, those with any amount of PA had lower risk of all-cause mortality; furthermore, the risk of all-cause mortality decreased rapidly until around 15.0 hours or 50.0 MET-hours per week of total PA, but the sharply decreasing trend of all-cause mortality risk was changed to slightly decreasing trend while time or amount of all PA increased. Similar trends were also observed in participants with light, moderate and vigorous PA, respectively. Compared participants without PA, those with the combination of 0.1 ~5.0 hours per week light PA, ≥5.0 hours per week moderate PA and ≥1.3 hours per week vigorous PA had relatively lowest risk not only for all-cause mortality, but also for cancer-cause, cardiovascular disease-cause, respiratory disease-cause and diabetes-cause mortality. Conclusions: This study found that any amount and intensity of PA certainly benefited on lowering mortality among all populations with different characteristics, and based on input-output ratio, up to 15.0 hours or 50.0 MET-hours per week of PA is optimal. The mode of combined light, moderate and vigorous PA is recommended. Funding: This study was funded by Chinese National Natural Science Foundation (81973055), Major research and development projects of Zhejiang science and Technology Department (2018C03010) and the Fundamental Research Funds for the Central Universities. Declaration of Interest: There was no conflict of interest. Ethical Approval: The NIH-AARP study was approved by the Special Studies Institutional Review Board of the National Cancer Institute, and all participants gave written informed consent.