Patterns Of Recommended Levels Of Physical Activity And Mortality: A Prospective Cohort Study

Abstract

PURPOSE: We examined the association of different patterns of recommended levels of physical activity with all-cause, cardiovascular disease (CVD), and cancer mortality. METHODS: We included 403,681 participants (≥18 years) from National Health Interview Survey (1997-2013) who were linked to the National Death Index with follow-up to date of death or Dec 31, 2015, whichever came first. Leisure-time physical activity was measured through frequency (times/week) and duration of light to moderate intensity physical activity and vigorous intensity physical activity. Cox proportional hazards regression models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CI), adjusted for potential confounders including total amount of physical activity. RESULTS: During median 10.1 years of follow-up, 36,861 deaths occurred, including 7,634 from CVD and 8,902 from cancer. Compared to participants who had not met the physical activity guidelines, those who met the recommended levels of physical activity in one or two sessions a week (aka “the weekend warriors”) had lower all-cause (HR 0.72; CI 0.66, 0.78; P < 0.01), CVD (HR 0.67; CI 0.53, 0.85; P < 0.01), and cancer mortality (HR 0.80; CI 0.67, 0.96; P < 0.01). HR for participants doing the recommended levels of physical activity in ≥3 sessions/week (regularly actives participants) were 0.64 (0.62, 0.65; P < 0.01) for all-cause mortality, 0.58 (CI 0.54, 0.62; P < 0.01) for CVD, and 0.74 (CI 0.70, 0.78; P < 0.01) for cancer mortality. Weekend warriors and regularly active participants had similar mortality, after adjusting for total physical activity. CONCLUSION: Weekend warriors had a lower mortality when compared to individuals classified as inactive. After accounting for total physical activity, weekend warriors and regularly active participants had similar mortality, suggesting that benefits of physical activity for reducing mortality can be obtained from different combination of sessions/week.