Arem Hannah, Moore Steven C, Patel Alpa, Hartge Patricia, Berrington de Gonzalez Amy, Visvanathan Kala, Campbell Peter T, Freedman Michal, Weiderpass Elisabete, Adami Hans Olov, Linet Martha S, Lee I-Min, Matthews Charles E
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
American Cancer Society, Atlanta, Georgia.
JAMA Intern Med. 2015 Jun;175(6):959-67. doi: 10.1001/jamainternmed.2015.0533.
The 2008 Physical Activity Guidelines for Americans recommended a minimum of 75 vigorous-intensity or 150 moderate-intensity minutes per week (7.5 metabolic-equivalent hours per week) of aerobic activity for substantial health benefit and suggested additional benefits by doing more than double this amount. However, the upper limit of longevity benefit or possible harm with more physical activity is unclear.
To quantify the dose-response association between leisure time physical activity and mortality and define the upper limit of benefit or harm associated with increased levels of physical activity.
DESIGN, SETTING, AND PARTICIPANTS: We pooled data from 6 studies in the National Cancer Institute Cohort Consortium (baseline 1992-2003). Population-based prospective cohorts in the United States and Europe with self-reported physical activity were analyzed in 2014. A total of 661,137 men and women (median age, 62 years; range, 21-98 years) and 116,686 deaths were included. We used Cox proportional hazards regression with cohort stratification to generate multivariable-adjusted hazard ratios (HRs) and 95% CIs. Median follow-up time was 14.2 years.
Leisure time moderate- to vigorous-intensity physical activity.
The upper limit of mortality benefit from high levels of leisure time physical activity.
Compared with individuals reporting no leisure time physical activity, we observed a 20% lower mortality risk among those performing less than the recommended minimum of 7.5 metabolic-equivalent hours per week (HR, 0.80 [95% CI, 0.78-0.82]), a 31% lower risk at 1 to 2 times the recommended minimum (HR, 0.69 [95% CI, 0.67-0.70]), and a 37% lower risk at 2 to 3 times the minimum (HR, 0.63 [95% CI, 0.62-0.65]). An upper threshold for mortality benefit occurred at 3 to 5 times the physical activity recommendation (HR, 0.61 [95% CI, 0.59-0.62]); however, compared with the recommended minimum, the additional benefit was modest (31% vs 39%). There was no evidence of harm at 10 or more times the recommended minimum (HR, 0.69 [95% CI, 0.59-0.78]). A similar dose-response relationship was observed for mortality due to cardiovascular disease and to cancer.
Meeting the 2008 Physical Activity Guidelines for Americans minimum by either moderate- or vigorous-intensity activities was associated with nearly the maximum longevity benefit. We observed a benefit threshold at approximately 3 to 5 times the recommended leisure time physical activity minimum and no excess risk at 10 or more times the minimum. In regard to mortality, health care professionals should encourage inactive adults to perform leisure time physical activity and do not need to discourage adults who already participate in high-activity levels.
《2008年美国体育活动指南》建议，每周进行至少75分钟的高强度或150分钟的中等强度有氧运动（每周7.5个代谢当量小时），以获得显著的健康益处，并指出运动量超过此量的两倍可能会带来更多益处。然而，体育活动量增加对寿命的益处上限或可能的危害尚不清楚。
量化休闲时间体育活动与死亡率之间的剂量反应关系，并确定与体育活动量增加相关的益处或危害上限。
设计、背景和参与者：我们汇总了美国国立癌症研究所队列联盟6项研究的数据（基线时间为1992 - 2003年）。2014年对美国和欧洲基于人群的前瞻性队列进行了分析，这些队列中的个体自我报告了体育活动情况。共纳入661137名男性和女性（年龄中位数为62岁；范围为21 - 98岁），其中有116686人死亡。我们使用队列分层的Cox比例风险回归来生成多变量调整后的风险比（HR）和95%置信区间（CI）。中位随访时间为14.2年。
休闲时间的中等至高强度体育活动。
高水平休闲时间体育活动对死亡率益处的上限。
与报告无休闲时间体育活动的个体相比，我们观察到，每周体育活动量低于建议最低量7.5个代谢当量小时的人群，其死亡风险降低了20%（HR，0.80 [95% CI，0.78 - 0.82]）；体育活动量为建议最低量1至2倍的人群，死亡风险降低了31%（HR，0.
