Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz, and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz, and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
Prog Cardiovasc Dis. 2024 Mar-Apr;83:116-123. doi: 10.1016/j.pcad.2024.02.011. Epub 2024 Feb 27.
To examine the trends in the association between meeting the physical activity (PA) guidelines and mortality in adults.
We included seventeen annual representative samples of US adults 1998-2014 (n = 482,756) and all-cause and cause-specific mortality ascertained through December 2019. Participants were grouped according to PA Guidelines: 150 or more min/week in aerobic PA and muscle-strengthening activities 2 or more times/week. To provide further context, we also examined the trends in mortality risk associated with other modifiable health factors.
Meeting the PA guidelines was associated with lower 5-year mortality risk (HR = 0.59, 95%CI, 0.55, 0.63) based on the pooled analyses. We consistently observed an inverse association in all years, but there was a nonsignificant trend association (P for trend = 0.305) between meeting PA guidelines and 5-year mortality across the seventeen annual surveys. Meeting aerobic (HR = 0.58, 95%CI, 0.56, 0.61) and muscle-strengthening (HR = 0.86, 95%CI, 0.81, 0.90) guidelines were independently associated with 5-year mortality risk in pooled analyses, without any evidence for trends in the associations. Similar results were found with cause-specific mortality and 10-year mortality risk. In pooled analyses, attaining a high educational level, body mass index <30 kg/m2, being noncurrent smoker, nonheavy drinker, and living without history of hypertension and diabetes with 5-year mortality were 0.70 (95%CI, 0.67, 0.73), 1.19 (95%CI, 1.15, 1.23), 0.56 (95%CI, 0.54, 0.59), 0.85 (95%CI,0.79, 0.92), 0.91 (95%CI, 0.88-0.94) and 0.65 (95%CI, 0.88, 0.94), respectively. Only no history of diabetes showed a significant trend analysis (B = 0.77, 95%CI, 0.46, 0.91, P for trend <0.001).
Meeting PA guidelines lower mortality risk and this association does not seem to have varied over time. Encouraging adults to meet the PA guidelines may provide substantial health benefits, despite social, demographic and lifestyle changes, as well as the advances in medical technology and pharmacological treatments.
探讨成年人达到身体活动（PA）指南与死亡率之间的关联趋势。
我们纳入了美国 1998-2014 年的 17 项年度代表性成年人样本（n=482756），并通过 2019 年 12 月确定了全因和特定原因的死亡率。参与者根据 PA 指南进行分组：每周进行 150 分钟或更多的有氧运动和每周进行 2 次或更多的肌肉强化活动。为了提供更多的背景信息，我们还研究了与其他可改变的健康因素相关的死亡率风险趋势。
基于汇总分析，达到 PA 指南与 5 年死亡率风险降低相关（HR=0.59，95%CI，0.55，0.63）。我们在所有年份都观察到了相反的关联，但在 17 项年度调查中，达到 PA 指南与 5 年死亡率之间的趋势关联无统计学意义（趋势检验 P 值=0.305）。达到有氧运动（HR=0.58，95%CI，0.56，0.61）和肌肉强化（HR=0.86，95%CI，0.81，0.90）指南与汇总分析中的 5 年死亡率风险独立相关，没有任何趋势关联的证据。在特定原因的死亡率和 10 年死亡率风险中也得到了类似的结果。在汇总分析中，达到高教育水平、体重指数（BMI）<30kg/m2、非当前吸烟者、非重度饮酒者、没有高血压和糖尿病史与 5 年死亡率相关的风险比（HR）分别为 0.70（95%CI，0.67，0.73）、1.19（95%CI，1.15，1.23）、0.56（95%CI，0.54，0.59）、0.85（95%CI，0.79，0.92）、0.91（95%CI，0.88-0.94）和 0.65（95%CI，0.88，0.94）。只有没有糖尿病史的患者显示出有统计学意义的趋势分析（B=0.77，95%CI，0.46，0.91，趋势检验 P 值<0.001）。
达到 PA 指南可降低死亡率风险，而且这种关联似乎没有随时间变化。尽管社会、人口和生活方式发生了变化，以及医学技术和药物治疗的进步，鼓励成年人达到 PA 指南可能会带来显著的健康益处。
