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Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies

OBJECTIVE: To estimate the dose–response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN: Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES: PubMed, Scopus, Web of Science an...

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Autores principales: Garcia, Leandro, Pearce, Matthew, Abbas, Ali, Mok, Alexander, Strain, Tessa, Ali, Sara, Crippa, Alessio, Dempsey, Paddy C, Golubic, Rajna, Kelly, Paul, Laird, Yvonne, McNamara, Eoin, Moore, Samuel, de Sa, Thiago Herick, Smith, Andrea D, Wijndaele, Katrien, Woodcock, James, Brage, Soren
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423495/
https://www.ncbi.nlm.nih.gov/pubmed/36854652
http://dx.doi.org/10.1136/bjsports-2022-105669
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author Garcia, Leandro
Pearce, Matthew
Abbas, Ali
Mok, Alexander
Strain, Tessa
Ali, Sara
Crippa, Alessio
Dempsey, Paddy C
Golubic, Rajna
Kelly, Paul
Laird, Yvonne
McNamara, Eoin
Moore, Samuel
de Sa, Thiago Herick
Smith, Andrea D
Wijndaele, Katrien
Woodcock, James
Brage, Soren
author_facet Garcia, Leandro
Pearce, Matthew
Abbas, Ali
Mok, Alexander
Strain, Tessa
Ali, Sara
Crippa, Alessio
Dempsey, Paddy C
Golubic, Rajna
Kelly, Paul
Laird, Yvonne
McNamara, Eoin
Moore, Samuel
de Sa, Thiago Herick
Smith, Andrea D
Wijndaele, Katrien
Woodcock, James
Brage, Soren
author_sort Garcia, Leandro
collection PubMed
description OBJECTIVE: To estimate the dose–response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN: Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES: PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA: Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS: 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS: Inverse non-linear dose–response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
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spelling pubmed-104234952023-08-14 Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies Garcia, Leandro Pearce, Matthew Abbas, Ali Mok, Alexander Strain, Tessa Ali, Sara Crippa, Alessio Dempsey, Paddy C Golubic, Rajna Kelly, Paul Laird, Yvonne McNamara, Eoin Moore, Samuel de Sa, Thiago Herick Smith, Andrea D Wijndaele, Katrien Woodcock, James Brage, Soren Br J Sports Med Systematic Review OBJECTIVE: To estimate the dose–response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN: Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES: PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA: Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS: 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS: Inverse non-linear dose–response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481. BMJ Publishing Group 2023-08 2023-02-28 /pmc/articles/PMC10423495/ /pubmed/36854652 http://dx.doi.org/10.1136/bjsports-2022-105669 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Systematic Review
Garcia, Leandro
Pearce, Matthew
Abbas, Ali
Mok, Alexander
Strain, Tessa
Ali, Sara
Crippa, Alessio
Dempsey, Paddy C
Golubic, Rajna
Kelly, Paul
Laird, Yvonne
McNamara, Eoin
Moore, Samuel
de Sa, Thiago Herick
Smith, Andrea D
Wijndaele, Katrien
Woodcock, James
Brage, Soren
Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies
title Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies
title_full Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies
title_fullStr Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies
title_full_unstemmed Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies
title_short Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies
title_sort non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423495/
https://www.ncbi.nlm.nih.gov/pubmed/36854652
http://dx.doi.org/10.1136/bjsports-2022-105669
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