Relation between mortality and physical activity levels or sedentary behavior: Proof cohort

Although moderate-to-vigorous physical activity has been proven to be effective in preventing major chronic diseases, the most recent epidemiological studies now focus on low-intensity physical activity, due to the need to promote all activities. However, the evidence currently remains weak. The objective of the study is to clarify the effects of different levels of physical activity and sedentary behavior on mortality. The different levels of physical activity were assessed by a validated self-administered questionnaire (POPAQ) covering different types of physical activity in the previous 7 days. Medical history and examinations were taken during each clinical visit to determine clinical events. The relationships between the intensity of physical activity (light, moderate to vigorous) as well as periods of physical inactivity in relation to mortality or cardiovascular events were analyzed by splines and COX models. Of the 1011 65-year-old subjects initially included in 2001 (60% women), the last 18-year follow-up is now completed since 2019. A total of 197 deaths (19.2% including 77 cardiovascular deaths) and 195 cardiovascular events (19.3%) have been reported. The means (standard deviation) of moderate or intense activity, light or sedentary activity were respectively 1.2 h/d (0.3), 5.8 h/d (1.1) and 6.6 h/d (2.3). For all-cause deaths, as well as cardiovascular deaths, splines were significant for light (p = 0.04 and p = 0.01) and moderate to vigorous (p < 0.001 and p < 0.001) activities, but not for sedentary lifestyle (p = 0.24 and p = 0.90). However, there is a significant reduction in cardiovascular events when the sedentary time decreased from 10.9 to 3.3 h/d. The PROOF cohort study shows a clear dose-response relationship between the dose of light, moderate to vigorous and sedentary behavior with mortality and cardiovascular events. These results provide evidence to support the inclusion of light physical activity in future activity guidelines physical. KEY MESSAGES: • Relationship between the dose of light, moderate to vigorous and sedentary lifestyle with mortality and cardiovascular events. • Importance of inclusion of light physical activity in future activity guidelines physical.