Association between domains of physical activity and all-cause, cardiovascular and cancer mortality (original) (raw)

Abstract

Few studies have investigated the independent effects of domain-specific physical activity on mortality. We sought to investigate the association of physical activity performed in different domains of daily living on all-cause, cardiovascular (CVD) and cancer mortality. Using a prospective cohort design, 4,672 men and women, aged 25–74 years, who participated in the baseline examination of the MONICA/KORA Augsburg Survey 1989/1990 were classified according to their activity level (no, light, moderate, vigorous). Domains of self-reported physical activity (work, transportation, household, leisure time) and total activity were assessed by the validated MOSPA (MONICA Optional Study on Physical Activity) questionnaire. After a median follow-up of 17.8 years, a total of 995 deaths occurred, with 452 from CVD and 326 from cancer. For all-cause mortality, hazard ratios and 95% confidence interval (HR, 95% CI) of the highly active versus the inactive reference group were 0.69 (0.48–1.00) for work, 0.48 (0.36–0.65) for leisure time, and 0.73 (0.59–0.90) for total activity after multivariable adjustments. Reduced risks of CVD mortality were observed for high levels of work (0.54, 0.31–0.93), household (0.80, 0.54–1.19), leisure time (0.50, 0.31–0.79) and total activity (0.75, 0.55–1.03). Leisure time (0.36, 0.23–0.59) and total activity (0.62, 0.43–0.88) were associated with reduced risks of cancer mortality. Light household activity was related to lower all-cause (0.82, 0.71–0.95) and CVD (0.72, 0.58–0.89) mortality. No clear effects were found for transportation activities. Our findings suggest that work, household, leisure time and total physical activity, but not transportation activity, may protect from premature mortality.

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Abbreviations

95% CI:

95% Confidence Interval

BMI:

Body Mass Index

BP:

Blood Pressure

CDC:

Centers for Disease Control and Prevention

CVD:

Cardiovascular Disease

HDL:

High-density Lipoprotein Cholesterol

HR:

Hazard Ratio

ICD:

International Classification of Diseases

MET(s):

Metabolic Equivalent(s)

MONICA/KORA:

Monitoring of Trends and Determinants in Cardiovascular Disease/Cooperative Health Research in the Region of Augsburg

MOSPA:

MONICA Optional Study on Physical Activity

References

  1. Nocon M, Hiemann T, Muller-Riemenschneider F, Thalau F, Roll S, Willich SN. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil. 2008;15(3):239–46.
    Article PubMed Google Scholar
  2. U.S. Department of Health and Human Services. Physical activity and health: A report of the surgeon general. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996.
  3. Wannamethee SG, Shaper AG. Physical activity in the prevention of cardiovascular disease: an epidemiological perspective. Sports Med. 2001;31(2):101–14.
    Article CAS PubMed Google Scholar
  4. Sjöström M, Oja P, Hagströmer M, Smith BJ, Bauman A. Health-enhancing physical activity across European Union countries: the Eurobarometer study. J Public Health. 2006;14(5):291–300.
    Article Google Scholar
  5. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1423–34.
    Article PubMed Google Scholar
  6. Arrieta A, Russell LB. Effects of leisure and non-leisure physical activity on mortality in U.S. adults over two decades. Ann Epidemiol. 2008;18(12):889–95.
    Article PubMed Google Scholar
  7. Dorn JP, Cerny FJ, Epstein LH, Naughton J, Vena JE, Winkelstein W Jr, et al. Work and leisure time physical activity and mortality in men and women from a general population sample. Ann Epidemiol. 1999;9(6):366–73.
    Article CAS PubMed Google Scholar
  8. Mensink GB, Deketh M, Mul MD, Schuit AJ, Hoffmeister H. Physical activity and its association with cardiovascular risk factors and mortality. Epidemiology. 1996;7(4):391–7.
    Article CAS PubMed Google Scholar
  9. Andersen LB, Schnohr P, Schroll M, Hein HO. All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med. 2000;160(11):1621–8.
    Article CAS PubMed Google Scholar
  10. Barengo NC, Hu G, Lakka TA, Pekkarinen H, Nissinen A, Tuomilehto J. Low physical activity as a predictor for total and cardiovascular disease mortality in middle-aged men and women in Finland. Eur Heart J. 2004;25(24):2204–11.
    Article PubMed Google Scholar
  11. Matthews CE, Jurj AL, Shu XO, Li HL, Yang G, Li Q, et al. Influence of exercise, walking, cycling, and overall nonexercise physical activity on mortality in Chinese women. Am J Epidemiol. 2007;165(12):1343–50.
    Article PubMed Google Scholar
  12. Besson H, Ekelund U, Brage S, Luben R, Bingham S, Khaw KT, et al. Relationship between subdomains of total physical activity and mortality. Med Sci Sports Exerc. 2008;40(11):1909–15.
    Article PubMed Google Scholar
  13. Dunn AL, Andersen RE, Jakicic JM. Lifestyle physical activity interventions. History, short- and long-term effects, and recommendations. Am J Prev Med. 1998;15(4):398–412.
    Article CAS PubMed Google Scholar
  14. Murphy M. Lifestyle physical activity for health In: Oja P, Borms J, editors. Health enhancing physical activity Oxford: Meyer & Meyer Sport; 2004. p. 209–37.
  15. Stamatakis E, Hamer M, Lawlor DA. Physical activity, mortality, and cardiovascular disease: is domestic physical activity beneficial? The Scottish Health Survey–1995, 1998, and 2003. Am J Epidemiol. 2009;169(10):1191–200.
    Article PubMed Google Scholar
  16. Hu G, Tuomilehto J, Silventoinen K, Barengo NC, Peltonen M, Jousilahti P. The effects of physical activity and body mass index on cardiovascular, cancer and all-cause mortality among 47 212 middle-aged Finnish men and women. Int J Obes (Lond). 2005;29(8):894–902.
    Article CAS Google Scholar
  17. Schnohr P, Lange P, Scharling H, Jensen JS. Long-term physical activity in leisure time and mortality from coronary heart disease, stroke, respiratory diseases, and cancer. The Copenhagen City Heart Study. Eur J Cardiovasc Prev Rehabil. 2006;13(2):173–9.
    Article PubMed Google Scholar
  18. World Health Organization. The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol. 1988;41(2):105–14.
    Article Google Scholar
  19. Lowel H, Doring A, Schneider A, Heier M, Thorand B, Meisinger C. The MONICA Augsburg surveys—basis for prospective cohort studies. Gesundheitswesen. 2005;67(Suppl 1):S13–8.
    Article PubMed Google Scholar
  20. Ainsworth BE, Haskell WL, Leon AS, Jacobs DR Jr, Montoye HJ, Sallis JF, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc. 1993;25(1):71–80.
    Article CAS PubMed Google Scholar
  21. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402–7.
    Article CAS PubMed Google Scholar
  22. Hense HW, Filipiak B, Döring A, Stieber J, Liese A, Keil U. Ten year trends of cardiovascular risk factors in the MONICA Augsburg region in southern Germany: Results from the 1984/1985, 1989/1990, and 1994/1995 surveys. CVD Prevention. 1998;1(4):318–27.
    Google Scholar
  23. Keil U, Stieber J, Doring A, Chambless L, Hartel U, Filipiak B, et al. The cardiovascular risk factor profile in the study area Augsburg. Results from the first MONICA survey 1984/85. Acta Med Scand Suppl. 1988;728:119–28.
    CAS PubMed Google Scholar
  24. Lee IM, Skerrett PJ. Physical activity and all-cause mortality: what is the dose-response relation? Med Sci Sports Exerc. 2001;33(6 Suppl):S459–71. discussion S93–4.
    CAS PubMed Google Scholar
  25. Orsini N, Mantzoros CS, Wolk A. Association of physical activity with cancer incidence, mortality, and survival: a population-based study of men. Br J Cancer. 2008;98(11):1864–9.
    Article CAS PubMed Google Scholar
  26. Lee IM. Physical activity and cancer prevention—data from epidemiologic studies. Med Sci Sports Exerc. 2003;35(11):1823–7.
    Article PubMed Google Scholar
  27. Thune I, Furberg AS. Physical activity and cancer risk: dose-response and cancer, all sites and site-specific. Med Sci Sports Exerc. 2001;33(6 Suppl):S530–50. discussion S609–10.
    CAS PubMed Google Scholar
  28. Laukkanen JA, Rauramaa R, Makikallio TH, Toriola AT, Kurl S. Intensity of leisure-time physical activity and Cancer mortality in men. Br J Sports Med. 2009. doi:10.1136/bjsm.2008.056713.
  29. Vatten LJ, Nilsen TI, Holmen J. Combined effect of blood pressure and physical activity on cardiovascular mortality. J Hypertens. 2006;24(10):1939–46.
    Article CAS PubMed Google Scholar
  30. Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136(7):493–503.
    PubMed Google Scholar
  31. Koster A, Harris TB, Moore SC, Schatzkin A, Hollenbeck AR, van Eijk JT, et al. Joint associations of adiposity and physical activity with mortality: the National Institutes of Health-AARP Diet and Health Study. Am J Epidemiol. 2009;169(11):1344–51.
    Article PubMed Google Scholar
  32. Oguma Y, Sesso HD, Paffenbarger RS Jr, Lee IM. Physical activity and all cause mortality in women: a review of the evidence. Br J Sports Med. 2002;36(3):162–72.
    Article CAS PubMed Google Scholar
  33. Iqbal R, Rafique G, Badruddin S, Qureshi R, Gray-Donald K. Validating MOSPA questionnaire for measuring physical activity in Pakistani women. Nutr J. 2006;5:18.
    Article PubMed Google Scholar
  34. Roeykens J, Rogers R, Meeusen R, Magnus L, Borms J, de Meirleir K. Validity and reliability in a Flemish population of the WHO-MONICA Optional Study of Physical Activity Questionnaire. Med Sci Sports Exerc. 1998;30(7):1071–5.
    Article CAS PubMed Google Scholar

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Acknowledgments

The KORA research platform (KORA, Cooperative Health Research in the Region of Augsburg) and the MONICA Augsburg studies were initiated and financed by the Helmholtz Zentrum München, German Research Center for Environmental Health (formerly GSF, National Research Center for Environment and Health), which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria. The present study was performed within the KORA Age project which was financed by the German Federal Ministry of Education and Research (BMBF FKZ 01ET0713). We thank all members of the Institute of Epidemiology of the Helmholtz Zentrum München and the field staff in Augsburg who were involved in the planning and conduct of the MONICA/KORA Augsburg studies. We are thankful to Prof. Dr. med Ulrich Keil, PhD, the principal investigator of the WHO MONICA Augsburg project. Finally, we express our appreciation to all study participants.

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Authors and Affiliations

  1. Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
    Christine S. Autenrieth, Jens Baumert, Annette Peters, Angela Döring & Barbara Thorand
  2. Institute of Community Medicine, University of Greifswald, Greifswald, Germany
    Sebastian E. Baumeister
  3. Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany
    Beate Fischer

Authors

  1. Christine S. Autenrieth
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  2. Jens Baumert
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  3. Sebastian E. Baumeister
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  4. Beate Fischer
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  5. Annette Peters
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  6. Angela Döring
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  7. Barbara Thorand
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Corresponding author

Correspondence toBarbara Thorand.

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Autenrieth, C.S., Baumert, J., Baumeister, S.E. et al. Association between domains of physical activity and all-cause, cardiovascular and cancer mortality.Eur J Epidemiol 26, 91–99 (2011). https://doi.org/10.1007/s10654-010-9517-6

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