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Physical Activity Guidelines Advisory Committee Report
Part G. Section 1: All-Cause Mortality Online Table
Table G1.A1. Summary of Epidemiologic Studies on Physical Activity and
All-Cause Mortality
| Reference |
Subjects |
Special
Populations? |
Follow-up
Duration;
No. of
Deaths |
Assessment
of
Physical
Activity |
Main Results* |
Findings
Independent
of
Body
Weight? (Y/N) |
Dose-
Response?
Volume†
(Y/N) |
Dose-
Response?
Intensity†
(Y/N) |
Dose-
Response?
Duration†
(Y/N) |
Dose-
Response?
Frequency†
(Y/N) |
Covariates
Adjusted
For |
Comments |
| Eaton et al., 1995 (1) |
8,463 men, ≥40 y (Israeli Ischemic Heart Disease
Study) |
– |
Up to 21 y; 2,593 |
1 question each on sitting at work LTPA |
Vs. sitting at work:
standing: RR = 0.99
(0.88-1.12)
walking: RR = 1.09 (0.99-1.20)
physical labor: RR = 1.16
(1.03-1.30)
Vs. sedentary LTPA:
light: RR = 0.84 (0.74-0.94)
light daily: RR = 0.81 (0.73-0.90)
heavy: RR = 0.84 (0.72-0.98) |
N |
Apparent N |
– |
– |
– |
Age |
– |
| Lee et al., 1995 (2) |
17,321 men, mean age 46 y (Harvard Alumni Health
Study) |
– |
22-26 y; 3,728 |
Reported walking, climbing stairs, sports/recreational
activity |
Vs. lowest non-vigorous activity (<150
kcal/wk):
150-399 kcal/wk: RR = 0.89 (0.79-1.01)
400-749 kcal/wk: RR =
1.00 (0.89-1.12)
750-1499 kcal/wk: RR = 0.98 (0.88-1.12)
≥1500
kcal/wk: RR = 0.92 (0.82-1.02)
P for trend = 0.36
Vs.
lowest vigorous activity (<150 kcal/wk):
150-399 kcal/wk: RR = 0.88
(0.82-0.96)
400-749 kcal/wk: RR = 0.92 (0.82-1.02)
750-1499 kcal/wk: RR
= 0.87 (0.77-0.99)
≥1500 kcal/wk: RR = 0.87 (0.78-0.97)
P
for trend = 0.007 |
Y |
Y |
Y (vigorous activity) |
– |
– |
Age, BMI, smoking, hypertension, diabetes, early
parental death; mutually adjusted for the 2 kinds of energy expenditure |
Analyses of non-vigorous and vigorous activities were
mutually adjusted |
| Haapanen et al., 1996 (3) |
1,072 men, 35-63 y |
– |
10.8 y; 168 |
23 questions on LTPA, household chores, and
commuting |
Vs. >2,100 kcal/wk:
1500.1-2100kcal/wk: RR =
1.74 (0.87-3.50)
800.1-1500 kcal/wk: RR = 1.10 (0.55-2.21)
<800
kcal/wk: RR = 2.74 (1.46-5.14)
P for trend, <0.0001
Specific activities showing independent inverse associations were leisure time
forestry work, gardening, and repair work |
N |
Y |
– |
– |
– |
Age |
– |
| Kaplan et al., 1996 (4) |
2,832 men and 3,299 women,
16-94 y (Alameda
County Study) |
– |
28 y; 1,226 |
LTPA index assessed using answers to 3 questions
on physical exercise, sports participation, and long walks/
swimming |
Vs. lowest LTPA tertile (T1), men:
T2: RR =
0.46
T3: RR = 0.31
Vs. lowest LTPA tertile (T1), women:
T2: RR
= 0.42
T3: RR = 0.22 |
N |
Apparent Y |
– |
– |
– |
Crude.
Adjustment for age, sex, ethnicity,
education, health conditions, and social isolation still yielded significant
inverse associations. |
Findings persisted when physical activity updated over
time |
| LaCroix et al., 1996 (5) |
615 men and 1,030 women, ≥65 y |
All subjects ≥65 y |
4.2 y; 128 |
Modified Minnesota LTPA questionnaire |
Vs. walked <1 hour/week:
1-4 hours/wk: RR =
0.83 (0.53-1.29)
>4 hours/wk: RR = 0.91 (0.58-1.42) |
Y |
Apparent N |
– |
– |
– |
Age, sex, functional status, smoking, BMI, chronic
disease score, self-rated health, alcohol use |
Inverse association significant for women but not men,
and for >75 y but not 65-74 y |
| Lissner et al., 1996 (6) |
1,405 women, 38-60 y (Gothenborg Prospective
Study of Women) |
– |
20 y; 424 |
OPA and LTPA in the 12 months prior, assessed
from questionnaire in 1968-69 and 1974-75 |
Vs. low LTPA in 1968-69:
medium: RR = 0.56
(0.39-0.82)
high: RR = 0.45 (0.24-0.86)
Vs. low OPA in 1968-69:
medium: RR = 0.28 (0.17-0.46)
high: RR = 0.24 (0.14-0.43)
Vs. no
change between 1968-69 and 1974-75:
increased LTPA: RR = 1.11
(0.67-1.86)
decreased LTPA: RR = 2.07 (1.39-3.09) |
Y |
Apparent Y |
– |
– |
– |
Age.
Findings little changed with additional
adjustment for smoking, alcohol use, education, BMI, waist-to-hip ratio, diet,
blood pressure, blood lipids, peak expiratory flow. |
Increased LTPA over time associated with lower
mortality rates |
| Mensink et al., 1996 (7) |
7,689 men and 7,747 women,
25-69 y (German
Cardiovascular Prevention Study) |
– |
5-8 y; 110 |
Questionnaire assessed 18 leisure activities; one
question on OPA |
Vs. low total activity, men:
moderate: RR = 0.56
(0.30-1.04)
high: RR = 0.78 (0.42-1.44)
Vs. low LTPA, men:
moderate: RR = 0.61 (0.35-1.05)
high: RR = 0.79 (0.48-1.31)
Vs. no
sports activity, men:
<1 hour/wk: RR = 0.49 (0.26-0.95)
1-2 hours:
RR = 0.57 (0.30-1.09)
>2 hours: RR = 0.36 (0.16-0.79)
Vs. low
total activity, women:
moderate: RR = 1.24 (0.60-2.58)
high: RR = 1.29
(0.58-2.85)
Vs. low LTPA, women:
moderate: RR = 0.94
(0.51-1.75)
high: RR = 0.81 (0.44-1.49)
Vs. no sports activity,
women:
<1 hour/wk: RR = 0.38 (0.12-1.23)
1-2 hours: RR = 0.52
(0.23-1.17)
>2 hours: RR = 0.28 (0.07-1.17) |
Y |
Apparent Y (sports activity) |
– |
– |
– |
Age, systolic blood pressure, total serum cholesterol,
BMI, smoking |
– |
| Finucane et al., 1997 (8) |
970 men and 818 women, ≥70 y (Australian
Longitudinal Study of Ageing) |
All subjects ≥70 y |
2 y; 189 |
4 questions on type of exercise undertaken |
Vs. some exercise:
no exercise: RR = 1.74
(1.29-2.34) |
N |
– |
– |
– |
– |
Age, sex, marital status, self-rated health, chronic
medical conditions, smoking, alcohol, age at leaving school |
– |
| Hedblad et al., 1997 (9) |
642 men, 55 y (Men Born in 1914 Study, Malmo) |
– |
25 y; 333 |
Reported LTPA and bicycling or walking to work |
Vs. no LTPA:
vigorous LTPA: RR = 0.7
(0.5-0.9) |
Y |
– |
– |
– |
– |
Smoking, smoking amount, hypertension, diabetes
mellitus, history of chronic renal disease, hyperlipidemia, weight |
– |
| Kushi et al., 1997 (10) |
40,417 women, 55-69 y (Iowa Women's Health Study) |
– |
7 y; 2,260 |
Frequency of moderate and vigorous LTPA assessed by
questionnaire
3-level LTPA index based on frequency and intensity of
activity |
Vs. rarely/never participating in moderate
activity:
1/week-few/mo: RR = 0.71 (0.63-0.79)
2-4 times/wk: RR = 0.63
(0.56-0.71)
>4 times/wk: RR = 0.59 (0.51-0.67)
P for trend
<0.001
Vs. rarely/never participating in vigorous activity:
1/week-few /mo: RR = 0.83 (0.69-0.99)
2-4 times/wk: RR = 0.74
(0.59-.093)
>4 times/wk: 0.62 (0.42-0.90)
P for trend =
0.009
Vs. low activity index:
medium: RR = 0.77 (0.69-0.86)
high: RR = 0.68 (0.60-0.77)
P for trend <0.001 |
Y |
Y |
Y |
– |
– |
Age, reproductive factors, alcohol, total energy
intake, smoking, estrogen use, BMI at baseline and 18 years, waist-to-hip
ratio, high blood pressure, diabetes, education level, marital status, family
history of cancer |
Analyses of moderate and vigorous activity not
adjusted for each other
Significant inverse association in subgroup
>65 y |
| Leon et al., 1997 (11) |
12,138 men,
35-57 y (MRFIT) |
No clinical CHD, but at high risk for (upper 10-15%
Framingham risk score) |
16 y; 1,904 |
Minnesota LTPA; classified into deciles and analyzed
as decile 1 (4.9 min/
day), 2-4 (22.7 min/
day), 5-7 (53.9
min/
day), 8-10 (140.0 min/
day) |
Vs. decile 1:
deciles 2-4: RR = 0.85
(0.73-0.99)
deciles 5-7: RR = 0.87 (0.75-1.02)
deciles 8-10 RR = 0.83
(0.71-0.97) |
Y |
Apparent Y |
– |
Apparent Y |
– |
Age, intervention, education, cigarettes/d,
cholesterol, diastolic blood pressure, BMI |
Analyses of duration do not address short vs. long
bouts |
| Morgan & Clarke 1997 (12) |
406 men and 635 women, ≥65 y (Nottingham
Longitudinal Study of Aging and Activity) |
All subjects ≥65 y |
10 y; 568 |
Interview using detailed inventory of activities |
Vs. high activity, men:
intermediate: RR = 1.35
(0.96-1.89)
low: RR = 1.59 (1.12-2.25)
Vs. high activity,
women:
intermediate: RR = 1.53 (1.12-2.09)
low: RR = 2.07
(1.53-2.79) |
N |
Apparent Y |
– |
– |
– |
Age, health index score, smoking |
– |
| Rosengren & Wilhelmsen 1997 (13) |
7,142 men, 47-55 y (Göteborg study) |
– |
20 y; 684 |
4 levels of OPA and LTPA assessed by questionnaire.
Few men fell into the highest level of LTPA so top 3 levels combined |
No significant association with OPA
Vs. sedentary
LTPA:
moderately active: RR = 0.84 (0.77-0.93)
regular exercise: RR =
0.83 (0.77-0.90) |
Y |
Apparent Y |
– |
– |
– |
Age, diastolic blood pressure, serum cholesterol,
smoking, alcohol use, BMI, diabetes, occupation |
– |
| Sarna et al., 1997 (14) |
2,613 men representing Finland in Olympic Games
1920-65, mean ages 21.3-28.5 y; 1,712 men selected from military recruits, mean
age 20.1 y |
– |
Up to 71 y; 1,910 |
Olympic athletes, compared with military recruits |
Life expectancies, y:
military recruits: 69.9
(69.0-70.9)
endurance sports: 75.6 (73.6-77.5)
team sports: 73.9
(72.7-75.1)
power sports: 71.5 (70.4-72.2) |
N |
– |
– |
– |
– |
– |
– |
| Schroll et al., 1997 (15) |
196 men and 210 women, 75 y |
All subjects 75 y |
5 y; 98 |
1 interview question with 6 levels of activity;
analyzed as not active vs. active |
Vs. not active:
active: RR = 0.41 |
N |
– |
– |
– |
– |
– |
– |
| Bijnen et al., 1998 (16) |
802 men, 64-84 y (Zutphen Study) |
Most ≥65 y |
10 y; 373 |
Questionnaire on walking, cycling, hobbies/gardening;
odd jobs/sports; classified into tertiles and also as not active/active
(walk/
cycle at least 20 min 3 d/wk) |
Vs. lowest tertile:
middle tertile: RR = 0.80
(0.63-1.02)
top tertile: RR = 0.77 (0.59-1.00)
P for trend =
0.04
P for trend across vigorous activities <0.01; non-vigorous
activities = 0.54
Vs. not active:
active: RR = 0.71
(0.58-0.88) |
N |
Y |
Y (vigorous activity) |
– |
– |
Age, smoking, alcohol, CVD, cancer diabetes, lung
diseases |
– |
| Fried et al., 1998 (17) |
5,201 men and 685 women, ≥65 y (Cardiovascular
Health Study) |
All subjects ≥65 y
685 African Americans
in a validation cohort, NOT used for physical activity analyses. |
4.8 y; 646 |
Reported moderate or vigorous exercise |
Vs. ≤67.5 kcal/wk:
67.5-472.5 kcal/wk: RR =
0.78 (0.60-1.00)
472.5-980 kcal/wk: RR = 0.81 (0.63-1.05)
980-1890
kcal/wk: RR = 0.72 (0.55-0.93)
>1890 kcal/wk: RR = 0.56 (0.43-0.74)
P for trend <0.001 |
Y |
Y |
– |
– |
– |
Age, sex, education, income, widowed, weight, smoking,
alcohol, blood pressure factors, diuretic use, LDL, fasting glucose, albumin,
creatinine, fibrinogen, CHF, CHD, FEV1, aortic stenosis, ECG abnormality,
internal carotid artery stenosis, ADL difficulty, digit symbol substitution
test score, self-assessed health |
– |
| Hakim et al., 1998 (18) |
707 men, 61-81 y (Honolulu Heart Study) |
– |
12 y; 208 |
Daily distance walked |
Vs. <1 mile/day:
1.0-2.0: RR = 0.68
2.1-8.0: RR = 0.59
P for trend = 0.002 |
N |
Y |
– |
– |
– |
Age. Subjects were all nonsmokers. |
– |
| Kujala et al., 1998 (19) |
7,925 men and 7,977 women,
25-64 y (Finnish Twin
Cohort) |
– |
18 y; 1,253 |
Questionnaire on frequency, duration, and intensity of
LTPA |
Vs. sedentary:
occasional exercisers: RR = 0.80
(0.69-0.91)
conditioning exercisers: RR = 0.76 (0.59-0.98)
Vs.
lowest quintile (Q1, <0.58 MET-hr/day):
Q2 (0.59-1.29 MET-hr/day): RR =
0.85
Q3 (1.30-2.49 MET-hr/day): RR = 0.72
Q4 (2.50-4.49 MET-hr/day):
RR = 0.68
Q5 (≥4.50 MET-hr/day): RR = 0.60
P for trend =
0.04
Participation in vigorous activities, RR = 0.79 (0.56-1.10) |
N |
Y |
– |
– |
– |
Age, sex, smoking, occupation, alcohol |
Inverse association observed for men and women.
Inverse association remained after taking into account genetic factors (twin
status). |
| Villeneuve et al., 1998 (20) |
6,246 men and 8,196 women,
20-69 y (Canada
Fitness Survey) |
– |
7 y; 1,116 |
Modified Minnesota LTPA questionnaire; average daily
energy expenditure (KKD) was estimated |
Vs. lowest KKD (<0.5), men:
0.5 to <1.5 KKD:
RR = 0.81 (0.59-1.11)
1.5 to <3.0: RR = 0.79 (0.54-1.13)
≥3.0: RR
= 0.86 (0.61-1.22)
Vs. lowest KKD (<0.5), women:
0.5 to <1.5
KKD: RR = 0.94 (0.69-1.30)
1.5 to <3.0: RR = 0.92 (0.64-1.34)
≥3.0: RR = 0.71 (0.45-1.11)
Participation in vigorous (>6
METs) LTPA:
men: RR = 0.72 (0.53-0.96)
women: RR = 0.71
(0.48-1.05) |
N |
N |
Y (vigorous activity in men) |
– |
– |
Age, smoking |
No significant associations with increasing
nonvigorous LTPA among subjects without vigorous LTPA. |
| Wannamethee et al., 1998 (21) |
7,735 men, 40-59 y (British Regional Heart Study) |
– |
15 y; 1,064 |
Questionnaire on walking/cycling, recreational
activity, vigorous sporting activity; physical activity score calculated based
on intensity and frequency of these activities |
Vs. inactive:
occasional: RR = 0.79
(0.64-0.96)
light: RR = 0.69 (0.56-0.86)
moderate: RR = 0.64
(0.50-0.81)
moderately vigorous: RR = 0.63 (0.48-0.82)
vigorous: RR =
0.54 (0.38-0.77)
Vs. 0 min/day regular walking:
≤20 min/day: RR
= 1.15 (0.73-1.79)
21-40 min/day: RR = 1.06 (0.75-1.50)
41-60 min/day:
RR = 0.97 (0.65-1.46)
> 60 min/day: RR = 0.62 (0.37-1.05) |
Y |
Apparent Y |
– |
– |
– |
Age, smoking, alcohol use, BMI |
– |
| Weller & Corey 1998 (22) |
6,620 women, ≥30 y (Canada Fitness
Survey) |
– |
7 y; 449 |
Modified Minnesota LTPA questionnaire; average daily
energy expenditure (KKD) was estimated for leisure and non-leisure
activity |
Vs. lowest KKD quartile (Q1) of leisure activity:
Q2: RR = 0.91 (0.66-1.25)
Q3: RR = 0.94 (0.72-1.23)
Q4: RR = 0.89
(0.67-1.17)
Vs. lowest KKD quartile (Q1) of non-leisure activity:
Q2: RR = 0.66 (0.50-0.87)
Q3: RR = 0.68 (0.51-0.89)
Q4: RR = 0.71
(0.50-0.87) |
N |
Apparent Y |
– |
– |
– |
Age |
– |
| Bijnen et al., 1999 (23) |
472 men, 64-84 y (Zutphen Elderly Study) |
Most ≥65 y |
5 y; 118 |
Questionnaire on walking, cycling, hobbies/gardening;
odd jobs/sports; classified into tertiles and also as not active/active
(walk/cycle at least 20 min 3 d/wk) administered in 1985 and
1990 |
Vs. lowest tertile in 1985:
middle tertile: RR =
1.25 (0.79-1.99)
top tertile: RR = 1.25 (0.73-2.12)
P for
trend = 039
Vs. lowest tertile in 1990:
middle tertile: RR = 0.56
(0.35-0.89)
top tertile: RR =0.44 (0.25-0.80)
P for trend
<0.01
No consistent associations with type/intensity of
activity.
Vs. active 1985/ active 1990:
inactive/active: RR = 1.36
(0.78-2.36)
active/inactive: RR = 1.72 (1.04-2.85)
inactive/inactive:
RR = 2.01 (1.19-3.39) |
N |
Y |
N |
– |
– |
Age, smoking, alcohol, CVD, cancer, diabetes, lung
diseases, functional status |
Increased activity over time associated with lower
mortality rates |
| Engstrom et al., 1999 (24) |
642 men, 55 y (Men Born in 1914 Study, Malmo) |
– |
25 y; 333 |
4 categories of activity, based on reported LTPA and
bicycling or walking to work; collapsed to 2 levels for analyses |
Vs. no vigorous activity (normotensive men):
vigorous activity: RR = 0.89 (0.60-1.31)
Vs. no vigorous activity
(hypertensive men):
vigorous activity: RR = 0.43 (0.22-0.82) |
N |
– |
Y (vigorous activity) |
– |
– |
Smoking, antihypertensive therapy, systolic blood
pressure |
– |
| Glass et al., 1999 (25) |
1,169 men and 1,643 women, ≥65 y (Established
Populations for Epidemiological Studies of the Elderly, EPESE) |
All subjects ≥65 y |
18 y; 1,712 |
Interview asking about active sports or swimming,
walking, physical exercise; response options were never, sometimes, often,
scored as 0, 1, and 2 |
Vs. most active quartile:
least active quartile:
RR = 0.85 (0.77-0.95) |
Y |
– |
– |
– |
– |
Age, sex, race, marital status, income, BMI, smoking,
functional disability, history of cancer, diabetes, stroke, and MI |
– |
| Andersen et al., 2000 (26) |
17,265 men and 13,375 women, 20-93 y (Copenhagen
City Heart Study, Glostrup Population Studies, Copenhagen Male Study) |
– |
14.5 y; 8,549 |
Questionnaire on LTPA and OPA, 4 response
options |
Vs. inactive LTPA:
light: RR = 0.68
(0.64-0.71)
moderate: RR = 0.61 (0.57-0.66)
heavy: RR = 0.53
(0.41-0.68)
Among subjects with light, moderate, and heavy LTPA, sports
participation:
in men: RR = 0.63 (0.51-0.79)
in women: RR = 0.47
(0.34-0.66)
OPA: inverse association in women, no association in men. |
N |
Apparent Y |
Y (sports) |
– |
– |
Age, sex |
Significant inverse trends in subgroup ≥65 y |
| Davey Smith et al., 2000 (27) |
6,702 men, 40-64 y (Whitehall Study) |
– |
15 y; 2,859 |
Reported walking pace and types of hobbies/sports |
Vs. faster pace, compared to others of same age:
the same: RR = 1.21 (1.1-1.3)
slower: RR = 1.87 (1.6-2.1)
P
for trend <0.001
Vs. active LTPA:
moderately active: RR =
1.07 (1.0-1.2)
inactive: RR = 1.20 (1.1-1.3)
P for trend
<0.001 |
Y |
Y |
– |
– |
– |
Age, civil service grade, smoking, BMI, systolic blood
pressure, cholesterol, glucose intolerance, diabetes, FEV1, ischemia |
– |
| Hirvensalo et al., 2000 (28) |
391 men and 493 women, 65-84 y (Evergreen
Project) |
All subjects ≥65 y; subjects with impaired
mobility examined separately |
8 y; 389 |
Interview with overall activity assessed on a 6-point
scale; frequency of participation in various sports. Active defined as 3-6
points and moderate activity daily or vigorous activities once/wk. "Mobile"
defined as ability to walk 2 km and climb 1 flight with no
difficulty |
Vs. mobile-active, men:
mobile-sedentary: RR =
0.92 (0.53-1.59)
impaired-active: RR = 1.69 (1.01-2.84)
impaired-sedentary: RR = 2.67 (1.75-4.08)
Vs. mobile-active, women:
mobile-sedentary: RR = 0.87 (0.55-1.40)
impaired-active: RR = 1.72
(1.10-2.70)
impaired-sedentary: RR = 2.83 (1.82-3.81) |
N |
– |
– |
– |
– |
Age, sex, marital status, education, asthma,
neurological diseases, stroke, mental disease, CVD, musculoskeletal disease,
smoking, past physical activity |
Inverse association with physical activity apparent
only in those with impaired mobility. |
| Lee & Paffenbarger 2000 (29) |
13,485 men, mean age 57.5 y (Harvard Alumni Health
Study) |
– |
Up to 15 y; 2,359 |
Reported walking, climbing stairs, sports/recreational
activity |
Vs. <1,000 kcal/wk:
1,000-1,999 kcal/wk: RR =
0.80 (0.72-0.88)
2,000-2,999 kcal/wk: RR = 0.74 (0.65-0.83)
3,000-3,999
kcal/wk: RR = 0.80 (0.69-0.93)
≥4,000 kcal/wk: RR = 0.73 (0.64-0.84)
P for trend <0.001
P for linear trend across
categories of:
walking = 0.004
climbing stairs <0.001
light
activities = 0.72
moderate activities = 0.07
vigorous activities
<0.001 |
Y |
Y |
Y (walking, stairs, and vigorous activity) |
– |
– |
Age, BMI, smoking, alcohol, early parental
mortality.
Analyses of the different physical activity components were
adjusted for the other activity components. |
– |
| Stessman et al., 2000 (30) |
249 men and 207 women born in 1920-21 (Jerusalem
70-Year-Olds Longitudinal Study) |
All subjects 70 y |
6 y; 240 |
Interview asking about LTPA at baseline - no
activity (walks less than 4 hours weekly), moderate activity (walks
~4 hours weekly), sports participation at least twice weekly, and regular
activity (walks at least 1 hour a day) |
Vs. no activity:
moderate: RR = 0.41
(0.19-0.91)
sports: RR = 0.73 (0.33-1.62)
regular: RR = 0.14
(0.04-0.50) |
N |
Apparent N |
– |
– |
– |
Sex, smoking, subjective economic hardship,
preexisting medical conditions |
– |
| Hein et al., 2001 (31) |
2,826 men, 53-75 y (Copenhagen Male Study) |
– |
11 y; 214 |
Questionnaire on LTPA, 4 response options; grouped in
analyses as low (1 and 2) and high (3 and 4) LTPA |
Vs. low LTPA, Le(a-b-) phenotype:
high LTPA: RR =
0.76
Vs. low LTPA, Le(a+b-)/Le(a-/b+) phenotype:
high LTPA: RR =
0.84 |
N |
– |
– |
– |
– |
Crude |
– |
| Rockhill et al., 2001 (32) |
80,348 women, 34-59 y (Nurses’
Health Study) |
– |
16 y; 4,746 |
Questionnaire asking about hr/wk in moderate to
vigorous activities 1980-1982; 1986-1992, questionnaire on walking pace and
time/wk participating in a list of LTPA |
Vs. <1 hr/wk moderate to vigorous LTPA:
1-1.9:
RR = 0.82 (0.76-0.89)
2-3.9: RR = 0.75 (0.69-0.81)
4-6.9: RR = 0.74
(0.68-0.81)
≥7: RR = 0.71 (0.61-0.82)
P for trend
<0.001 |
Y |
Y |
– |
Y |
– |
Age, smoking, alcohol, BMI, height, postmenopausal
hormones |
Physical activity updated over time.
Analyses of
duration do not address short vs. long bouts. |
| Aijo et al., 2002 (33) |
499 men and 704 women, 75 y (Nordic Research Project
on Ageing, NORA) |
All subjects 75 y |
5 y; 212 |
Questionnaire on LTPA, work, and daily activities,
with 6 responses; collapsed to 2 levels for analyses |
Vs. active men:
inactive (Glostrup): RR = 2.46
(1.29-4.69)
inactive (Goteborg): RR = 2.88 (1.31-6.34)
inactive
(Jyvaskyla): RR = 1.33 (0.56-3.17)
Vs. active women:
inactive
(Glostrup): RR = 2.26 (1.08-4.74)
inactive (Goteborg): RR = 2.71
(1.07-6.90)
inactive (Jyvaskyla): RR = 2.92 (1.56-5.46) |
N |
– |
– |
– |
– |
Smoking, alcohol, CVD |
– |
| Batty et al., 2002 (34) |
6,408 men, 40-64 y (Whitehall Study) |
352 men with type 2 diabetes or IGT |
25 y; 2,765 |
Reported walking pace, and types of
hobbies/sports |
Among normoglycemic:
Vs. faster pace, compared to
others of same age:
the same: RR = 1.22 (1.1-1.3)
slower: RR = 1.76
(1.5-2.0)
P for trend = 0.0001
Vs. active LTPA:
moderately
active: RR = 1.05 (0.9-1.2)
inactive: RR = 1.17 (1.1-1.3)
P
for trend = 0.002
Among type 2 diabetics/IGT:
Vs. faster pace,
compared to others of same age:
the same: RR = 1.15 (0.8-1.7)
slower:
RR = 2.36 (1.4-3.8)
P for trend = 0.003
Vs. active
LTPA:
moderately active: RR = 1.59 (1.1-2.4)
inactive: RR = 1.65
(1.1-2.5)
P for trend = 0.03 |
Y |
Y |
– |
– |
– |
Age, civil service grade, smoking, BMI, systolic blood
pressure, cholesterol, FEV1, disease at study entry, unexplained weight loss in
preceding year |
Similar associations in normoglycemic and type 2
diabetes/
IGT men |
| Crespo et al., 2002 (35) |
9,136 men, 35-74 y (Puerto Rico Heart Health
Program) |
Hispanic men |
12 y; 1,445 |
Time spent sleeping, resting, or engaged in light,
moderate, or heavy physical activity assessed by interview (Framingham physical
activity index) |
Vs. lowest activity quartile (Q1):
Q2: RR = 0.68
(0.58-0.79)
Q3: RR = 0.63 (0.54-0.75)
Q4: RR = 0.55 (0.45-0.65) |
Y |
Apparent Y |
– |
– |
– |
Age, smoking, education, residence, hypertension, high
cholesterol |
Similar associations in underweight, healthy weight,
overweight, and obese |
| Ostbye et al., 2002 (36) |
12,652 men and women, 50-60y (Health Retirement
Survey) |
– |
6 y; 782 |
Interview with 2 questions on frequency of light
and vigorous physical activity; combined responses classified as sedentary,
light, moderate, and heavy |
Vs. sedentary:
light: RR = 0.44
moderate: RR =
0.40
heavy: RR = 0.21 |
N |
Apparent Y |
– |
– |
– |
Crude |
– |
| Wang et al., 2002 (37) |
303 men and 67 women from 50 y+ Runners
Association (throughout US); 139 men and 110 women, ≥50 y, from
community around Stanford, CA |
– |
13 y; 93 |
Classified as running club member or not;
questionnaire also assessed min/wk spent in aerobic exercise |
Vs. not running club member:
member: RR = 0.36
(0.20-0.65)
Per additional unit of time/wk in aerobic exercise:
RR =
0.88 (0.77-0.88) |
N |
Y |
– |
Y |
– |
Age, sex, smoking, running club member, time in
aerobic exercise |
Analyses of duration do not address short vs. long
bouts |
| Batty et al., 2003 (38) |
6,479 men, 40-64 y (Whitehall Study) |
186 men with chronic bronchitis |
25 y; 2,660 |
Reported types of hobbies/sports; classified as
inactive, moderate, and active |
Vs. active LTPA, no chronic bronchitis:
moderately
active: RR = 1.06 (1.0-1.2)
inactive: RR = 1.21 (1.1-1.3)
P
for trend = 0.0003
Vs. active LTPA, chronic bronchitis:
moderately active: RR = 0.73 (0.3-1.6)
inactive: RR = 0.70 (0.3-1.4)
P for trend = 0.45 |
Y |
Y (among men without chronic bronchitis) |
– |
– |
– |
Age, civil service grade, smoking, BMI, systolic blood
pressure, cholesterol, FEV1, disease at study entry |
Results significantly different among men without and
with chronic bronchitis |
| Gregg et al., 2003 (39) |
1,376 men and 1,520 women with diabetes, ≥18 y
(National Health Interview Study) |
Diabetics in nationally representative sample |
8 y; 671 |
Interview asking about walking frequency and duration,
LTPA frequency and duration |
Vs. no walking:
>0-1.9 hr/wk: RR = 0.93
(0.74-1.16)
≥2 hr/wk: RR = 0.61 (0.48-0.78)
P for trend
<0.001
Vs. no LTPA:
>0-1.9 hr/wk: RR = 0.95 (0.77-1.17)
≥2 hr/wk: RR = 0.71 (0.59-0.87)
P for trend = 0.003 |
Y |
Y |
– |
Y |
– |
Age, sex, race, BMI, self-rated health, smoking,
weight loss approaches, hospitalizations, hypertension and use of
antihypertensives, physician visits, limitations caused by CVD and cancer,
functional limitation |
Analyses of duration do not address short vs. long
bouts |
| Schnohr et al., 2003 (40) |
3,220 men and 3,803 women, 20-79 y (Copenhagen City
Heart Study) |
– |
18 y; 2,725 |
Questionnaire on LTPA, 4 response options,
administered 1976-78 and 1981-83. Top 2 levels grouped in analyses. |
Vs. low activity both times, men:
moderate: RR =
0.71 (0.57-0.88)
high: RR = 0.61 (0.48-0.76)
low to moderate: RR = 0.64
(0.49-0.83)
low to high: RR = 0.64 (0.47-0.87)
Vs. low activity
both times, women:
moderate: RR = 0.64 (0.52-0.79)
high: RR = 0.66
(0.51-0.85)
low to moderate: RR = 0.75 (0.57-0.97)
low to high: RR =
0.72 (0.50-1.05) |
Y |
Apparent Y |
– |
– |
– |
Age, education, income, smoking, cholesterol, systolic
blood pressure, diabetes, alcohol, BMI |
– |
| Tanasescu et al., 2003 (41) |
2,803 men with type 2 diabetes, 40-75 y (Health
Professionals Follow-up Study) |
Diabetics |
14 y; 355 |
Questionnaire asking about walking pace and time/wk
participating in a list of LTPA |
Vs. 0-5.1 MET-hr/wk LTPA:
5.2-12.0: RR = 0.88
(0.64-1.21)
12.1-21.7: RR = 0.64 (0.45-0.91)
21.8-37.1: RR = 0.64
(0.45-0.90)
≥37.2: RR = 0.65 (0.45-0.93)
P for trend =
0.01
Vs. 0-1.4 MET-hr/wk walking:
1.5-4.1: RR = 0.99 (0.71-1.40)
4.2-7.9: RR = 0.96 (0.68-1.36)
8.0-16.0: RR = 1.08 (0.76-1.53)
≥16.1: RR = 0.60 (0.41-0.88)
P for trend = 0.004 |
Y |
Y |
– |
– |
– |
Age, alcohol, smoking, family history of MI,
vitamin E supplements, duration of diabetes, diabetes medication, trans
fat, saturated fat, fiber, folate, angina and coronary artery bypass surgery,
hypertension, high cholesterol |
Physical activity updated over time |
| Wyshak 2003 (42) |
4,171 alumnae from 10 colleges and universities, mean
age 39 y |
– |
15 y; 258 |
Women were either former college athletes or not; all
women also answered a questionnaire on contemporary regular exercise |
Vs. non-athlete:
athlete: RR = 0.94
(0.73-1.20)
Vs. regular exercise:
none: RR = 1.36 (1.06-1.74) |
N |
– |
– |
– |
– |
Age |
– |
| Yu et al., 2003 (43) |
1,975 men, 49-64 y (Caerphilly Collaborative Heart
Disease Study) |
– |
11 y; 252 |
Modified Minnesota LTPA questionnaire, with light and
moderate activities classified as those <6 METs and vigorous activities
≥6 METs; OPA classified as 4 levels |
Vs. 0-161.6 kcal/day total LTPA:
161.8-395.3
kcal/day: RR = 0.79 (0.58-1.08)
395.5-2747.2 kcal/day: RR = 0.76
(0.56-1.04)
P for trend = 0.08
Vs. 0-133.0 kcal/day light
and moderate LTPA:
133.1-342.6 kcal/day: RR = 0.95 (0.65-1.31)
342.7-2743.2 kcal/day: RR = 1.04 (0.76-1.43)
P for trend =
0.80
Vs. 0-0.6 kcal/day vigorous LTPA:
0.7-23.8 kcal/day: RR = 0.87
(0.65-1.17)
23.9-2142.9 kcal/day: RR = 0.61 (0.43-0.86)
P for
trend = 0.006
No association for OPA; P for trend = 0.71 |
Y |
Y |
Y (vigorous activity only) |
– |
– |
Age, diastolic blood pressure, BMI, smoking social
class, family history of CHD, diabetes, OPA |
– |
| Barengo et al., 2004 (44) |
15,853 men and 16,824 women, 30-59 y (FINMONICA
Study) |
– |
20 y; 5,272 |
Questionnaire on LTPA, 4 response options; grouped in
analyses as light, moderate, and high (3 and 4) LTPA; OPA classified into
3 levels, light, moderate, and active; commuting activity (walking,
cycling) |
Vs. low LTPA:
moderate, men: RR = 0.91
(0.84-0.98)
high, men: RR = 0.79 (0.70-0.90)
moderate, women: RR = 0.89
(0.81-0.98)
high, women: RR = 0.98 (0.83-1.16)
Vs. light OPA:
moderate, men: RR = 0.75 (0.68-0.83)
active, men: RR = 0.77 (0.71-0.84)
moderate, women: RR = 0.79 (0.70-0.89)
active, women: RR = 0.78
(0.70-0.87)
Vs. <15 min/day walking/cycling commute:
15-29
min/day, men: RR = 1.01 (0.92-1.11)
≥30 min/day, men: RR = 1.07
(0.98-1.17)
15-29 min/day, women: RR = 0.89 (0.78-1.02)
≥30 min/day,
women: RR = 0.98 (0.88-1.09) |
Y |
Apparent Y |
– |
– |
– |
Age, study year, BMI, systolic blood pressure,
cholesterol, education, smoking, different kinds of activity |
– |
| Evenson et al., 2004 (45) |
3,000 men and 2,712 women, mean age 43 y (Lipid
Research Clinics Prevalence Study) |
1,717 hypertensives examined separately |
25 y; 1,225 |
Interview with 1 question on exercise training;
classified in analyses as inactive (no strenuous exercise or hard labor) or
active |
Vs. active-normotensive men:
inactive-normotensive: RR = 1.4 (1.1-1.7)
active-hypertensive: RR = 1.5
(1.1-2.1)
inactive-hypertensive: RR = 1.9 (1.5-2.4)
Vs.
active-normotensive women:
inactive-normotensive: RR = 1.4 (0.9-2.0)
active-hypertensive: RR = 2.1 (1.2-3.5)
inactive-hypertensive: RR = 2.2
(1.5-3.5) |
Y |
– |
– |
– |
– |
Age, smoking, education, alcohol, BMI, race,
hyperlipidemic sampling strata |
Significant inverse relation apparent only in
normotensives |
| Fujita et al., 2004 (46) |
20,004 men and 21,159 women, 40-64 y (Miyagi
Cohort Study) |
– |
11 y; 1,879 |
Questionnaire asking about average walking duration
per day, with options ≤30 min, >30 min to <1 hr, ≥1
hr |
Vs. ≥1 hr/day, men:
>05-<1: RR = 1.0
(0.87-1.15)
≤0.5: RR = 1.10 (0.96-1.25)
P for trend =
0.32
Vs. ≥1 hr/day, women:
>05-<1: RR = 1.21
(0.99-1.47)
≤0.5: RR = 1.34 (1.11-1.62)
P for trend =
0.002 |
Y |
Y |
– |
Y |
– |
Age, marital status, hypertension, renal disease,
liver disease, diabetes, peptic ulcer, tuberculosis, BMI, intake of green
vegetables and oranges |
Analyses of duration do not address short vs. long
bouts. Significant inverse associations seen in never and former smokers, but
not current smokers. |
| Hillsdon et al., 2004 (47) |
4,929 men and 5,593 women, 35-64 y (OXCHECK
Study) |
– |
10 y; 825 |
1 question on baseline questionnaire regarding
frequency of vigorous sports/
recreation, classified as never/<1 per
month, <2/wk or ≥2/wk; 1 similar question at nurse health check on a
subset of 7,704, classified as <1/month, 1-3/month, 1/wk, or ≥2/wk |
Vs. never/<1 per month (baseline):
<2/wk: RR
= 0.63 (0.45-0.89)
≥2/wk: RR = 0.81 (0.60-1.09)
Vs. <1/month
(nurse health check):
1-3/month: RR = 1.14 (0.74-1.78)
1/wk: RR = 0.53
(0.35-0.82)
≥2/wk: RR = 0.52 (0.35-0.78) |
Y |
Apparent Y |
– |
– |
Apparent Y |
Age, sex, smoking, alcohol, pre-existing disease,
social class |
Analyses of frequency not adjusted for total energy
expended |
| Hu et al., 2004a (48) |
116,564 women, 30-55 y (Nurses’
Health Study) |
– |
24 y; 10,282 |
Questionnaire asking about hr/wk in
moderate-to-vigorous activities 1980-1982; 1986-1992, questionnaire on walking
pace and time/wk participating in a list of LTPA |
Vs. ≥3.5/wk moderate-to-vigorous LTPA:
1.0-3.4:
RR = 1.14 (1.06-1.22)
≤0.5: RR = 1.44 (1.34-1.55)
P for
trend <0.001 |
Y |
Y |
– |
Y |
– |
Age, smoking, parental history of CHD, menopause, use
of postmenopausal hormones, alcohol |
Analyses of duration do not address short vs. long
bouts. Similar associations seen in normal weight, overweight, and obese
women. |
| Hu et al., 2004b (49) |
1,637 men and 1,679 women, 25-74 |
All subjects had type 2 diabetes |
18.4 y; 1,410 |
Questionnaire on LTPA, grouped in analyses as low
(almost completely inactive), moderate (some activity for >4 hr/wk) and
high (vigorous activity for >3 hr/wk); OPA classified into
3 levels, light, moderate, and active; commuting activity (walking,
cycling) classified as 0, 1-29, and ≥30 min/day |
Vs. low LTPA:
moderate: RR = 0.82 (0.73-0.91)
high: RR = 0.71 (0.56-0.92)
P for trend <0.001
Vs.
light OPA:
moderate: RR = 0.86 (0.74-1.00)
active: RR = 0.60
(0.52-0.69)
P for trend <0.001
Vs. 0 min/day
walking/cycling commute:
1-29 min/day: RR = 0.91 (0.76-1.05)
≥30
min/day: RR = 0.88 (0.75-1.04)
P for trend = 0.21 |
Y |
Y |
– |
– |
– |
Age, sex, study year, BMI, systolic blood pressure,
cholesterol, smoking, kinds of physical activity |
– |
| Lam et al., 2004 (50) |
13,778 male cases and 3,918 male controls, 10,301
female cases and 9,136 female controls, ≥35 y |
– |
Cases were deaths over 2 y in Hong Kong; 24,079 |
Interview asking proxy (for both cases and controls)
about frequency of LTPA lasting ≥30 min |
Vs. <1/mo, men:
1/mo to 1-3/wk: RR = 0.60
(0.54-0.67)
≥4/mo: RR = 0.66 (0.60-0.73)
Vs. <1/mo,
women:
1/mo to 1-3/wk: RR = 0.81 (0.74-0.88)
≥4/mo: RR = 0.71
(0.66-0.77) |
N |
Apparent Y (women) |
– |
– |
Apparent Y (women) |
Age, education, smoking, alcohol, OPA |
Analyses of frequency not adjusted for total energy
expended. |
| Landi et al., 2004 (51) |
1,137 men and 1,620 women, mean age 78.2 y, admitted
to home care programs (Italian Silver Network Home Care Project) |
Included subjects 70-80 and >80 y |
10 months; 442 |
Single question on hr/wk in domestic activities or
recreational activities |
Vs. < 2hr/wk:
≥2 hr/wk: RR = 0.51
(0.35-0.73)
Similar associations in <70, 70-80, and >80 y
(RR =
0.48, 0.50, 0.55, respectively) |
N |
– |
– |
– |
– |
Age, sex, physical and cognitive disability, CVD,
pneumonia, cancer, stroke, diabetes, chronic obstructive pulmonary disease,
renal failure, Parkinson’s disease, depression, delirium,
arthritis |
– |
| Lee et al., 2004 (52) |
8,421 men, mean age 66 y (Harvard Alumni Health
Study) |
– |
Up to 10 y; 1,234 |
Reported walking, climbing stairs, sports/recreational
activity; classified as: sedentary (<500 kcal/wk), insufficiently
active (500-999 kcal/wk), weekend warrior (≥1,000 kcal/wk in 1-2 episodes),
regularly active (≥1,000 kcal/wk in ≥3 episodes) |
Vs. sedentary:
insufficiently active: RR = 0.75
(0.62-0.91)
weekend warrior: RR = 0.85 (0.65-1.11)
regularly active: RR
= 0.64 (0.55-0.73)
Among low-risk men (nonsmoker, normal BMI, normal BP,
normal cholesterol), weekend warrior: RR = 0.41 (0.21-0.81)
Among high
risk-men (≥1 risk factor above), weekend warrior: RR = 1.02 (0.75-1.38) |
N |
– |
– |
– |
– |
Age, smoking, alcohol, red meat, vegetables,
vitamins/minerals, early parental mortality |
Physical activity updated over time |
| Myers et al., 2004 (53) |
842 men, mean age 58.9 y |
– |
5.5 y; 89 |
Modified Harvard Alumni Health Study questionnaire on
walking, stairs, and recreational activity |
Vs. lowest (sedentary) quartile (Q1):
Q2: RR =
0.63 (0.36-1.10)
Q3: RR = 0.42 (0.23-0.78)
Q4 (most active): RR = 0.38
(0.19-0.73) |
N |
Apparent Y |
– |
– |
– |
Age |
– |
| Richardson et al., 2004 (54) |
4,642 men and 4,969 women,
51-61 y (Health
Retirement Survey) |
Subgroup analyses by low (0 CVD risk factor), moderate
(1) or high (≥2) CVD risk |
8 y; 810 |
Interview with 2 questions on frequency of light
and vigorous physical activity; combined responses classified as sedentary,
occasional, and regular |
Vs. sedentary:
occasional: RR = 0.64
(0.52-0.81)
regular: RR = 0.62 (0.44-0.86)
No significant interactions
with CVD risk group. |
Y |
Apparent N |
– |
– |
– |
Age, sex, race, history of cancer, self-rated health
status, obesity, income, CVD risk |
– |
| Shnohr et al., 2004 (55) |
16,236 men and 14,399 women, 20-93 y (Copenhagen City
Heart Study, Glostrup Population Studies, Copenhagen Male Study) |
– |
16 y; 10,952 |
Questionnaire on LTPA, 4 levels analyzed: none/very
little LTPA, 1-4 hr/wk light activity, >4 hr/wk light activity or
2-4 hr/wk high-level activity, >4 hr/wk high-level activity or
competition level sports |
Generally inverse linear dose-response across all 4
levels of LTPA in men and women, stratified by <8, 8-11, and ≥12 y
education (graphical data only) |
N |
Apparent Y |
– |
– |
– |
Age, birth cohort, cohort membership |
– |
| Sundquist et al., 2004 (56) |
1,414 men and 1,792 women, ≥65 y (Swedish Annual
Level of Living Survey) |
All subjects ≥65 y |
11.7 y, 1,806 |
Questionnaire on LTPA with 5 response options: no
exercise, occasional exercise, 1/wk, ≥2/wk, or vigorous exercise
≥2/wk |
Vs. none:
occasional: RR = 0.72 (0.64-0.81)
1/wk: RR = 0.60 (0.50-0.71)
≥2/wk: RR = 0.50 (0.42-0.59)
≥2/wk
vigorous exercise: RR = 0.60 (0.46-0.79) |
Y |
Apparent Y |
– |
– |
– |
Age, sex, education, smoking, BMI |
– |
| Bucksch 2005 (57) |
3,742 men and 3,445 women,
30-69 y |
– |
16 y; 943 |
Modified Minnesota LTPA questionnaire, classified into
4 groups. Also classified as meeting moderate-intensity PA recommendation
vs. not, meeting vigorous-intensity PA recommendation vs. not, and
meeting either recommendation vs. not. |
Vs. 0 kcal/kg/wk LTPA, men:
>0 to <14: RR =
0.98 (0.76-1.17)
14 to <33.5: RR = 0.80 (0.63-1.00)
≥33.5: RR =
0.91 (0.74-1.13)
P for trend = 0.20
Vs. 0 kcal/kg/wk LTPA,
women:
>0 to <14: RR = 0.79 (0.57-1.08)
14 to <33.5: RR = 0.68
(0.50-0.94)
≥33.5: RR = 0.57 (0.41-0.79)
P for trend
<0.001
Vs. not meeting moderate PA recommendation:
meeting, men:
RR = 0.90 (0.77-1.01)
meeting, women: RR = 0.65 (0.51-0.82)
Vs. not
meeting vigorous PA recommendation:
meeting, men: RR = 0.74 (0.61-0.90)
meeting, women: RR = 0.78 (0.57-1.08)
Vs. not meeting either PA
recommendation:
meeting, men: RR = 0.80 (0.68-0.94)
meeting, women: RR
= 0.60 (0.47-0.75) |
Y |
Y (women only) |
– |
– |
– |
Age, social class, smoking, BMI, CVD risk factors,
chronic disease, alcohol, diet |
– |
| Fang et al., 2005 (58) |
3,779 men and 6,012 women,
25-74 y (NHANES I)
|
Normotensive, prehypertensive and hypertensive
subjects examined separately |
17 y; 3,069 |
1 question on recreational activity, with response
options: much exercise, moderate exercise, little/no exercise |
Vs. little/no exercise, normotensives:
moderate
exercise: RR = 0.75 (0.53-1.05)
much exercise: RR = 0.71 (0.45-1.12)
Vs. little/no exercise, pre-hypertensives:
moderate exercise: RR = 0.79
(0.65-0.97)
much exercise: RR = 0.93 (0.74-1.18)
Vs. little/no
exercise, hypertensives:
moderate exercise: RR = 0.88 (0.80-0.98)
much
exercise: RR = 0.83 (0.72-0.95) |
Y |
Apparent Y (normo-tensives and hyper-tensives
only) |
– |
– |
– |
Age, sex, race, BMI, education, diabetes, smoking,
alcohol, caloric, sodium, calcium and potassium intake, systolic blood
pressure, serum cholesterol |
– |
| Hu et al., 2005 (59) |
22,258 men and 24,684 women, 25-64 y |
– |
17.7 y; 7,394 |
Questionnaire on LTPA and OPA grouped in analyses as
low (light for both), moderate (moderate or high in one domain), and high
(moderate or high in both domains). For joint analyses with BMI, classified as
inactive (low) vs. active (moderate or high). |
Vs. low activity, men:
moderate: RR = 0.74
(0.68-0.81)
high: RR = 0.63 (0.58-0.70)
P for trend
<0.001
Vs. low activity, women:
moderate: RR = 0.64
(0.58-0.70)
high: RR = 0.58 (0.52-0.64)
P for trend
<0.001
Vs. non-obese/active:
obese/active: RR = 1.21 men, 1.12
women
non-obese/inactive: RR = 1.53 men, 1.59 women
obese/inactive: RR
= 1.78 men, 2.10 women |
Y |
Y |
– |
– |
– |
Age, study year, education, smoking, systolic blood
pressure, cholesterol, diabetes, BMI |
– |
| Trolle-Lagerros et al., 2005 (60) |
99,099 women, 30-49 y (Women’s
Lifestyle and Health Study, Norway/
Sweden) |
– |
11.4 y; 1,313 |
Questionnaire asking about overall level of activity
(including household, occupation, and recreation), ranked on a 5-point scale,
at ages 14, 30, and baseline |
Vs. none, at baseline:
low: RR = 0.78
(0.61-1.00)
moderate: RR = 0.62 (0.49-0.78)
high: RR = 0.58
(0.44-0.75)
vigorous: RR = 0.46 (0.33-0.65)
P for trend
<0.0001
No significant associations for physical activity at ages 30 or
14; when examining changes in physical activity, only activity at baseline
predicted lower mortality. |
Y |
Y |
– |
– |
– |
Age, education, BMI, alcohol, smoking, country |
– |
| Carlsson et al., 2006 (61) |
27,734 women, 51-83 y (Swedish Mammography
Cohort) |
– |
7 y; 1,232 |
Questionnaire asking about average time in household
work, walking and bicycling, work activity, and leisure-time activity;
MET-hr/day estimated |
Vs. >50 MET-hr/day:
45-50: RR = 1.05
(0.77-1.42)
40-45: RR = 1.09 (0.81-1.46)
35-40: RR = 1.26
(0.94-1.70)
<35: RR = 2.56 (1.85-3.53)
Significant inverse
associations observed for all domains of activity, analyzed separately |
Y |
Y |
– |
– |
– |
Smoking, education, number of children, hormone
therapy, fruit and vegetable intake, BMI, various chronic diseases |
– |
| Janssen & Jolliffe 2006 (62) |
603 men and 442 women, ≥65 y (Cardiovascular Health
Study) |
All subjects with CAD and ≥65 y |
9 y; 489 |
Interview asking about frequency and duration of 12
common leisure-time activities at baseline and year 3 (in 785 subjects) |
Vs. <500 kcal/wk, baseline:
500-999: RR = 0.87
(0.68-1.26)
1000-1999: RR = 0.77 (0.59-0.99)
2000-2999: RR = 0.54
(0.36-0.81)
≥3000: RR = 0.63 (0.44-0.91)
P for trend
<0.001
P for trend <0.001 (inverse, linear trend) for change
in activity between baseline and year 3 |
Y |
Y |
– |
– |
– |
Age, sex, race, smoking, alcohol, socioeconomic class,
adiposity, prevalent disease, type of CAD |
– |
| Katzmarzyk & Craig 2006 (63) |
5,421 women,
20-69 y (Canada Fitness Survey) |
– |
12.4 y; 225 |
Modified Minnesota LTPA questionnaire |
Per 1 SD unit of activity:
RR = 0.79
(0.65-0.96) |
Y |
Y |
– |
– |
– |
Age, smoking, alcohol |
– |
| Khaw et al., 2006 (64) |
9,984 men and 12,207 women, 45-79 y (EPIC-Norfolk
study) |
Similar results in subgroup >65 y |
8 y; 1,553 |
1 question each on job and recreational activity
(rec); combined into 4 groups: inactive (no job and rec), moderately
inactive (sedentary job + <0.5 hr/d rec or standing job + no rec),
moderately active (sedentary job + 0.5-1 hr/d rec or standing job +
<0.5 hr/d rec or physical job + no rec), active (sedentary/
standing job + >1 hr/d rec or physical job + some rec or heavy manual
job) |
Vs. inactive:
moderately inactive: RR = 0.83
(0.73-0.95)
moderately active: RR = 0.68 (0.58-0.80)
active: RR = 0.68
(0.57-0.81) |
Y |
Apparent Y |
– |
– |
– |
Age, sex, blood pressure, cholesterol, smoking,
alcohol, diabetes, BMI, social class |
Similar results in men and women |
Lan et al., 2006 (65) |
1,081 men and 1,032 women, ≥65 y (Taiwan
National Health Interview Survey) |
All subjects ≥65 y |
2 y; 197 |
Interview asking about kinds, frequency, and duration
of LTPA |
Vs. sedentary:
<500 kcal/wk: RR = 0.80
(0.49-1.30)
500-999 kcal/wk: RR = 0.74 (0.46-1.17)
1000-1999 kcal/wk:
RR = 0.50 (0.27-0.90)
≥2000 kcal/wk: RR = 0.43 (0.21-0.87)
P for trend = 0.04
A model simultaneously considered amount
(p<0.05), intensity (p<0.05), duration (p=0.06), and frequency (p=0.08)
of LTPA. |
Y |
Y |
Y |
Borderline p=0.06 |
Borderline p=0.08 |
Age, sex, education, number of diseases, alcohol,
smoking, BMI, self-rated health, physical function, occupation |
– |
| Manini et al., 2006 (66) |
150 men and 152 women, 70-82 y (Health ABC Study)
|
All subjects ≥70 y |
6.2 y; 55 |
Doubly-labeled water |
Vs. <521 kcal/day of activity energy
expenditure:
521-770 kcal/day: RR = 0.65 (0.33-1.28)
>770 kcal/day:
RR = 0.33 (0.15-0.74)
P for trend = 0.007 |
Y |
Y |
– |
– |
– |
Age, sex, race, study site, weight, height, % body
fat, sleep duration, self-rated health, smoking, CVD, lung disease, diabetes,
osteoarthritis, osteoporosis, cancer, depression |
– |
| Schooling et al., 2006 (67) |
1,875 men and 37,417 women, ≥65 y (Hong Kong
Elderly Health Centers) |
All subjects ≥65 y |
4.1 y; 3,819 |
Interview on frequency and duration of LTPA;
classified as none, ≤30 min/day, or >30 min/day |
Vs. no LTPA:
≤30 min/day: RR = 0.83
(0.76-0.91)
>30 min/day: RR = 0.73 (0.67-0.80)
P for trend
<0.001 |
Y |
Y |
– |
Y |
– |
Age, sex, education, alcohol, smoking, income,
housing, BMI |
Analyses of duration do not address short vs. long
bouts |
| Schnohr et al., 2006 (68) |
2,136 men and 2,758 women,
20-79 y (Copenhagen
City Heart Study) |
– |
19 y; 1,787 |
Questionnaire on LTPA, 3 levels analyzed: none/very
little LTPA (low), 1-4 hr/wk light activity (moderate), >4 hr/wk light
activity or >2 hr/wk high level activity (high). Only subjects with
unchanged activity levels in 1976-78 and 1981-83 included. |
Vs. low LTPA:
moderate: RR = 0.78 (0.68-0.89)
high: RR = 0.75 (0.64-0.87)
P for trend = 0.001 |
Y |
Y |
– |
– |
– |
Age, sex, smoking, total cholesterol, HDL-cholesterol,
systolic blood pressure/anti-hypertensive drugs, diabetes, alcohol, BMI,
education, income, FEV1 |
– |
| Boyle et al., 2007 (69) |
205 men and 582 women, men age 80.5 y (Rush
Memory and Aging Project) |
Mean age 80.5 y |
2.6 y; 156 |
Adapted from 1985 National Health Interview Survey
(types, duration, and frequency of LTPA) |
Per hr/wk of LTPA: RR = 0.89 (0.83-0.95) |
N |
Y |
– |
Y |
– |
Age, sex, education, baseline gait |
Analyses of duration do not address short vs. long
bouts |
| Matthews et al., 2007 (70) |
67,143 women, 40-70 y (Shanghai
Women’s Health Study) |
– |
5.7 y; 1,091 |
Interview asking about exercise participation,
household activities, walking/cycling for transport, occupation. Analyses also
considered exercise and non-exercise (walking/cycling, household activities,
stair climbing) separately |
Vs. ≤9.9 MET-hr/day, overall activity:
10.0-13.6 MET-hr/day: RR = 0.81 (0.69-0.96)
13.7-18.0 MET-hr/day: RR = 0.67
(0.57-0.80)
≥18.1 MET-hr/day: RR = 0.61 (0.51-0.73)
P for
trend <0.001
Vs. 0 MET-hr/day,
exercise:
0.1-3.4 MET-hr/day: RR = 0.84 (0.74-0.96)
3.5-7.0 MET-hr/day:
RR = 0.77 (0.59-0.99)
≥7.1 MET-hr/day: RR = 0.64 (0.36-1.14)
P
for trend = 0.008
Vs. ≤9.9 MET-hr/day, exercise:
10.0-13.6
MET-hr/day: RR = 0.81 (0.69-0.94)
13.7-18.0 MET-hr/day: RR = 0.63
(0.53-0.75)
≥18.1 MET-hr/day: RR = 0.66 (0.55-0.79)
P for
trend = 0.07
Vs. 0-3.4 MET-hr/day, walking for transport:
3.5-7.0
MET-hr/day: RR = 0.94 (0.81-1.09)
7.1-10.0 MET-hr/day RR = 0.83
(0.69-1.00)
≥10.1 MET-hr/day: RR = 0.86 (0.75-1.05)
P for
trend = 0.07
Vs. 0 MET-hr/day, cycling for transport:
0.1-3.4
MET-hr/day: RR = 0.79 (0.61-1.01)
≥3.5 MET-hr/day: RR = 0.66
(0.40-1.07)
P for trend = 0.02
Higher levels of non-exercise
activity associated with lower risks; at the highest level of non-exercise
activity (≥18.1 MET-hr/day), the addition of exercise activity did not
change risk. |
N |
Y |
– |
– |
– |
Age, marital status, education, income, smoking,
alcohol, number of pregnancies, oral contraceptive use, menopause, chronic
disease, kinds of physical activity |
– |
| Schnohr et al., 2007 (71) |
3,204 men and 4,104 women,
20-93 y (Copenhagen
City Heart Study) |
– |
12 y; 1,391 |
Questionnaire on walking pace and duration |
Vs. <0.5 hr/day walking duration, men:
0.5-1
hr/day: RR = 1.00 (0.77-1.30)
1-2 hr/day: RR = 1.04 (0.80-1.36)
>2
hr/day: RR = 0.80 (0.59-1.10)
Vs. slow walking pace, men:
average:
RR = 0.75 (0.61-0.92)
fast: RR = 0.48 (0.35-0.66)
Vs. <0.5
hr/day walking duration, women:
0.5-1 hr/day: RR = 0.87 (0.68-1.10)
1-2
hr/day: RR = 0.95 (0.75-1.21)
>2 hr/day: RR = 0.89 (0.69-1.14)
Vs. slow walking pace, women:
average: RR = 0.54 (0.45-0.67)
fast: RR =
0.43 (0.32-0.59) |
Y |
Y |
Y |
Y |
– |
Age, number of sports, BMI, systolic BP,
antihypertensive medication, cholesterol, HDL-cholesterol, smoking, education,
income, alcohol, diabetes |
Analyses of walking intensity were adjusted for
walking duration. Analyses of duration do not address short vs. long
bouts. |
| Smith et al., 2007 (72) |
741 men and 923 women, 50-90 y (Rancho Bernado
Study) |
347 with type 2 diabetes |
10 y; 538 |
Reported city blocks walked daily |
Normal, vs non-walker:
<1 mile/d: RR = 0.98
(0.76-1.25)
≥1 mile/d: RR = 0.89 (0.67-1.18)
Diabetics, vs
non-walker:
<1 mile/d: RR = 1.02 (0.70-1.43)
≥1 mile/d: RR = 0.54
(0.33-0.88) |
Y |
Apparent Y |
– |
– |
– |
Age, sex, smoking, BMI, alcohol, exercise,
hypertension, triglycerides, HDL, history of CHD |
In a sample followed 6-12 y from baseline, 45%
reported same level of walking. |
| Wyshak 2007 (73) |
5,398 alumnae from 10 colleges and universities, mean
age 39 y |
– |
15 y; 259 |
Questionnaire on contemporary regular exercise |
Vs. no regular exercise:
regular exercise: RR =
0.76 (0.57-1.00) |
N |
– |
– |
– |
– |
Age, BMI, smoking, alcohol, breast cancer, high blood
pressure, asthma/
emphysema/
bronchitis |
– |
* Numbers in parentheses are 95% confidence limits; if not provided,
they were not available. P-values for trend come from tests of linear
trend.
† "Apparent" associations refer to those where the data
appear to support an inverse, dose-response relation, but no formal statistical
testing was conducted.
ADL, activities of daily living; BMI, body mass
index; BP, blood pressure; CAD, coronary artery disease; CHD, coronary heart
disease; CHF, congestive heart failure; CVD, cardiovascular disease; ECG,
electrocardiogram; FEV1, forced expiratory volume in one second, HDL,
high-density lipoprotein cholesterol; IGT, impaired glucose tolerance; KKD,
kcal/kg body weight/day; LDL, low-density lipoprotein cholesterol; LTPA,
leisure-time physical activity; MI, myocardial infarction; N, no; OPA,
occupational physical activity; RR, risk ratio; Y, yes; y, year(s)
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Physical Activity Guidelines Advisory Committee
Report
Last revised: June 11, 2008
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