| Title: | Dose Response of Incidental Physical Activity Against Cardiovascular Events and Mortality |
| Journal: | Circulation |
| Published: | 14 Apr 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40228066/ |
| DOI: | https://doi.org/10.1161/circulationaha.124.072253 |
Publication 15505
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Abstract
BACKGROUND: Few middle-aged and older adults engage in regular leisure-time exercise. Incidental physical activity (IPA) encompasses activities of daily living outside the leisure-time domain. No dose-response study is available to guide IPA-focused interventions and guidelines. We examined the associations of device-assessed IPA intensities (vigorous [VIPA], moderate [MIPA], light [LIPA]) with major adverse cardiovascular events (MACE) and mortality, and we estimated the "health equivalence" of LIPA and MIPA against 1 minute of VIPA.</p>
METHODS: A total of 24 139 nonexercisers from the 2013 to 2015 UK Biobank accelerometry substudy (56.2% women) with a mean±SD age of 61.9±7.6 years were analyzed using a prospective cohort design. IPA energy expenditure and daily durations of VIPA, MIPA, and LIPA were calculated with a validated machine learning-based intensity classifier. MACE included incident stroke, myocardial infarction, and heart failure; CVD death; CVD mortality; and all-cause mortality.</p>
RESULTS: Analyses included 22 107 (MACE), 22 174 (CVD mortality), and 24 139 (all-cause mortality) participants, corresponding to 908/223/1071 events over 7.9 years of follow-up. IPA volume exhibited an L-shaped association with a nadir at ≈35 to 38 kJ·kg-1·d-1, corresponding to hazard ratios of 0.49 (95% CI, 0.39-0.61) for MACE, 0.33 (95% CI, 0.22-0.52) for CVD mortality, and 0.31 (95% CI, 0.25-0.38) for all-cause mortality. Any amounts of VIPA or MIPA were associated with lower risk, with a plateau of ≈14 minutes per day (VIPA) and 34 to 50 minutes per day (MIPA). The median VIPA (4.6 min/d) and MIPA (23.8 min/d) durations were associated with CVD mortality hazard ratio of 0.62 (95% CI, 0.46-0.83) and 0.50 (95% CI, 0.31-0.80), respectively. LIPA showed a subtle inverse gradient which was statistically significant only for CVD mortality at levels >130 minutes per day. One minute of VIPA was equivalent to 2.8 (MACE) to 3.4 (CVD mortality) minutes of MIPA and 34.7 (CVD mortality) to 48.5 (MACE) minutes of LIPA.</p>
CONCLUSIONS: Any daily IPA amount of vigorous or moderate intensity was associated with lower CVD risk in a dose-response manner. LIPA had weak associations with all outcomes. One minute of vigorous or ≈3.0 to 3.5 minutes of moderate IPA was associated with a similar degree of lower CVD risk. Our findings highlight the potential cardiovascular health value of incidental physical activity, especially for people who struggle to do structured exercise.</p>
11 Keywords
- Accelerometry
- Aged
- Cardiovascular Diseases
- Exercise
- Female
- Humans
- Male
- Middle Aged
- Prospective Studies
- Risk Factors
- United Kingdom
15 Authors
- Emmanuel Stamatakis
- Raaj K. Biswas
- Nicholas A. Koemel
- Angelo Sabag
- Richard Pulsford
- Andrew J. Atkin
- Afroditi Stathi
- Sonia Cheng
- Cecilie Thøgersen-Ntoumani
- Joanna M. Blodgett
- Adrian Bauman
- Carlos Celis-Morales
- Mark Hamer
- Jason M.R. Gill
- Matthew N. Ahmadi
1 Application
| Application ID | Title |
|---|---|
| 25813 | Integrated paradigms to investigate the interplay between lifestyle behaviours, the social environment, and genetic risk in the development of cardio- metabolic disease and mental health. |
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