| Title: | Compositional mediation of 24-hour movement behaviors in the longitudinal association of obesity and mortality: A focus on the European association for the study of obesity's new framework definition |
| Journal: | Journal of Sports Sciences |
| Published: | 18 Jul 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42482328/ |
| DOI: | https://doi.org/10.1080/02640414.2026.2703384 |
Publication 21346
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Abstract
The European Association for the Study of Obesity (EASO) recently proposed a new obesity definition, yet the extent to which 24-hour movement behaviors mediate the obesity - mortality association under this framework remains unclear, and sex-specific time-use recommendations for individuals with obesity are lacking. This study aimed to quantify the mediating role of 24-hour movement behaviors, estimate mortality risk associated with time reallocation these behaviors, and identify the optimal daily composition for lowing mortality risk. Using UK Biobank data (N = 90,289), obesity was defined via BMI, waist-to-height ratio, and the EASO framework. Behaviors were measured by 7-day wrist accelerometry. Compositional mediation Cox models and isotemporal substitution analyses were applied. Results showed 24-hour movement behaviors mediated 37.7%-49.0% of the obesity - mortality association, with MVPA contributing most. Sex-stratified analyses revealed heterogeneous mediation effects (total indirect effect: 59.2% in males [43.0% via MVPA] vs. 38.6% in females [20.9% via MVPA]). Optimal compositions associated with lowest mortality risk were: females: 1 h MVPA, 7 h LPA, 7 h SB, 9 h sleep; males: 1.5 h MVPA, 7 h LPA, 7 h SB, 8.5 h sleep. These findings quantify the mediating role of daily movement and provide sex-specific time-use targets for obesity management.</p>
15 Keywords
- Accelerometry
- Aged
- Exercise
- Female
- Humans
- Longitudinal Studies
- Male
- Middle Aged
- Movement
- Obesity
- Sex Factors
- Sleep
- Sleep Duration
- Time Factors
- United Kingdom
12 Authors
- Yiting Huang
- Yutai Cai
- Fan Zhang
- Zhehao Wang
- Tao Zhang
- Qiaoman Mo
- Qingguang Zhong
- Jiaxin Shen
- Guanren Chen
- Lixia Li
- Ziqiang Lin
- Yanhui Gao
1 Application
| Application ID | Title |
|---|---|
| 90162 | Study on the complex associations of physical and mental diseases with genetics and environment |
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