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Original Investigation |

Effect of Moderate to Vigorous Physical Activity on All-Cause Mortality in Middle-aged and Older Australians

Klaus Gebel, PhD1,2; Ding Ding, PhD2; Tien Chey, MAppStats2; Emmanuel Stamatakis, PhD3,4; Wendy J. Brown, PhD5; Adrian E. Bauman, PhD2
[+] Author Affiliations
1Centre for Chronic Disease Prevention, College of Public Health, Medical, and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
2Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
3Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
4Exercise and Sport Sciences, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
5Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
JAMA Intern Med. 2015;175(6):970-977. doi:10.1001/jamainternmed.2015.0541.
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Importance  Few studies have examined how different proportions of moderate and vigorous physical activity affect health outcomes.

Objective  To examine whether the proportion of total moderate to vigorous activity (MVPA) that is achieved through vigorous activity is associated with all-cause mortality independently of the total amount of MVPA.

Design, Setting, and Participants  We performed a prospective cohort study with activity data linked to all-cause mortality data from February 1, 2006, through June 15, 2014, in 204 542 adults aged 45 through 75 years from the 45 and Up population-based cohort study from New South Wales, Australia (mean [SD] follow-up, 6.52 [1.23] years). Associations between different contributions of vigorous activity to total MVPA and mortality were examined using Cox proportional hazards models, adjusted for total MVPA and sociodemographic and health covariates.

Exposures  Different proportions of total MVPA as vigorous activity. Physical activity was measured with the Active Australia Survey.

Main Outcomes and Measures  All-cause mortality during the follow-up period.

Results  During 1 444 927 person-years of follow-up, 7435 deaths were registered. Compared with those who reported no MVPA (crude death rate, 8.34%), the adjusted hazard ratios for all-cause mortality were 0.66 (95% CI, 0.61-0.71; crude death rate, 4.81%), 0.53 (95% CI, 0.48-0.57; crude death rate, 3.17%), and 0.46 (95% CI, 0.43-0.49; crude death rate, 2.64%) for reporting 10 through 149, 150 through 299, and 300 min/wk or more of activity, respectively. Among those who reported any MVPA, the proportion of vigorous activity revealed an inverse dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity (crude death rate, 3.84%) the fully adjusted hazard ratio was 0.91 (95% CI, 0.84-0.98; crude death rate, 2.35%) in those who reported some vigorous activity (but <30% of total activity) and 0.87 (95% CI, 0.81-0.93; crude death rate, 2.08%) among those who reported 30% or more of activity as vigorous. These associations were consistent in men and women, across categories of body mass index and volume of MVPA, and in those with and without existing cardiovascular disease or diabetes mellitus.

Conclusions and Relevance  Among people reporting any activity, there was an inverse dose-response relationship between proportion of vigorous activity and mortality. Our findings suggest that vigorous activities should be endorsed in clinical and public health activity guidelines to maximize the population benefits of physical activity.

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