Association of changes in physical activity and adiposity with mortality and incidence of cardiovascular disease: longitudinal findings from the UK Biobank

Ahmadi, M. N., Gill, J. M.R. and Stamatakis, E. (2022) Association of changes in physical activity and adiposity with mortality and incidence of cardiovascular disease: longitudinal findings from the UK Biobank. Mayo Clinic Proceedings, 97(5), pp. 847-861. (doi: 10.1016/j.mayocp.2021.11.026) (PMID:35410749)

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Abstract

Objective: To examine the association of changes in physical activity and adiposity with all-cause mortality and incident cardiovascular disease (CVD). Methods: Physical activity, body mass index (BMI), body fat percentage, waist circumference, and waist to hip ratio changes were categorized on the basis of public health and clinical guidelines. Among 29,610 participants (mean ± SD follow-up, 5.1±2.1 years), 545 deaths and 2970 CVD events occurred. Participants were observed from baseline (March 13, 2006, to October 10, 2010) and follow-up (August 1, 2012 to November 9, 2018) assessment through March 31, 2021. Results: Compared with stable-insufficient physical activity, increasing physical activity to meet guidelines at follow-up was associated with lower all-cause mortality (hazard ratio, 0.64 [0.49 to 0.85]) and CVD (0.83 [0.72 to 0.96]) risk. This risk was similar to that of those who achieved physical activity guidelines at both time points (all-cause mortality, 0.74 [0.60 to 0.92]; CVD, 0.88 [0.79 to 0.99]). For obese and overweight participants, decreasing BMI category was associated with a lower CVD risk (0.70 [0.47 to 1.04]) similar to the risk of those who had a healthy weight at both time points (0.85 [0.76 to 0.96]). In the joint analyses, the only combination that lowered all-cause mortality and CVD risk was physical activity increase and adiposity decrease over time (eg, CVD risk: BMI, 0.64 [0.42 to 0.96]; body fat percentage, 0.76 [0.55 to 0.97]; waist circumference, 0.66 [0.48 to 0.89]; waist to hip ratio, 0.78 [0.62 to 0.97]) compared with the reference group (stable physical activity and adiposity). Conclusion: Increases in physical activity to meet guidelines lowered all-cause mortality and CVD risk equal to that of those who continually met guidelines. The risk was effectively eliminated in those who had concurrent adiposity decrease.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gill, Professor Jason
Authors: Ahmadi, M. N., Gill, J. M.R., and Stamatakis, E.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Mayo Clinic Proceedings
Publisher:Elsevier
ISSN:0025-6196
ISSN (Online):1942-5546
Published Online:09 April 2022
Copyright Holders:Copyright © 2021 Mayo Foundation for Medical Education and Research
First Published:First published in Mayo Clinic Proceedings 97(5): 847-861
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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