Brief bouts of device-measured intermittent lifestyle physical activity and its association with major adverse cardiovascular events and mortality in people who do not exercise: a prospective cohort study

Matthew N Ahmadi, Mark Hamer, Jason M R Gill, Marie Murphy, James P Sanders, Aiden Doherty, Emmanuel Stamatakis

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Abstract

Background: Guidelines emphasise the health benefits of bouts of physical activity of any duration. However, the associations of intermittent lifestyle physical activity accumulated through non-exercise with mortality and major adverse cardiovascular events (MACE) remain unclear. We aimed to examine the associations of bouts of moderate-to-vigorous intermittent lifestyle physical activity (MV-ILPA) and the proportion of vigorous activity contributing within these bouts with mortality and MACE. Methods: In this prospective cohort study, we used data from the UK Biobank on adults who do not exercise (ie, those who did not report leisure-time exercise) who had wrist-worn accelerometry data available. Participants were followed up until Nov 30, 2022, with the outcome of interest of all-cause mortality obtained through linkage with NHS Digital of England and Wales, and the NHS Central Register and National Records of Scotland, and MACE obtained from inpatient hospitalisation data provided by the Hospital Episode Statistics for England, the Patient Episode Database for Wales, and the Scottish Morbidity Record for Scotland. MV-ILPA bouts were derived using a two-level Random Forest classifier and grouped as short (<1 min), medium (1 to <3 min; 3 to <5 min), and long (5 to <10 min). We further examined the dose–response relationship of the proportion of vigorous physical activity contributing to the MV-ILPA bout. Findings: Between June 1, 2013, and Dec 23, 2015, 103 684 Biobank participants wore an accelerometer on their wrist. 25 241 adults (mean age 61·8 years [SD 7·6]), of whom 14 178 (56·2%) were women, were included in our analysis of all-cause mortality. During a mean follow-up duration of 7·9 years (SD 0·9), 824 MACE and 1111 deaths occurred. Compared with bouts of less than 1 min, mortality risk was lower for bouts of 1 min to less than 3 min (hazard ratio [HR] 0·66 [0·53–0·81]), 3 min to less than 5 min (HR 0·56 [0·46–0·69]), and 5 to less than 10 min (HR 0·48 [0·39–0·59]). Similarly, compared with bouts of less than 1 min, risk of MACE was lower for bouts of 1 min to less than 3 min (HR 0·71 [0·54–0·93]), 3 min to less than 5 min (0·62 [0·48–0·81]), and 5 min to less than 10 min (0·59 [0·46–0·76]). Short bouts (<1 min) were associated with lower MACE risk only when bouts were comprised of at least 15% vigorous activity. Interpretation: Intermittent non-exercise physical activity was associated with lower mortality and MACE. Our results support the promotion of short intermittent bouts of non-exercise physical activity of moderate-to-vigorous intensity to improve longevity and cardiovascular health among adults who do not habitually exercise in their leisure time. Funding: Australian National Health, Medical Research Council, and Wellcome Trust.

Original languageEnglish
Pages (from-to)e800-e810
Number of pages11
JournalThe Lancet. Public health
Volume8
Issue number10
DOIs
Publication statusPublished (in print/issue) - 31 Oct 2023

Bibliographical note

Funding Information:
This study is funded by an Australian National Health and Medical Research Council Investigator Grant (APP 1194510) and an Ideas Grant (APP1180812). AD is supported by the Wellcome Trust (223100/Z/21/Z). This research was conducted using the UK Biobank Resource (application number 25813). The authors would like to thank all the participants and professionals contributing to the UK Biobank.

Publisher Copyright:
© 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license

Keywords

  • Australia
  • Prospective Studies
  • Exercise - physiology
  • Life Style
  • Cardiovascular Diseases
  • Male
  • Female
  • Adult
  • Sedentary Behavior
  • Middle Aged
  • Humans

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