Domains of physical activity and all-cause mortality: Systematic review and dose-response meta-analysis of cohort studies
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BACKGROUND: The dose-response relation between physical activity and all-cause mortality is not well defined at present. We conducted a systematic review and meta-analysis to determine the association with all-cause mortality of different domains of physical activity and of defined increases in physical activity and energy expenditure. METHODS: MEDLINE, Embase and the Cochrane Library were searched up to September 2010 for cohort studies examining all-cause mortality across different domains and levels of physical activity in adult general populations. We estimated combined risk ratios (RRs) associated with defined increments and recommended levels, using random-effects meta-analysis and dose-response meta-regression models. RESULTS: Data from 80 studies with 1 338 143 participants (118 121 deaths) were included. Combined RRs comparing highest with lowest activity levels were 0.65 [95% confidence interval (95% CI) 0.60-0.71] for total activity, 0.74 (95% CI 0.70-0.77) for leisure activity, 0.64 (95% CI 0.55-0.75) for activities of daily living and 0.83 (95% CI 0.71-0.97) for occupational activity. RRs per 1-h increment per week were 0.91 (95% CI 0.87-0.94) for vigorous exercise and 0.96 (95% CI 0.93-0.98) for moderate-intensity activities of daily living. RRs corresponding to 150 and 300 min/week of moderate to vigorous activity were 0.86 (95% CI 0.80-0.92) and 0.74 (95% CI 0.65-0.85), respectively. Mortality reductions were more pronounced in women. CONCLUSION: Higher levels of total and domain-specific physical activity were associated with reduced all-cause mortality. Risk reduction per unit of time increase was largest for vigorous exercise. Moderate-intensity activities of daily living were to a lesser extent beneficial in reducing mortality.
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- Authors
- Samitz, G., Egger, M., & Zwahlen, M.
- Affiliations
- University of Vienna (AT)
- University of Bern (CH)
- Corresponding author
- Zwahlen, Marcel
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-09-05
- Volume
- 40
- Issue
- 5
- Pages
- 1382-1400
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2124173430
- Cited by
- 836
- References
- 140
- Citations by year
- 2026: 30 · 2025: 27 · 2024: 29 · 2023: 47 · 2022: 62 · 2021: 68 · 2020: 71 · 2019: 59 · 2018: 74 · 2017: 94 · 2016: 76 · 2015: 81 · 2014: 47 · 2013: 46 · 2012: 22
- FWCI
- 4.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- reroDoc Digital Library (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Open Access CRIS of the University of Bern
- Funders
- Universität Wien
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- physical activity, all-cause mortality, dose-response relationship, leisure-time physical activity, activities of daily living, occupational physical activity, high-intensity exercise, moderate physical activity, energy expenditure, sex differences, recommended physical activity levels
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cause of Death, Energy Metabolism, Female, Humans, Leisure Activities, Male, Middle Aged, Mortality, Motor Activity, Sports, Cohort Studies, Exercise, Age Distribution, Sex Distribution, Young Adult
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