Accelerometry-assessed physical activity and sedentary time and associations with chronic disease and hospital visits – a prospective cohort study with 15 years follow-up
Open accessAbstract
BACKGROUND: Associations of objectively assessed physical activity in different intensities and risk of developing chronic disease that requires hospital care have not yet been examined in long term population-based studies. Studies addressing the link between physical activity and sedentary time and subsequent hospital admissions are lacking. OBJECTIVE: To examine the prospective associations between physical activity and sedentary time with morbidity defined as: 1) a registered main diagnosis of cardiovascular disease, cancer, type-2 diabetes, dementia, obesity or depression; 2) number of in- and outpatient hospital visits; and 3) number of in-hospital days. METHODS: In total, 1220 women and men, 18-75 years, from the population-based Sweden Attitude Behaviour and Change study 2000-2001 were included. Time spent sedentary, in light-intensity physical activity and in moderate-to-vigorous physical activity, and total accelerometer counts were assessed using the ActiGraph 7164 accelerometer. Morbidity data were obtained 2016 from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR) of morbidity with 95% confidence intervals (CI) and negative binomial regression estimated incidence rate ratio (IRR) with 95% CI for number of hospital visits, and length of hospital stay. RESULTS: Over a follow-up of 14.4 years (SD = 1.6), 342 persons had at least one registered hospital visit due to any of the included diagnoses. Higher moderate-to-vigorous physical activity was associated with significant risk reductions for combined morbidity (all included diagnoses) (HR: 0.65, 95% CI: 0.48-0.88) and cardiovascular disease (HR: 0.52, 95% CI: 0.33-0.82). Higher total counts showed similar results, and was also associated with fewer hospital visits (IRR = 0.56, 95% CI: 0.37-0.85). Higher sedentary time increased the risk of in-hospital days. (IRR = 2.38, 95% CI: 1.20-4.74). CONCLUSION: This study supports the importance of moderate-to-vigorous physical activity for preventing chronic disease that requires hospital care, especially cardiovascular disease. High volumes of sedentary behavior may increase the risk of future hospitalization. Our results support the public health message "sit less and move more".
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The existing evidence regarding associations between light-intensity physical activity and risks for developing cardiovascular events in the general population is conflicting.
“The existing evidence regarding associations between LPA and risks for developing cardiovascular events in the general population is conflicting.13, 14, 15, 16”
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Yerramalla, M. S., McGregor, D. E., van Hees, V. T., Fayossé, A., Dugravot, A., Tabák, Á. G., Chen, M., Chastin, S. F. M., & Sabia, S. (2021) · Figshare · doi:10.6084/m9.figshare.14955983
Lindblom, H., Lowén, M., Faresjö, T., Hedman, K., & Sandström, P. (2021) · Figshare · doi:10.6084/m9.figshare.14175749
Additional file 1 of The role of physical activity on healthcare utilization in China
Lei·, X., Gao, K., Wang, H., Chen, W., Chen, G.-R., & Wen, X. (2023) · Figshare · doi:10.6084/m9.figshare.24709024
Lindblom, H., Lowén, M., Faresjö, T., Hedman, K., & Sandström, P. (2021) · Figshare · doi:10.6084/m9.figshare.14175764
- Authors
- Dohrn, I.-M., Welmer, A.-K., & Hagströmer, M.
- Affiliations
- Karolinska Institutet (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Dohrn, Ing-Mari
- Venue
- International Journal of Behavioral Nutrition and Physical Activity
- Published
- 2019-12
- Volume
- 16
- Issue
- 1
- Pages
- 125-125
- ISSN
- 1479-5868 (ISSN-L)
- PMC
- PMC6902520
- OpenAlex
- W2993493821
- Cited by
- 57
- References
- 36
- Citations by year
- 2025: 9 · 2024: 9 · 2023: 9 · 2022: 7 · 2021: 20 · 2020: 3
- FWCI
- 5.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Stockholms Läns Landsting (ALF)
- Centrum for Idrottsforskning (na)
- European union (2006120)
- Folksam (na)
- Karolinska Institutet (SFO-V fellowship)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- physical activity, sedentary behavior, moderate-to-vigorous physical activity, light physical activity, accelerometer-measured activity, chronic disease, hospitalization, cardiovascular disease, cancer, type 2 diabetes, dementia, obesity, depression, length of hospital stay, physical activity intensity, men and women, long-term follow-up
- MeSH terms
- Adolescent, Adult, Aged, Chronic Disease, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Prospective Studies, Sweden, Exercise, Young Adult, Actigraphy, Sedentary Behavior, Accelerometry
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