BACKGROUND AND PURPOSE:

• Data from previous studies not only focus on higher-income regions, but also generally recreational activities
• Limited data on activities related to daily occupational and physical activities
• Lear et al. (Lancet, 2017) sought to determine whether not only the amount but also the type of activity had any effect on mortality and CVD

METHODS:

• Data from the Prospective Urban Rural Epidemiologic (PURE) study
• International prospective cohort study recruited participants from both high- and low-income countries
• Within each county, both urban and rural communities were selected
• Total physical activity was assessed using the International Physical Activity Questionnaire (IPQA) reported using metabolic equivalents (MET)
• Total physical activity categories
  • low (<600 MET × minutes per week) = less than 150 minutes per week of moderate intensity physical activity
  • moderate (600 – 3000 MET × minutes per week) = 150–750 minutes per week of moderate intensity physical activity
  • high (>3000 MET × minutes per week) more than 750 minutes per week of moderate intensity physical activity
• Physical activity guideline thresholds
• IPAQ: ≥600 MET × minutes per week
• WHO: ≥150 minutes per week of moderate intensity physical activity
• Mortality and CVD were recorded during a mean of 6.9 years of follow-up
• Primary clinical outcome
  • Mortality plus major CVD, either as a composite or separately
• Risks adjusted for sociodemographic factors and other risk factors

RESULTS:

• 168,916 participants were enrolled, of whom 141,945 completed the IPAQ
  • Analyses limited to 130,843 participants without pre-existing CVD
• Compared with low physical activity, moderate and high physical activity were associated with reduction in all-cause mortality
  • Moderate activity: Hazard ratio (HR) 0.80, 95% CI 0.74–0.87
  • High activity: HR 0.65, 95% CI 0.60–0.71
• Compared with low physical activity, moderate and high physical activity were associated with reduction in major CVD
  • Moderate activity: HR 0.80, 95% CI 0.74–0.87
  • High activity: HR 0.75, 95% CI 0.69–0.82
• Meeting physical activity guidelines was associated with HRs of
  • 0.78 for mortality plus major CVD (95% CI 0.74–0.83)
  • 0.72 (0.67–0.77) for mortality
  • 0.80 (0.74–0.86) for major CVD
  • P<0.0001 for all the above
• Higher physical activity was associated with lower risk of CVD and mortality in all countries, regardless of income level
• The adjusted population attributable fraction for not meeting the physical activity guidelines was 8.0% for mortality and 4.6% for major CVD and for not meeting high physical activity was 13.0% for mortality and 9.5% for major CVD
• Both recreational and non-recreational physical activity were associated with benefits

CONCLUSION:

• Both recreational and non-recreational physical activity are associated with lower mortality and CVD and the effect is consistent across countries and economic strata
• These results are independent of type of physical activity or other risk factors
• Meeting physical activity guidelines such as walking for 30 minutes on most days of the week had a substantial benefit
  • Higher physical activity (> 17X recommended physical activity guidelines) were associated with even lower risks
• Study supports public health initiatives worldwide to reduce CVD and deaths

Learn More – Primary Sources:

The effect of physical activity on mortality and cardiovascular disease in 130,000 people from 17 high-income, middle-income, and low-income countries: the PURE study

Related ObG Topics:

PURE Study Results – Carbs vs Fat Intake to Reduce Cardiovascular Morbidity and Mortality?

Lancet Commission: Over a Third of Dementia Cases May be Preventable

Does Exercise During Pregnancy Impact Hypertension or Macrosomia?

How Does Exercise Affect Health Postmenopause?