Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies.
Level 1 - systematic review of randomized trials
Systematic review and dose-response meta-analysis of prospective cohort studies examining non-occupational physical activity and health outcomes.
PubMed 36854652 · doi:10.1136/bjsports-2022-105669
What was done
A systematic review and cohort-level dose-response meta-analysis was conducted across PubMed, Scopus, and Web of Science. The review included prospective cohort studies of general adult populations with sample sizes greater than 10,000 participants and at least three categories of non-occupational physical activity. Outcomes evaluated included all-cause mortality, incident total cardiovascular disease (CVD) and specific CVD subtypes, and total and site-specific cancers. In total, 196 articles covering 94 unique cohorts and over 30 million participants were analyzed.
What was found
Higher non-occupational physical activity was non-linearly associated with lower risk across all evaluated outcomes, with the steepest risk reductions observed between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week, equivalent to 150 min/week of moderate-to-vigorous physical activity). Beyond 17.5 mMET-hours/week, additional differences in risk were small and uncertain. At 8.75 mMET-hours/week, relative risks were 0.69 (95% CI 0.65 to 0.73) for all-cause mortality (50 results; 163,415,543 person-years, 811,616 events), 0.71 (95% CI 0.66 to 0.77) for CVD mortality, and 0.85 (95% CI 0.81 to 0.89) for cancer mortality. The authors estimated that achieving 8.75 mMET-hours/week would avert 15.7% (95% CI 13.1 to 18.2) of all premature deaths.
Why it matters
This study provides precise population-level estimates showing that the largest reductions in premature mortality and cardiovascular risk occur with small to moderate increases in leisure-time physical activity up to standard guideline recommendations.
Limits
The findings are based entirely on observational prospective cohort studies, carrying potential for residual confounding and reverse causality. Physical activity was based on non-occupational categories, and data on specific intensities or device-measured activity were not synthesized.
Cited by
- partial Spending about 30 to 40 minutes per day performing vigorous physical activity is associated with a 50% or greater reduction in cardiovascular mortality, all-cause mortality, and type 2 diabetes incidence.