#VisualAbstract: Higher proportions time spent in physical activity decreased all-cause mortality

1. In this compositional analysis, results suggested that in a 24hr period, replacing sedentary time with physical activity of any intensity was associated with decreased all-cause mortality.

2. The results of this study did not find any clear indication that time spent asleep was associated with all-cause mortality.

Evidence Rating Level: 1 (Excellent)

There is currently a lack of evidence on the joint association of physical activity, sedentary activity, and sleep with health outcomes. Given that there are only 24 hours in a day, there is a lack of data surrounding how to best utilize those hours with the aforementioned behaviors to optimize health. As a result, the purpose of the present study was to perform a federated pooled analysis of prospective cohorts to investigate the influence of time spent in each behavior on all-cause mortality.

The present pooled compositional analysis included 6 English prospective studies (130 239 participants) from database inception until February 2018. Studies were included if they examined the influence of time spent engaging in sedentary behavior (SD), low-intensity physical exercise (LIPA), and moderate to vigorous exercise (MVPA) using a body sensor on all-cause mortality using Cox regression analysis. The study analysis was conducted according to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Day composition was defined as the amount of time spent in MVPA, LIPA, SB, and sleep.

Results showed that day compositions with higher MVPA were associated with a lower risk of all-cause mortality. Higher LIPA and lower sedentary time were also associated with a lower risk of all-cause mortality, specifically in studies which examined this relationship using a hip accelerometer. Interestingly, there was no clear indication that time spent asleep was associated with all-cause mortality. This study was limited by the lack of adjustment for several confounders such as body mass index and fitness levels. However, the study’s compositional analysis design ensured that the interaction between all variables was properly accounted for.

Click to read the study in British Journal of Sports Medicine

Image: PD

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