BACKGROUND: We studied the relations between physical activity and changes in physical activity, all-cause mortality, and incidence of major coronary-heart-disease events in older men. METHODS: In 1978-80 (Q1), 7735 men aged 40-59 were selected from general practices in 24 British towns, and enrolled in a prospective study of cardiovascular disease, which included physical activity data. In 1992 (Q92), 12-14 years later, 5934 of the men (91% of available survivors, mean age 63 years) gave further information on physical activity and were then followed up for a further 4 years. The main endpoints were all-cause mortality during 4 years of follow-up from Q92, and major fatal and non-fatal coronary-heart-disease events during 3 years of follow-up from Q92. FINDINGS: Among 4311 men with no history of coronary heart disease, stroke, or "other heart trouble" by Q92 and who did not report "poor health", there were 219 deaths. In the inactive/occasionally active, light, moderate, and moderately vigorous/vigorous activity groups there were 101 (18.5/1000 person-years) 48 (11.4), 23 (7.3), and 47 (9.1) deaths, respectively (adjusted risk ratios 1.00, 0.61 [95% CI 0.48-0.86], 0.50 [0.31-0.79], 0.65 [0.45-0.94]). Men who were sedentary at Q1 and who began at least light activity by Q92 had significantly lower all-cause mortality than those who remained sedentary, even after adjustment for potential confounders (risk ratio=0.55 [0.36-0.84]). Physical activity improved both cardiovascular mortality (0.66 [0.35-1.23]) and non-cardiovascular mortality (0.48 [0.27-0.85]). The relation between physical activity at Q92, changes in physical activity, and mortality were similar for men with pre-existing cardiovascular disease. INTERPRETATION: Maintaining or taking up light or moderate physical activity reduces mortality and heart attacks in older men with and without diagnosed cardiovascular disease. Our results support public-health recommendations for older sedentary people to increase physical activity, and for active middle-aged people to continue their activity into old age.

Intense domestic physical activity (IDPA) is promoted by preventive health campaigns, but this recommendation is not supported by evidence. The authors used data from the 1995, 1998, and 2003 Scottish Health Survey samples and the associated mortality and hospital episode records to determine the independent effects of IDPA on cardiovascular disease (CVD) events and all-cause mortality. The sample comprised 13,726 (6,102 men) CVD-free respondents (> or =35 years). Multivariable survival analysis assessed the relation between IDPA and the risk for CVD (fatal/nonfatal combined) or all-cause mortality. During 8.4 (standard deviation, 3.4) years of follow-up, there were 1,103 deaths (573 among men) and 890 CVD events (521 among men). Participation in IDPA was associated with lower all-cause mortality (men: relative risk = 0.68, 95% confidence interval: 0.50, 0.91; women: relative risk = 0.70, 95% confidence interval: 0.52, 0.93). In both sexes, IDPA was unrelated to the risk for CVD. Total physical activity (including IDPA) was unrelated to fatal/nonfatal CVD, but when domestic activity was excluded from the calculations there was an association (men: relative risk = 0.76, 95% confidence interval: 0.58, 0.98; women: relative risk = 0.68, 95% confidence interval: 0.50, 0.93). These results indicate that IDPA may not offer protection against CVD, but it may protect against all-cause mortality. CVD preventive efforts may need to focus on moderate-to-vigorous-intensity physical activities other than those performed in and around the household.

PURPOSE: Conduct a systematic umbrella review to evaluate the relationship of physical activity (PA) with all-cause mortality, cardiovascular mortality, and incident cardiovascular disease (CVD); to evaluate the shape of the dose-response relationships; and to evaluate these relationships relative to the 2008 Physical Activity Guidelines Advisory Committee Report. METHODS: Primary search encompassing 2006 to March, 2018 for existing systematic reviews, meta-analyses, and pooled analyses reporting on these relationships. Graded the strength of evidence using a matrix developed for the Physical Activity Guidelines Advisory Committee. RESULTS: The association of self-reported moderate-to-vigorous physical activity (MVPA) on all-cause mortality, CVD mortality, and atherosclerotic CVD-including incident coronary heart disease, ischemic stroke and heart failure-are very similar. Increasing MVPA to guidelines amounts in the inactive US population has the potential to have an important and substantial positive impact on these outcomes in the adult population. The following points are clear: the associations of PA with beneficial health outcomes begin when adopting very modest (one-third of guidelines) amounts; any MVPA is better than none; meeting the 2008 PA guidelines reduces mortality and CVD risk to about 75% of the maximal benefit obtained by physical activity alone; PA amounts beyond guidelines recommendations amount reduces risk even more, but greater amounts of PA are required to obtain smaller health benefits; and there is no evidence of excess risk over the maximal effect observed at about three to five times the amounts associated with current guidelines. When PA is quantified in terms of energy expenditure (MET·h·wk), these relationships hold for walking, running, and biking. CONCLUSIONS: To avoid the risks associated with premature mortality and the development of ischemic heart disease, ischemic stroke, and all-cause heart failure, all adults should strive to reach the 2008 Physical Activity Guidelines for Americans.

INTRODUCTION: The association of light-intensity physical activity (LPA) with mortality is poorly understood. This meta-analysis of cohort studies aimed to examine the dose-response relationships between daily device-measured LPA and mortality in adults aged 18 or older and to explore whether the associations were independent of moderate-to-vigorous physical activity (MVPA). METHODS: Searches for prospective cohort studies providing effect estimates of daily LPA (exposure) on all-cause mortality (outcome) were systematically undertaken in electronic databases up to 30 April 2019. Subgroup analyses and meta-regression analyses with random-effects models were performed to quantify the dose-response relationships between daily LPA and mortality. Sensitivity analyses were also conducted to assess the stability of the results. RESULTS: A total of 11 studies were included in the meta-analysis. Analyses contained 49,239 individuals (mean age 60.7, SD = 13.6) who were followed up for a mean 6.2 years (2.3 - 14.2 years), during which 3,669 (7.5%) died. In comparison with the reference group (< 3 hours/day), the pooled HRs (and 95% CIs) of mortality were 0.71 (0.62 - 0.82), 0.68 (0.59 - 0.79), 0.56 (0.44 - 0.71) for groups 3 - < 5 hours/day, 5 - < 7 hours/day, and more than 7 hours a day LPA respectively. Meta-regression models indicated that there was a log-cubic dose-response relationship between daily LPA and mortality in adults and older people, independent of MVPA. CONCLUSIONS: Time spent in daily LPA was associated with reduced risks of mortality in adults and older people. These data support the inclusion of LPA in the future physical activity guidelines.

BACKGROUND: There are conflicting data on the association between physical activity (PA) intensity and amount and prognosis of breast cancer. It is unknown whether increasing or decreasing PA is associated with all-cause mortality. OBJECTIVE: The purpose of this study was to estimate the associations between PA and the risk of mortality. METHODS: MEDLINE and EMBASE were used to find eligible studies published from January 1970 to March 2017 for this meta-analysis. We included 24 studies, with a total of 144 224 patients and follow-up periods ranging from 1.9 to 12.7 years. We categorized the amount of PA as low (<300 min/wk), moderate (300-500 min/wk), and high (>500 min/wk). RESULTS: We found that high amounts of PA had an inverse relationship with breast-cancer-specific mortality and all-cause morality. Patients who decreased PA after diagnosis showed poorer all-cause mortality, whereas patients who increased PA postdiagnosis had a favorable association with all-cause mortality. Last, patients who met PA guidelines after diagnosis had a lower breast-cancer-specific mortality and all-cause mortality. CONCLUSION: Physical activity may play a pivotal role in reducing the risk of death. Getting at least 300 min/wk of moderate-intensity PA will help improve the risk of breast cancer death. IMPLICATIONS FOR PRACTICE: Participating in PA is an essential factor in breast cancer care that extends throughout the life span of cancer survivors. Higher levels of PA than current PA guidelines should be recommended to cancer patients.

OBJECTIVES: Multimorbidity and physical inactivity are individually associated with increased mortality risk, but the possibility for physical activity to moderate the multimorbidity-mortality relationship has yet to be investigated. METHODS: Data from the 1999-2006 NHANES were employed, with 16,091 participants constituting the analytic sample. Participants were followed through 2011, including a median follow-up of 99 months. Physical activity was assessed via self-report with multimorbidity assessed from physician diagnosis. RESULTS: After adjustment, for every 1 morbidity increase, participants had a 23% increased risk of all-cause mortality (HR = 1.23; 95% CI: 1.19-1.28; p < 0.001). Multimorbidity mostly remained associated with all-cause mortality across all levels of physical activity, with the exception of those achieving four times the dose of the government guidelines. DISCUSSION: With the exception of those who engaged in high levels of self-reported physical activity, physical activity had a minimal effect on the multimorbidity-mortality relationship.

BACKGROUND: Recommendations for improved survival after cancer through physical activity (PA) exist, although the evidence is still emerging. Our primary objective was to conduct a systematic review and meta-analysis of the association between prediagnosis and postdiagnosis PA and survival (cancer-specific, all-cause, and cardiovascular disease mortality) for all cancers and by tumor site. Secondary objectives were to examine the associations within population subgroups, by PA domain, and to determine the optimal dose of PA related to survival. METHODS: PubMed, EMBASE, and SportsDiscus databases were searched from inception to November 1, 2018. DerSimonian-Laird random-effects models were used to estimate the summary hazard ratios (HRs) and 95% confidence intervals (CI) for primary and secondary analyses and to conduct dose-response analyses. RESULTS: Evidence from 136 studies showed improved survival outcomes with highest vs lowest levels of prediagnosis or postdiagnosis total or recreational PA for all-cancers combined (cancer specific mortality: HR = 0.82, 95% CI = 0.79 to 0.86, and HR = 0.63, 95% CI = 0.53 to 0.75, respectively) as well as for 11 specific cancer sites. For breast and colorectal cancers, greater reductions were observed for postdiagnosis PA (HR = 0.58-0.63) compared with prediagnosis PA (HR = 0.80-0.86) for cancer-specific and all-cause mortality. Survival benefits through PA were observed in most subgroups (within sex, body mass index, menopausal status, colorectal subtypes, and PA domain) examined. Inverse dose-response relationships between PA and breast cancer-specific and all-cause mortality were observed, with steep reductions in hazards to 10-15 metabolic equivalent hours per week. CONCLUSION: Higher prediagnosis and postdiagnosis levels of PA were associated with improved survival outcomes for at least 11 cancer types, providing support for global promotion of PA guidelines following cancer.

This article has no abstract

BACKGROUND: : Physical activity has been shown to be beneficial for the prevention and management of hypertension. In the general population, physical activity has been shown to decrease mortality. PURPOSE: : The purpose of this systematic review was to identify and synthesize the literature examining the impact of physical activity on mortality in patients with high blood pressure (BP). METHODS: : An extensive search was conducted by two independent authors using Medline, Embase and Cochrane Library electronic databases (between 1985 and January 2012) and manual search from the reference list of relevant articles. Inclusion criteria were as follows: longitudinal design with minimum 1-year follow-up; hypertensive status of the cohort was indicated; and BP, physical activity, and mortality were measured. RESULTS: : Six articles evaluating a combined total of 48 448 men and 47 625 women satisfied the inclusion criteria. Cardiovascular and/or all-cause mortality were shown to be inversely related to physical activity in all studies. For example, patients with high BP who participated in any level of physical activity had a reduced risk (by 16-67%) of cardiovascular mortality, whereas a greater than two-fold increase in risk of mortality was noted in nonactive individuals. However, activity classification and parameters, such as frequency, duration, intensity, and volume, as well as BP status, were not consistent across studies. CONCLUSIONS: : Regular physical activity is beneficial for reducing mortality in patients with high BP. More research is needed to establish the impact of specific kinds of physical activity and whether any differences exist between sexes.

BACKGROUND Physical activity (PA) is considered a cornerstone of diabetes mellitus management to prevent complications, but conclusive evidence is lacking. METHODS This prospective cohort study and meta-analysis of existing studies investigated the association between PA and mortality in individuals with diabetes. In the EPIC study (European Prospective Investigation Into Cancer and Nutrition), a cohort was defined of 5859 individuals with diabetes at baseline. Associations of leisure-time and total PA and walking with cardiovascular disease (CVD) and total mortality were studied using multivariable Cox proportional hazards regression models. Fixed- and random-effects meta-analyses of prospective studies published up to December 2010 were pooled with inverse variance weighting. RESULTS In the prospective analysis, total PA was associated with lower risk of CVD and total mortality. Compared with physically inactive persons, the lowest mortality risk was observed in moderately active persons: hazard ratios were 0.62 (95% CI, 0.49-0.78) for total mortality and 0.51 (95% CI, 0.32-0.81) for CVD mortality. Leisure-time PA was associated with lower total mortality risk, and walking was associated with lower CVD mortality risk. In the meta-analysis, the pooled random-effects hazard ratio from 5 studies for high vs low total PA and all-cause mortality was 0.60 (95% CI, 0.49-0.73). CONCLUSIONS Higher levels of PA were associated with lower mortality risk in individuals with diabetes. Even those undertaking moderate amounts of activity were at appreciably lower risk for early death compared with inactive persons. These findings provide empirical evidence supporting the widely shared view that persons with diabetes should engage in regular PA.