Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 1:370:m2031.
doi: 10.1136/bmj.m2031.

Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study

Min Zhao  1   2 , Sreenivas P Veeranki  3   4 , Costan G Magnussen  5   6   7 , Bo Xi  8
Affiliations

Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study

Min Zhao et al. BMJ. .

Abstract

Objective: To determine the association between recommended physical activity according to the 2018 physical activity guidelines for Americans and all cause and cause specific mortality using a nationally representative sample of US adults.

Design: Population based cohort study.

Setting: National Health Interview Survey (1997-2014) with linkage to the National Death Index records to 31 December 2015.

Participants: 479 856 adults aged 18 years or older.

Exposures: Participant self-reports of the amount of leisure time spent in aerobic physical activity and muscle strengthening activity each week were combined and categorised into four groups: insufficient activity, aerobic activity only, muscle strengthening only, and both aerobic and muscle strengthening activities according to the physical activity guidelines.

Main outcome measures: All cause mortality and cause specific mortality (cardiovascular disease, cancer, chronic lower respiratory tract diseases, accidents and injuries, Alzheimer's disease, diabetes mellitus, influenza and pneumonia, and nephritis, nephrotic syndrome, or nephrosis) obtained from the National Death Index records.

Results: During a median follow-up of 8.75 years, 59 819 adults died from all causes, 13 509 from cardiovascular disease, 14 375 from cancer, 3188 from chronic lower respiratory tract diseases, 2477 from accidents and injuries, 1470 from Alzheimer's disease, 1803 from diabetes mellitus, 1135 from influenza and pneumonia, and 1129 from nephritis, nephrotic syndrome, or nephrosis. Compared with those who did not meet the physical activity guidelines (n=268 193), those who engaged in recommended muscle strengthening activity (n=21 428; hazard ratio 0.89, 95% confidence interval 0.85 to 0.94) or aerobic activity (n=113 851; 0.71, 0.69 to 0.72) were found to be at reduced risk of all cause mortality; and even larger survival benefits were found in those engaged in both activities (n=76 384; 0.60, 0.57 to 0.62). In addition, similar patterns were reported for cause specific mortality from cardiovascular disease, cancer, and chronic lower respiratory tract diseases.

Conclusions: Adults who engage in leisure time aerobic and muscle strengthening activities at levels recommended by the 2018 physical activity guidelines for Americans show greatly reduced risk of all cause and cause specific mortality. These data suggest that the physical activity levels recommended in the guidelines are associated with important survival benefits.

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support from the Innovation Team of “Climbing” Program of Shandong University, Youth Team of Humanistic and Social Science of Shandong University, and National Heart Foundation of Australia future leader fellowship for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig 1
Fig 1
Association between meeting the 2018 physical activity guidelines for Americans and all cause and cause specific mortality from three diseases. Estimates are from the fully adjusted model that includes the covariates of sex, age, race/ethnicity, education, marital status, body mass index, smoking, alcohol intake, and chronic conditions. Whiskers represent 95% confidence intervals
See this image and copyright information in PMC

Comment in

References

    1. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, Lancet Physical Activity Series Working Group Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012;380:219-29. 10.1016/S0140-6736(12)61031-9. - DOI - PMC - PubMed
    1. Ding D, Lawson KD, Kolbe-Alexander TL, et al. Lancet Physical Activity Series 2 Executive Committee The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet 2016;388:1311-24. 10.1016/S0140-6736(16)30383-X. - DOI - PubMed
    1. Kyu HH, Bachman VF, Alexander LT, et al. Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013. BMJ 2016;354:i3857. 10.1136/bmj.i3857. - DOI - PMC - PubMed
    1. Ekelund U, Tarp J, Steene-Johannessen J, et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ 2019;366:l4570. 10.1136/bmj.l4570. - DOI - PMC - PubMed
    1. US Department of Health and Human Services Physical Activity Guidelines for Americans. 2nd ed US Department of Health and Human Services, 2018.