Leisure time sports activity and all-cause mortality in West Germany (1984?1998)

Association of high amounts of physical activity with mortality risk: a systematic review and meta-analysis

OBJECTIVES

To systematically review and analyse studies of high amounts of physical activity and mortality risk in the general population.

ELIGIBILITY CRITERIA

Inclusion criteria related to follow-up (minimum 2 years), outcome (mortality from all causes, cancer, cardiovascular disease (CVD) or coronary heart disease), exposure (eg, a category of >1000 metabolic equivalent of task (MET) min/week), study design (prospective cohort, nested case control or case-cohort) and reports of cases and person years of exposure categories.

INFORMATION SOURCES

Systematic searches were conducted in Embase and Pubmed from database inception to 2 March 2019.

RISK OF BIAS

The quality of the studies was assessed with the Newcastle-Ottawa scale.

INCLUDED STUDIES

From 31 368 studies identified, 48 were included. Two authors independently extracted outcome estimates and assessed study quality.

SYNTHESIS OF RESULTS

We estimated hazard ratios (HRs) using random effect restricted cubic spline dose-response meta-analyses. Compared with the recommended level of physical activity (750 MET min/week), mortality risk was lower at physical activity levels exceeding the recommendations, at least until 5000 MET min/week for all cause mortality (HR=0.86, 95% CI 0.78 to 0.94) and for CVD mortality (HR=0.73, 95% CI 0.56 to 0.95).

STRENGTHS AND LIMITATIONS OF EVIDENCE

The strengths of this study include the detailed dose-response analyses, inclusion of 48 studies and examination of sources of heterogeneity. The limitations include the observational nature of the included studies and the inaccurate estimations of amount of physical activity.

INTERPRETATION

Compared with the recommended level, mortality risk was lower at physical activity levels well above the recommended target range. Further, there was no threshold beyond which lifespan was compromised.

REGISTRATION

PROSPERO CRD42017055727.

Subjective well-being and exercise in the second half of life: a critical review of theoretical approaches

Research has shown repeatedly that the “feeling better” effect of exercise is far more moderate than generally claimed. Examinations of subgroups in secondary analyses also indicate that numerous further variables influence this relationship. One reason for inconsistencies in this research field is the lack of adequate theoretical analyses. Well-being output variables frequently possess no construct definition, and little attention is paid to moderating and mediating variables. This article integrates the main models in an overview and analyzes how secondary analyses define well-being and which areas of the construct they focus on. It then applies a moderator and/or mediator framework to examine which person and environmental variables can be found in the existing explanatory approaches in sport science and how they specify the influence of these moderating and mediating variables. Results show that the broad understanding of well-being in many secondary analyses makes findings difficult to interpret. Moreover, physiological explanatory approaches focus more on affective changes in well-being, whereas psychological approaches also include cognitive changes. The approaches focus mostly on either physical or psychological person variables and rarely combine the two, as in, for example, the dual-mode model. Whereas environmental variables specifying the treatment more closely (e.g., its intensity) are comparatively frequent, only the social support model formulates variables such as the framework in which exercise is presented. The majority of explanatory approaches use simple moderator and/or mediator models such as the basic mediated (e.g., distraction hypothesis) or multiple mediated (e.g., monoamine hypotheses) model. The discussion draws conclusions for future research.

Physical activity, mortality, and cardiovascular disease: is domestic physical activity beneficial? The Scottish Health Survey -- 1995, 1998, and 2003

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.