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Shams-White MM, Brockton NT, Mitrou P, Kahle LL, Reedy J. The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score and All-Cause, Cancer, and Cardiovascular Disease Mortality Risk: A Longitudinal Analysis in the NIH-AARP Diet and Health Study. Curr Dev Nutr 2022; 6:nzac096. [PMID: 35755938 PMCID: PMC9217081 DOI: 10.1093/cdn/nzac096] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/07/2022] [Accepted: 05/12/2022] [Indexed: 08/21/2023] Open
Abstract
Background The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) published Cancer Prevention Recommendations in 2018 focused on modifiable lifestyle factors. Objectives The aim was to examine how adherence to WCRF/AICR recommendations via the 2018 WCRF/AICR score is associated with risk for all-cause, cancer, and cardiovascular disease (CVD) mortality outcomes among older US adults. Methods Baseline and follow-up questionnaire data (n = 177,410) were used to calculate weight, physical activity, and diet components of the 2018 WCRF/AICR score (0-7 total points). Adjusted HRs and 95% CIs were estimated, stratified by sex and smoking status. Results There were 16,055 deaths during a mean of 14.2 person-years. Each 1-point score increase was associated with a 9-26% reduced mortality risk for all outcomes, except for current male smokers' cancer mortality risk. When the score was categorized comparing highest (5-7 points) with lowest (0-2 points) scores, associations with reduced all-cause mortality risk were strongest in former smokers (HRmales: 0.51; 95% CI: 0.43, 0.61; HRfemales: 0.38; 95% CI: 0.31, 0.46), followed by current smokers (HRmales: 0.55; 95% CI: 0.34, 0.89; HRfemales: 0.44; 95% CI: 0.32, 0.59) and never smokers (HRmales: 0.57; 95% CI: 0.47, 0.70; HRfemales: 0.50; 95% CI: 0.41, 0.60). An association with cancer mortality risk was also seen in former smokers (HRmales: 0.59; 95% CI: 0.43, 0.81; HRfemales: 0.52; 95% CI: 0.37, 0.73) and female current (HRfemales: 0.55; 95% CI: 0.32, 0.96) and never (HRfemales: 0.57; 95% CI: 0.40, 0.80) smokers; findings were not statistically significant in other strata. For CVD mortality, highest compared with lowest scores were associated with a 49-73% risk reduction, except in male never and current smokers. In exploratory analysis, physical activity, body weight, alcohol, and plant-based foods were found to be predominant components in the score. Conclusions Greater 2018 WCRF/AICR scores were associated with lower mortality risk among older adults. Future research can explore how smoking modifies these relations, and further examine different populations and other cancer-relevant outcomes.
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Affiliation(s)
- Marissa M Shams-White
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | | | - Panagiota Mitrou
- World Cancer Research Fund International, London, United Kingdom
| | - Lisa L Kahle
- Information Management Services, Inc., Rockville, MD, USA
| | - Jill Reedy
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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Stamatakis E, Huang BH, Maher C, Thøgersen-Ntoumani C, Stathi A, Dempsey PC, Johnson N, Holtermann A, Chau JY, Sherrington C, Daley AJ, Hamer M, Murphy MH, Tudor-Locke C, Gibala MJ. Untapping the Health Enhancing Potential of Vigorous Intermittent Lifestyle Physical Activity (VILPA): Rationale, Scoping Review, and a 4-Pillar Research Framework. Sports Med 2021; 51:1-10. [PMID: 33108651 PMCID: PMC7806564 DOI: 10.1007/s40279-020-01368-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Recently revised public health guidelines acknowledge the health benefits of regular intermittent bouts of vigorous intensity incidental physical activity done as part of daily living, such as carrying shopping bags, walking uphill, and stair climbing. Despite this recognition and the advantages such lifestyle physical activity has over continuous vigorous intensity structured exercise, a scoping review we conducted revealed that current research in this area is, at best, rudimentary. Key gaps include the absence of an empirically-derived dose specification (e.g., minimum duration of lifestyle physical activity required to achieve absolute or relative vigorous intensity), lack of acceptable measurement standards, limited understanding of acute and chronic (adaptive) effects of intermittent vigorous bouts on health, and paucity of essential information necessary to develop feasible and scalable interventions (e.g., acceptability of this kind of physical activity by the public). To encourage collaboration and research agenda alignment among groups interested in this field, we propose a research framework to further understanding of vigorous intermittent lifestyle physical activity (VILPA). This framework comprises four pillars aimed at the development of: (a) an empirical definition of VILPA, (b) methods to reliably and accurately measure VILPA, (c) approaches to examine the short and long-term dose-response effects of VILPA, and (d) scalable and acceptable behavioural VILPA-promoting interventions.
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Affiliation(s)
- Emmanuel Stamatakis
- School of Health Sciences, Charles Perkins Centre, The University of Sydney, Faculty of Medicine and Health, Hub D17, L6 West, Sydney, NSW, Australia.
| | - Bo-Huei Huang
- School of Health Sciences, Charles Perkins Centre, The University of Sydney, Faculty of Medicine and Health, Hub D17, L6 West, Sydney, NSW, Australia
| | - Carol Maher
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Cecilie Thøgersen-Ntoumani
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
| | - Afroditi Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Paddy C Dempsey
- Physical Activity and Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Nathan Johnson
- School of Health Sciences, Charles Perkins Centre, The University of Sydney, Faculty of Medicine and Health, Hub D17, L6 West, Sydney, NSW, Australia
| | - Andreas Holtermann
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark
| | - Josephine Y Chau
- Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - Catherine Sherrington
- Institute of Musculoskeletal Health, University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health, Sydney, Australia
| | - Amanda J Daley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Mark Hamer
- Institute Sport Exercise Health, Faculty Medical Sciences, University College London, London, UK
| | - Marie H Murphy
- Doctoral College, Ulster University, Newtownabbey, Co Antrim, BT37 0QB, Northern Ireland, UK
| | - Catrine Tudor-Locke
- Department of Kinesiology, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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