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HU SS. Influencing Factors on Cardiovascular Health in China. J Geriatr Cardiol 2024; 21:4-33. [PMID: 38440341 PMCID: PMC10908586 DOI: 10.26599/1671-5411.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. This is the first section of the report, which dissects influential factors across diverse domains. The investigation identifies tobacco use as a paramount concern, portraying China as the global epicenter of tobacco consumption. Cigarette smoking, exacerbated by second-hand smoke exposure, emerges as a critical and preventable risk factor, contributing to a surge in attributable deaths over the past three decades. In the realm of dietary nutrition, the study discerns an overall improvement, yet discerns worrisome deviations, notably an escalating fat intake surpassing recommended guidelines. The shifting dietary structure reveals diminished consumption of cereals and vegetables juxtaposed with an uptick in animal foods, while excessive intake of cooking oil and salt persists, straying substantially from endorsed levels. The exploration of physical activity patterns unfolds a nuanced narrative. Varied trends are observed among students, with concerns arising from sedentary behaviors and inadequate adherence to recommended guidelines. The analysis spans a trajectory of declining physical activity in Chinese adults, coupled with an alarming surge in sedentary leisure time, ultimately linking these factors to heightened risks of cardiovascular diseases and increased adiposity. An examination of overweight and obesity trends uncovers a relentless upward trajectory, projecting substantial prevalence by 2030. Noteworthy prevalence rates underscore the imperative for targeted interventions to curtail this burgeoning health crisis, with the anticipated prevalence extending to nearly two-thirds of the adult population. Psychological factors, notably depression, constitute an integral facet of cardiovascular health. Prevalence rates among patients with coronary artery disease and acute myocardial infarction underscore the intricate interplay between mental health and cardiovascular outcomes. Additionally, persistent depressive symptoms are shown to significantly elevate the risk of cardiovascular diseases and mortality. This first section underscores the multifaceted challenges facing cardiovascular health in China, emphasizing the imperative for tailored interventions across tobacco control, dietary habits, physical activity, obesity management, and psychological well-being to mitigate the escalating burden of cardiovascular diseases in the population.
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Affiliation(s)
- Sheng-Shou HU
- Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, China
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Lei XL, Gao K, Wang H, Chen W, Chen GR, Wen X. The role of physical activity on healthcare utilization in China. BMC Public Health 2023; 23:2378. [PMID: 38037037 PMCID: PMC10691091 DOI: 10.1186/s12889-023-16625-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/26/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Evidence on the role of physical activity (PA) on healthcare utilization and expenditure is limited in China. We aimed to examine the association between the total physical activity (TPA) per week, healthcare service use and expenditure. METHODS We extracted the data from China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, and 2015. Participants more than 50 years old who completed the follow-up for the three waves were enrolled. We converted the volume of vigorous physical activity (VPA) into an equivalent volume of moderate physical activity (MPA) and calculated the TPA per week for each participant. 12,927 of the 17,708 participants in CHARLS were included in our analysis. More than one-third of participants over 50 years old never participate in any moderate or intensity activity, and the median of self-reported moderate or intensity PA was about 525 (IQR 0-1680) MET-minutes per week in 2015. RESULTS Compared to inactive subjects, the highest level of TPA was significantly related to the decreased risk number of inpatient visits (IRR: 0.58; 95% CI:0.50-0.67, p < 0.001), inpatient hospital days (IRR: 0.60; 95% CI: 0.42-0.84, p < 0.01), healthcare expenditure (IRR: 0.71; 95% CI: 0.65-0.79, p < 0.001) and catastrophic health expenditures (OR: 0.57; 95% CI: 0.45-0.72, p < 0.001) after adjusting for covariates. CONCLUSIONS Engaging in moderate-to-vigorous PA may drive a potential decrease in healthcare utilization, healthcare expenditure and household financial risk with a dose-response relationship in China, and some possible policy implications in public health may be considered to promote exercise in the middle-aged and elderly to reduce the medical burden on individuals and healthcare systems.
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Affiliation(s)
- Xiao-Lin Lei
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Ke Gao
- Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Huan Wang
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Wei Chen
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Gen-Rui Chen
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China.
| | - Xing Wen
- The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu &The Affiliated Hospital of Southwest, Jiaotong University, Chengdu, 610032, China.
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Lin B, Zhang Z, Zhang W, Zhang C, Xue L, An B, Wang K. Associations of physical activity types and intensity with cardiovascular diseases by age and gender among 18,730 Chinese adults. Sci Rep 2023; 13:14623. [PMID: 37670128 PMCID: PMC10480160 DOI: 10.1038/s41598-023-41768-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/31/2023] [Indexed: 09/07/2023] Open
Abstract
The associations of physical activity (PA) intensity and types with CVD (cardiovascular diseases) in different population are inconsistent and remains not very clear. A total of 7854 males and 10,876 females over 15 years were selected by multistage random sampling methods. In males, moderate-intensity physical activity (MPA) had no effect, while vigorous-intensity physical activity (VPA) played a significant protective role (OR = 1.319 and 0.615). However, in females, both MPA and VPA had significant protective effects (OR = 0.593 and 0.537). VPA presented as a significant protective factor in stroke patients and combined CVDs for males in all age groups; however, in females, the results suggested that, for those aged over 60-74 years, MPA was a protective factor. Furthermore, for the middle-aged or younger participants, the area under the curves (AUCs) of work, housework, and leisure activity were generally higher than that of other types, while for patients aged over 60 years, the AUCs of sedentary time and sleep activity seemed much higher. VPA had a better protective effect for preventing cardiovascular events, while the young and female population could benefit from MPA as well. Regardless of the types of PA, leisure activities were strongly recommended, and young people were much more likely to benefit from exercise than older people.
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Affiliation(s)
- Beilei Lin
- Nursing and Health School of Zhengzhou University, Zhengzhou, China
- Huaxian People Hospital of Henan Province, Anyang, China
| | - Zhenxiang Zhang
- Nursing and Health School of Zhengzhou University, Zhengzhou, China
| | - Weihong Zhang
- Nursing and Health School of Zhengzhou University, Zhengzhou, China
| | - Chunhui Zhang
- Nursing and Health School of Zhengzhou University, Zhengzhou, China
| | - Lihong Xue
- Huaxian People Hospital of Henan Province, Anyang, China
| | - Baoxia An
- Huaxian People Hospital of Henan Province, Anyang, China
| | - Kaijuan Wang
- Public Health School of Zhengzhou University, Zhengzhou, China.
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Garcia L, Pearce M, Abbas A, Mok A, Strain T, Ali S, Crippa A, Dempsey PC, Golubic R, Kelly P, Laird Y, McNamara E, Moore S, de Sa TH, Smith AD, Wijndaele K, Woodcock J, Brage S. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies. Br J Sports Med 2023; 57:979-989. [PMID: 36854652 PMCID: PMC10423495 DOI: 10.1136/bjsports-2022-105669] [Citation(s) in RCA: 41] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
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Affiliation(s)
- Leandro Garcia
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Matthew Pearce
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ali Abbas
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alexander Mok
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Tessa Strain
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Sara Ali
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rajna Golubic
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport, Physical Education and Health Sciences, Edinburgh, UK
| | - Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Eoin McNamara
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Economic and Social Research Institute, Dublin, Ireland
| | - Samuel Moore
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Thiago Herick de Sa
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Choi J, Park J, Kim J, Lee M, Lee K, Lee J, Kang D, Shin A, Choi J. Impact of pre- and post-diagnosis physical activity on the mortality of patients with cancer: Results from the Health Examinees-G study in Korea. Cancer Med 2023; 12:16591-16603. [PMID: 37317668 PMCID: PMC10469756 DOI: 10.1002/cam4.6253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/28/2023] [Accepted: 06/02/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Physical activity (PA) is recommended to improve the survival of cancer patients. However, the prognostic impact of specific PAs is not well understood. Therefore, we investigated the associations of the duration, type, intensity, and number of PAs one participates in pre- and post-diagnosis with mortality in Korean patients with cancer. METHODS Among the participants aged 40-69 years recruited from the Health Examines study, those diagnosed with cancer after baseline (n = 7749) and within 10 years before baseline (n = 3008) were included in the analyses for pre- and post-diagnosis PA, respectively. Duration, intensity, type, and number of leisure-time physical activities participated in were assessed using questionnaires. The Cox proportional hazard model was used to characterize the association between PA and cancer-specific mortality, adjusting for demographics, behaviors, comorbidities, and cancer stage based on the Surveillance, Epidemiology, and End Results program. RESULTS Pre-diagnosis, patients participating in vigorous-intensity activities (hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.61-0.82), walking (HR: 0.85, 95% CI: 0.74-0.97), climbing (HR: 0.65, 95% CI: 0.55-0.77), sports (HR: 0.39, 95% CI: 0.25-0.61), and more than two activities (HR: 0.73, 95% CI: 0.63-0.86) had significantly lower all-cause mortality. Importantly, these associations were only found in patients with colorectal cancer participating in vigorous-intensity activities (HR: 0.40, 95% CI: 0.23-0.70). Post-diagnosis, only patients who performed more than two activities (HR: 0.65, 95% CI: 0.44-0.95) had significantly lower all-cause mortality. Similar associations were found for cancer mortality, both pre- and post-diagnosis. CONCLUSION Specific characteristics of PA pre- and post-diagnosis may influence the survival of cancer patients.
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Affiliation(s)
- Jaesung Choi
- Institute of Health Policy and ManagementSeoul National University Medical Research CenterSeoulSouth Korea
| | - Joo‐Yong Park
- Department of Big Data Medical ConvergenceEulji UniversitySeongnam‐SiSouth Korea
| | - Ji‐Eun Kim
- Department of Biomedical SciencesSeoul National University Graduate SchoolSeoulSouth Korea
| | - Miyoung Lee
- College of Physical Education and Sport ScienceKookmin UniversitySeoulSouth Korea
| | - Kyuwan Lee
- Department of Population SciencesBeckman Research Institute, City of Hope (COH)DuarteCaliforniaUSA
| | - Jong‐Koo Lee
- Department of Family MedicineCollege of MedicineSeoul National UniversitySeoulSouth Korea
| | - Daehee Kang
- Department of Big Data Medical ConvergenceEulji UniversitySeongnam‐SiSouth Korea
- Department of Biomedical SciencesSeoul National University Graduate SchoolSeoulSouth Korea
- Department of Preventive MedicineSeoul National University College of MedicineSeoulSouth Korea
- Cancer Research InstituteSeoul National UniversitySeoulSouth Korea
| | - Aesun Shin
- Department of Preventive MedicineSeoul National University College of MedicineSeoulSouth Korea
- Cancer Research InstituteSeoul National UniversitySeoulSouth Korea
| | - Ji‐Yeob Choi
- Institute of Health Policy and ManagementSeoul National University Medical Research CenterSeoulSouth Korea
- Department of Biomedical SciencesSeoul National University Graduate SchoolSeoulSouth Korea
- Department of Preventive MedicineSeoul National University College of MedicineSeoulSouth Korea
- Cancer Research InstituteSeoul National UniversitySeoulSouth Korea
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Pradhan P, Wen W, Cai H, Gao YT, Shu XO, Zheng W. Prospective Cohort Study of Ginseng Consumption in Association with Cancer Risk: Shanghai Women's Health Study. J Nutr 2023; 153:1170-1177. [PMID: 36863482 PMCID: PMC10356994 DOI: 10.1016/j.tjnut.2023.02.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Ginseng has been commonly used in Asian countries to promote longevity and health for >2000 years. Recent in vitro and in vivo studies, coupled with limited epidemiologic studies, have suggested that regular ginseng consumption may be related to lower cancer risk. OBJECTIVES We evaluated the association of ginseng consumption with risk of total and 15 site-specific cancers in a large cohort study conducted among Chinese women. Given the previous literature on ginseng consumption and cancer risk, we hypothesized that ginseng consumption might be associated with varying risks of cancer. METHODS This study included 65,732 female participants (mean age: 52.2 years) of the Shanghai Women's Health Study, an ongoing prospective cohort study. Baseline enrollment occurred between 1997 and 2000, and follow-up concluded on 31 December 2016. Ginseng use and covariates were assessed via an in-person interview conducted at the baseline recruitment. The cohort was followed for cancer incidence. Cox proportional hazard models were used to estimate HRs and 95% CIs for ginseng-cancer associations after adjusting for confounders. RESULTS During a mean 14.7 years of follow-up, 5067 incident cancer cases were identified. Overall, regular ginseng use was mostly not associated with risk of any site-specific cancer, or all cancers combined. Short-term (<3 years) ginseng use was found to be significantly associated with increased risk of liver cancer (HR = 1.71; 95% CI: 1.04, 2.79; P = 0.035), whereas long-term (≥3 years) ginseng use was found to be associated with increased risk of thyroid cancer (HR = 1.40; 95% CI: 1.02, 1.91; P = 0.036). Long-term ginseng use was found to be significantly associated with decreased risk of lymphatic and hematopoietic tissue malignancy (HR = 0.67; 95% CI: 0.46, 0.98; P = 0.039) and non-Hodgkin's lymphoma (HR = 0.57; 95% CI: 0.34, 0.97; P = 0.039). CONCLUSIONS This study provides suggestive evidence that ginseng consumption may be associated with risk of certain cancers.
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Affiliation(s)
- Pranoti Pradhan
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Wei Zheng
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China.
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Wong MYC, Ou KL, Chung PK, Chui KYK, Zhang CQ. The relationship between physical activity, physical health, and mental health among older Chinese adults: A scoping review. Front Public Health 2023; 10:914548. [PMID: 36684983 PMCID: PMC9853435 DOI: 10.3389/fpubh.2022.914548] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
The aging Chinese population is growing fast, and the proportion of the population aged 60 years old is projected to reach 28% by 2040, estimated 402 million. With increased life expectancy, the aging population tends to suffer from health risks and diseases, which create a burden on public health policy. Hence, it is essential to promote healthy and active aging, which includes improving older adults' physical and mental capacities and advocating for the achievement of a healthy life expectancy. Despite the rapidly growing aging population in China, there have been no reviews investigating the effect of physical activity on physical and mental health among older Chinese adults. Therefore, the current study aimed to review studies from the past 15 years that illustrate the effect of physical activity on physical and mental health among Chinese older adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR), this review addresses the associations between physical activity, physical health and mental health among older Chinese adults. A total of 371 studies were included in the scoping review, which covered the relationships between physical activity, physical health and mental health variables. The scoping review also revealed the impact of various kinds of physical activity affecting older adults' physical health, such as functional fitness, body composition, fall risk and balance, and mental health issues, such as depression, anxiety, cognitive function and quality of life. Moreover, studies have identified innovative forms of physical activity as emerging trends in physical activity interventions for older adults. To conclude, this scoping review captured the common effects between physical activity and overall wellbeing, including physical, mental, and cognitive health. Additionally, diverse forms of physical activity intervention, such as group-based and supervised individual interventions, should be supported, and cross-cultural exercise comparisons should be made in future explorations.
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Affiliation(s)
- Ming Yu Claudia Wong
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Kai-ling Ou
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Pak Kwong Chung
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Kei Yee Katie Chui
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Chun-qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
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Suutari-Jääskö A, Parkkila K, Perkiömäki J, Huikuri H, Kesäniemi YA, Ukkola OH. Leisure time and occupational physical activity, overall and cardiovascular mortality: a 24-year follow-up in the OPERA study. Ann Med 2023; 55:2245429. [PMID: 37585501 PMCID: PMC10435002 DOI: 10.1080/07853890.2023.2245429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND In earlier studies, the health benefits of physical activity have only been related to leisure time physical activity (LTPA). High occupational physical activity (OPA) might even be harmful. The current physical activity recommendations do not separate the OPA and LTPA. We investigated the effect of LTPA and OPA on cardiovascular morbidity and mortality during long-term follow-up. We also examined how heavy work affects the benefits of leisure time exercise. MATERIAL AND METHODS The study was part of the OPERA study and the baseline examinations were conducted between the years 1991 and 1993. The Follow-up of events continued until the end of the year 2020. Study subjects (n = 1044) were divided into four groups according to their LTPA ("no exercise", "irregular", "regular" and "heavy regular") and into three groups according to their OPA ("no activity", "mild" and "heavy"). The amount of exercise was self-reported and the exercise status was defined at the beginning of the study. Study subjects were followed up for their overall mortality (26 years), fatal and non-fatal CVD events (24 and 20 years) and heart failure (20 years). The survival analysis was performed using Kaplan-Meier curves and Cox-proportional hazard models. RESULTS "Heavy" OPA group subjects belonging to the "irregular" (less than 1-2 times 30 min exercise per week) LTPA group experienced the lowest overall mortality compared to other LTPA groups. Also, overall mortality was increased in the "mild" (p = 0.002) and CVD mortality in the" heavy" (p = 0.005) OPA group compared to "no activity". The incidence of heart failure was increased in the "no exercise" LTPA compared to the "heavy regular" (p = 0.015) group. CONCLUSIONS Study subjects who were in physically demanding occupations (heavy OPA) seemed to benefit from less LTPA than WHO currently recommends. Thus we suggest targeting different LTPA recommendations to different OPA groups.
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Affiliation(s)
- Asla Suutari-Jääskö
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Karri Parkkila
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Juha Perkiömäki
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Heikki Huikuri
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Y. Antero Kesäniemi
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Olavi H. Ukkola
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
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Hu P, Zheng M, Huang J, Zhao W, Wang HHX, Zhang X, Chen Y, Deng H, Qin P, Liu X. Association of Habitual Physical Activity With the Risk of All-Cause Mortality Among Chinese Adults: A Prospective Cohort Study. Front Public Health 2022; 10:919306. [PMID: 35812492 PMCID: PMC9263353 DOI: 10.3389/fpubh.2022.919306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/27/2022] [Indexed: 01/09/2023] Open
Abstract
ObjectiveThis study was conducted to evaluate the association of the risk of all-cause mortality with habitual physical activity (HPA) and its different domains among Chinese adults.MethodsA total of 11,994 participants from the Guangzhou Heart Study were followed up until 1 January 2020. Information on HPA, including leisure-time physical activity (LTPA) and commute activity, was collected using a modified Global Physical Activity Questionnaire. Individual cause of death was obtained from the National Death Registry of China. Cox proportional hazards regression model was used to estimate hazard ratio (HR) and 95% confidence interval (CI) after adjustment for covariates.ResultsDuring 37,715 person-years of follow-up, 208 deaths (1.73%) were observed. When compared with the highest with the lowest exposure tertiles, HPA and LTPA were associated with 34% (HR: 0.66, 95% CI: 0.46–0.95) and 30% (HR: 0.70, 95% CI: 0.49–0.99) reduced risk of all-cause mortality after adjustment for covariates. Commute activity was not associated with mortality risk. For the specific component of LTPA, we found that every 1 MET-h/week increment of the housework was associated with a 1% (HR: 0.99, 95% CI: 0.98–0.99) decreased mortality risk, and performing brisk walking/health exercises/Yangko was associated with a 46% reduced mortality risk (HR: 0.54, 95% CI: 0.29–0.99).ConclusionThis study suggests that a higher level of HPA and LTPA was associated with a lower risk of all-cause mortality. Our findings suggest people to perform HPA, especially LTPA, as a strategy for mortality reduction and health promotion.
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Affiliation(s)
- Peng Hu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Murui Zheng
- Department of Community Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jun Huang
- Department of Geriatrics, Institute of Geriatrics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Harry H. X. Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Harry H. X. Wang
| | - Xiong Zhang
- Department of Neurology, Maoming People's Hospital, Maoming, China
| | - Yuanyuan Chen
- Department of Chronic Noncommunicable Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Pengzhe Qin
- Department of Chronic Noncommunicable Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Pengzhe Qin
| | - Xudong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Xudong Liu
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Association between physical activity energy expenditure and cardiometabolic risk factor clustering among Chinese adults in 2015. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:105-111. [PMID: 35782276 PMCID: PMC9219286 DOI: 10.1016/j.smhs.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/02/2022] [Accepted: 04/05/2022] [Indexed: 11/21/2022] Open
Abstract
To understand the association between cardiometabolic risk factor (CMRF) clustering and physical activity (PA) levels, we included 86520 Chinese adults aged 18–64 years having at least one CMRF (hypertension, diabetes, dyslipidemia, or obesity) from the China Chronic Disease and Nutrition Surveillance survey in 2015, a nationally and provincially representative investigation with a multistage clustering sampling design. Self-reported PA information was collected with the Global Physical Activity Questionnaire through face-to-face interviews. In view of the obesity epidemic in CMRF patients, PA energy expenditure (PAEE) per kilogram body weight was used, and was defined into four categories: (i) inactivity: 0 kJ/kg/day; (ii) low activity: 0–5 kJ/kg/day; (iii) moderate activity: 6–11 kJ/kg/day; and (iv) vigorous activity: ≥ 12 kJ/kg/day. The estimated weighted prevalence (95% confidence interval [CI]) of having 1, 2, 3, and 4 CMRFs was 60.57% (59.48%–61.67%), 28.10% (27.40%–28.79%), 9.82% (9.22%–15.42%) and 1.50% (1.37%–1.63%), respectively. The rate (95%CI) of inactivity, low activity, moderate activity, and vigorous activity was 34.52% (32.69%–36.35%), 22.22% (21.37%–23.37%), 15.98% (15.38%–16.58%) and 27.28% (26.02%–28.53%), respectively. For those having 2, 3 and 4 CMRFs (compared to those having 1 CMRF), the adjusted odds ratio (95%CI) for moderate activity and vigorous activity were 0.91 (0.85–0.98) and 0.92 (0.85–0.99), 0.87 (0.80–0.95) and 0.84 (0.77–0.92), and 0.77 (0.67–0.89) and 0.85 (0.72–1.00), respectively. In conclusion, CMRF clustering was a pandemic among Chinese adults in 2015 and was inversely associated with PA level. PAEE (in kJ/kg/day) may be introduced into PA management practice, especially for populations with high body weight.
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Pradhan P, Wen W, Cai H, Gao YT, Yang G, Shu XO, Zheng W. Association of ginseng consumption with all-cause and cause-specific mortality: Shanghai Women’s Health Study. J Epidemiol 2022; 32:469-475. [PMID: 35400709 PMCID: PMC9424189 DOI: 10.2188/jea.je20210393] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Pranoti Pradhan
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center
| | - Xiao-ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center
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Wang M, Huang Y, Song Y, Chen J, Liu X. Study on Environmental and Lifestyle Factors for the North-South Differential of Cardiovascular Disease in China. Front Public Health 2021; 9:615152. [PMID: 34336751 PMCID: PMC8322531 DOI: 10.3389/fpubh.2021.615152] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
Human death and life span are closely related to the geographical environment and regional lifestyle. These factors considerably vary among counties and regions, leading to the geographical disparity of disease. Quantitative studies on this phenomenon are insufficient. Cerebrovascular and heart diseases are the leading causes of death. The mortality rate of cerebrovascular and heart diseases is statistically higher in northern China than in southern China; the p-value of t-test for cerebrovascular and heart diseases was 0.047 and 0.000, respectively. The population attribution fraction of 12 major risk factors for cardiovascular disease (CVD) in each province was calculated based on their exposure and relative risk. The results found that residents in northern China consume high sodium-containing food, fewer vegetables, and less sea food products, and tend to be overweight. Fine particulate matter is higher in northern China than in southern China. Cold temperatures also cause a greater number of deaths than hot temperatures. All these factors have resulted in a higher CVD mortality rate in northern China. The attributive differential for sodium, vegetable, fruit, smoking, PM2.5, omega-3, obesity, low temperature, and high temperature of heart disease between the two parts of China is 9.1, 0.7, -2.5, 0.1, 1.4, 1.3, 2.0, 4.7, and -2.1%, respectively. Furthermore, the attributive differential for the above factors of cerebrovascular disease between the two parts of China is 8.7, 0.0, -5.2, 0.1, 1.0, 0.0, 2.4, 4.7, and -2.1%. Diet high in sodium is the leading cause of the north-south differential in CVD, resulting in 0.71 less years of life expectancy in northern compared with that in southern China.
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Affiliation(s)
- Mengqi Wang
- School of Geographic Sciences, Nantong University, Nantong, China
| | - Yi Huang
- School of Geographic Sciences, Nantong University, Nantong, China
| | - Yanxin Song
- School of Geographic Sciences, Nantong University, Nantong, China
| | - Jianwei Chen
- School of Geographic Sciences, Nantong University, Nantong, China
| | - Xiaoxiao Liu
- School of Geographic Sciences, Nantong University, Nantong, China
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Wiśniowska-Szurlej A, Ćwirlej-Sozańska A, Wołoszyn N, Sozański B, Wilmowska-Pietruszyńska A, Washburn R. Cultural adaptation and validation of the Polish version of the physical activity scale for older people living in a community: a cross-sectional study. Eur Rev Aging Phys Act 2020; 17:19. [PMID: 33292174 PMCID: PMC7679979 DOI: 10.1186/s11556-020-00252-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Polish clinicians and researchers face challenges in selecting physical activity tools appropriate and validated for older people. The aim of this study is to provide cultural adaptation and validation of the Polish version of the Physical Activity Scale for Elderly (PASE-P). METHODS This cross-sectional study was carried out among 115 older adults living in south-eastern Poland. The original version of the scale has been translated into the Polish language following standardized translation procedures. Validation was evaluated by Pearson's rank correlation coefficients between PASE-P, the normal Timed Up and Go test and that with a cognitive task (TUG and TUG cog, respectively), grip strength, basic and instrumental activities of daily living (ADL and IADL, respectively), Five Times Sit to Stand (5x STS), 10-m Walk Test (10MWT), the Berg Balance Scale (BBS) and the International Physical Activity Questionnaire (IPAQ). RESULTS The mean PASE-P was 91.54 (SD 71.15). Sufficient reliability of the test-retest of the PASE-P questionnaire components was found between the trials. The ICC test was strong and ranged from 0.988 to 0.778 for both major domains and the total scale score. A significant correlation was found between the total PASE-P score and the shorter TUG, TUG cog (r = - 0.514, p < 0.001; r = - 0.481, p < 0.001) and 10MWT (r = 0.472, p < 0.001). The total PASE-P score was also positively correlated with ADL and IADL (r = 0.337, p < 0.001; r = 0.415 p < 0.001), BBS (r = 0.537, p < 0.001) and 5xSTS (r = 0.558, p < 0.001). CONCLUSIONS The results obtained in the study confirm that the Polish version of the PASE scale is a valid and reliable tool for assessing the level of physical activity in older adults living in a community.
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Affiliation(s)
| | - Agnieszka Ćwirlej-Sozańska
- Institute of Health Sciences, Medical College of Rzeszow University, Warzywna 1a, Rzeszow, 35-310, Poland
| | - Natalia Wołoszyn
- Institute of Health Sciences, Medical College of Rzeszow University, Warzywna 1a, Rzeszow, 35-310, Poland
| | - Bernard Sozański
- Institute of Medicine, Medical College of Rzeszow University, Warzywna 1a, Rzeszow, 35-310, Poland
| | | | - Richard Washburn
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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ZHAO H, ZHANG XN, SHI Z, YIN L, ZHANG WL, HE K, Xue HUQ, ZHAO XY, SHI SH. Association of level of leisure-time physical activity with risks of all-cause mortality and cardiovascular disease in an elderly Chinese population: a prospective cohort study. J Geriatr Cardiol 2020; 17:628-637. [PMID: 33224182 PMCID: PMC7657942 DOI: 10.11909/j.issn.1671-5411.2020.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Implementing the current guidelines for leisure-time physical activity (LTPA) provides significant health benefits, especially for middle-aged adults, but it is unclear whether LTPA also translates into cardiovascular health benefits among elderly people. Therefore, we aimed to assess the association of LTPA with the risks of cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, and all-cause mortality in an elderly population. METHODS In this prospective cohort study, 32, 942 participants aged 60 years or older who participated in a health check-up programme in China between 2010 and 2018 were included. We evaluated the morbidity and mortality risks through the Cox regression model, competing risk model and restricted cubic spline model. RESULTS During a median of 6.84 years of follow-up, there were 6, 857 elderly people with incident CVD; a total of 6, 324 deaths occurred due to all causes and 2, 060 deaths occurred due to CVD. Compared with the inactive group, reductions in CVD morbidity and mortality were observed, with hazard ratios (HRs) of 0.89 (95% CI: 0.83-0.96) and 0.81 (95% CI: 0.71-0.92) in the insufficiently active group, 0.86 (95% CI: 0.80-0.92) and 0.79 (95% CI: 0.69-0.90) in the sufficiently active group, and 0.79 (95% CI: 0.70-0.89) and 0.58 (95% CI: 0.45-0.76) in the highly active group, respectively; but no significant reductions were observed in the very highly active group, with HRs of 0.87 (95% CI: 0.71-1.06) and 0.99 (95% CI: 0.70-1.40), respectively. Compared with the inactive group, reductions in all-cause mortality were also observed, with a HR of 0.90 (95% CI: 0.84-0.97) in the insufficiently active group, 0.82 (95% CI: 0.77-0.89) in the sufficiently active group, 0.77 (95% CI: 0.67- 0.87) in the highly active group, and 0.80 (95% CI: 0.64-0.98) in the very highly active group. A restricted cubic spline diagram showed that there was an L-shaped association between LTPA and the risk of all-cause mortality but a U-shaped or reverse J-shaped relationship between LTPA and the risk of CVD morbidity and mortality, especially stroke. In addition, a subgroup analysis showed that elderly population who consistently performed LTPA for ten years or more had a lower risk of morbidity and mortality. CONCLUSIONS In an elderly population, even insufficient activity is associated with a decreased risk of all-cause mortality and CVD, and moderate levels of LTPA may be optimal for CVD prevention. In addition, elderly people who consistently perform LTPA over several years may experience greater health benefits.
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Affiliation(s)
- Hao ZHAO
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, China
| | - Xue-Ning ZHANG
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, China
| | - Zhan SHI
- Department of Pharmacy, Zhengzhou First People's Hospital, Zhengzhou, Henan, China
| | - Ling YIN
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Wen-Li ZHANG
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, China
| | - Kun HE
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, China
| | - HU-Qi Xue
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, China
| | - Xiao-Yan ZHAO
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
- Xiao-Yan ZHAO, Department of Neurology, Chinese PLA
General Hospital, Beijing, China. E-mails:
| | - Song-He SHI
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, China
- Song-He SHI, Department of
Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, China.E-mails:
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15
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Risk factors for cardiovascular disease in the Chinese population: recent progress and implications. GLOBAL HEALTH JOURNAL 2020. [DOI: 10.1016/j.glohj.2020.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Liu Q, Liu FC, Huang KY, Li JX, Yang XL, Wang XY, Chen JC, Liu XQ, Cao J, Shen C, Yu L, Lu FH, Wu XP, Zhao LC, Li Y, Hu DS, Lu XF, Huang JF, Gu DF. Beneficial effects of moderate to vigorous physical activity on cardiovascular disease among Chinese adults. J Geriatr Cardiol 2020; 17:85-95. [PMID: 32165881 PMCID: PMC7051870 DOI: 10.11909/j.issn.1671-5411.2020.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/25/2020] [Accepted: 02/10/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In China, lack of evidence remains a significant challenge for the national initiative to promote physical activity (PA). We aimed to quantify the beneficial effects of meeting or maintaining the recommended PA level [150 minutes per week (min/wk) of moderate PA or 75 min/wk of vigorous PA or an equivalent combination] on incident cardiovascular disease (CVD) among Chinese population. METHODS We included 100,560 participants without history of CVD from three cohorts in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD events and its subtypes, including stroke, coronary heart disease, heart failure, and CVD death. RESULTS During a median follow-up of 7.3 years (range: 6-15 years), 777,163 person-years and 4693 incident CVD events were observed. Compared with participants who were inactive at baseline, the multivariable adjusted HR (95% CI) of developing CVD was 0.74 (0.69-0.79) for those who met recommended moderate to vigorous physical activity (MVPA) level at baseline. Furthermore, the risk of CVD incidence was reduced with increment of MVPA (P trend < 0.001), and the HR (95% CI) of highly-active versus inactive category was 0.62 (0.56-0.68). Compared with individuals who were inactive both at the baseline and follow-up, those keeping active over the period of follow-up had a substantial lower risk of incident CVD with the HR (95% CI) of 0.57 (0.43-0.77). CONCLUSIONS The findings demonstrated that meeting and maintaining the recommended MVPA level could reduce the cardiovascular risk. Wider adoption of the PA recommendations would have considerable health impacts to the Chinese population.
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Affiliation(s)
- Qiong Liu
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang-Chao Liu
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ke-Yong Huang
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian-Xin Li
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue-Li Yang
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin-Yan Wang
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ji-Chun Chen
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiao-Qing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China
| | - Jie Cao
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China
| | - Fang-Hong Lu
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China
| | - Xian-Ping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Lian-Cheng Zhao
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Li
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dong-Sheng Hu
- Department of Prevention Medicine, Shenzhen University School of Medicine, Shenzhen, China
| | - Xiang-Feng Lu
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian-Feng Huang
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dong-Feng Gu
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Friedenreich CM, Stone CR, Cheung WY, Hayes SC. Physical Activity and Mortality in Cancer Survivors: A Systematic Review and Meta-Analysis. JNCI Cancer Spectr 2019; 4:pkz080. [PMID: 32337494 PMCID: PMC7050161 DOI: 10.1093/jncics/pkz080] [Citation(s) in RCA: 199] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 09/17/2019] [Accepted: 10/01/2019] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Chelsea R Stone
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Winson Y Cheung
- Division of Medical Oncology, Tom Baker Cancer Centre, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sandra C Hayes
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Macek P, Terek-Derszniak M, Zak M, Biskup M, Ciepiela P, Krol H, Smok-Kalwat J, Gozdz S. WHO recommendations on physical activity versus compliance rate within a specific urban population as assessed through IPAQ survey: a cross-sectional cohort study. BMJ Open 2019; 9:e028334. [PMID: 31189681 PMCID: PMC6576125 DOI: 10.1136/bmjopen-2018-028334] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The study was designed to address the following three key areas, that is, (1) evaluate overall level of physical activity in the residents of a mid-sized, Central-European city, (2) compliance level with WHO's recommendations on physical activity in leisure time and (3) actual impact of select socioeconomic factors on the physical activity level within the study population. METHODS Assessment of the source data collected for 4619 participants (1532 men and 3087 women, aged 45-65 years; mean age 56.41±5.31 years) was completed. Three levels of physical activity, and compliance level with pertinent WHO recommendations was evaluated, based on International Physical Activity Questionnaire (long form). Multilevel logistic regression models of socioeconomic factors associated with moderate-level, high-level physical activity, and WHO recommendations were developed. RESULTS Data analyses revealed that 6.19% of the study participants (n=286) engaged in low-level physical activity, 48.86%-in moderate-level activity, while high-level activity was reported in 44.94% of them. Compliance with pertinent WHO recommendations was higher in men aged 44-55 years, boasting upper-level education, living without a partner and in the persons with a net income over €1140 per household. CONCLUSIONS Overall level of physical activity in the residents of a mid-sized, Central-European city was established as moderate. Pertinent WHO recommendations on physical activity were met by 4.2% of the subjects only.
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Affiliation(s)
- Pawel Macek
- Department of Epidemiology and Cancer Control, Holycross Cancer Centre, Kielce, Poland
| | | | - Marek Zak
- Faculty of Medicine and Health Sciences, The Jan Kochanowski University, Kielce, Poland
| | - Malgorzata Biskup
- Department of Rehabilitation, Holycross Cancer Centre, Kielce, Poland
- Faculty of Medicine and Health Sciences, The Jan Kochanowski University, Kielce, Poland
| | | | - Halina Krol
- Faculty of Medicine and Health Sciences, The Jan Kochanowski University, Kielce, Poland
| | | | - Stanislaw Gozdz
- Faculty of Medicine and Health Sciences, The Jan Kochanowski University, Kielce, Poland
- Clinic of Clinical Oncology, Holycross Cancer Centre, Kielce, Poland
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19
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Cheng W, Zhang Z, Cheng W, Yang C, Diao L, Liu W. Associations of leisure-time physical activity with cardiovascular mortality: A systematic review and meta-analysis of 44 prospective cohort studies. Eur J Prev Cardiol 2018; 25:1864-1872. [PMID: 30157685 DOI: 10.1177/2047487318795194] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Many cohort studies within the past few decades have shown the protective effect of leisure-time physical activity on cardiovascular mortality. To summarise the evidence from prospective cohort studies on the relationship between the amount of leisure-time physical activity and the risk of cardiovascular mortality, a dose–response meta-analysis was conducted in this study. Methods and results Electronic databases, including PubMed and Embase databases, Scopus and Cochrane Library, were systemically retrieved by two investigators from inception to 14 June 2018 for related studies. The maximum adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and a dose–response analysis was conducted using the restricted cubic splines. Finally, a total of 44 studies comprising 1,584,181 participants was enrolled into this meta-analysis. The HRs of cardiovascular mortality for moderate and high leisure-time physical activity were 0.77 (95% CI 0.74–0.81) and 0.73 (95% CI 0.69–0.77), respectively. Among these 44 studies, 19 were eligible for the dose–response meta-analysis, which suggested a linear negative correlation of leisure-time physical activity with cardiovascular mortality, regardless of age, gender and the presence of underlying cardiovascular disease or not. Conclusions Leisure-time physical activity shows a linear negative correlation with the risk of cardiovascular mortality regardless of age, gender and the presence of cardiovascular disease or not. However, the cardiovascular benefits of leisure-time physical activity is decreased for those aged over 65 years or those with a history of cardiovascular disease. Moreover, leisure-time physical activity displays more cardiovascular benefits to people followed up for over 10 years than to those followed up for less than 10 years. Besides, high-intensity leisure-time physical activity has more obvious cardiovascular benefits than those of moderate-intensity leisure-time physical activity.
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Affiliation(s)
- Wenke Cheng
- Department of Cardiology, Affiliated Hospital of Qinghai University, China
| | - Zhen Zhang
- Department of Oncology, Affiliated Hospital of Qinghai University, China
| | - Wensi Cheng
- School of Nursing, Heze Medical College, China
| | - Chong Yang
- Department of Obstetrics, Zaozhuang Municipal Hospital, China
| | - Linlin Diao
- Department of Cardiology, Zaozhuang Municipal Hospital, China
| | - Weijun Liu
- Department of Cardiology, Affiliated Hospital of Qinghai University, China
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Puaschitz NG, Assmus J, Strand E, Karlsson T, Vinknes KJ, Lysne V, Drevon CA, Tell GS, Dierkes J, Nygård O. Adherence to the Healthy Nordic Food Index and the incidence of acute myocardial infarction and mortality among patients with stable angina pectoris. J Hum Nutr Diet 2018; 32:86-97. [PMID: 30091209 DOI: 10.1111/jhn.12592] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The Healthy Nordic Food Index (HNFI) has been associated with beneficial effects on markers of cardiovascular disease (CVD). Whether such effects are present among patients with established coronary heart disease is unknown. In the present study, we investigated the association between adherence to the HNFI and the risk of acute myocardial infarction (AMI) (fatal or nonfatal) and death among patients with stable angina pectoris. METHODS In the Western Norway B-vitamin Intervention Trial, participants completed a 169-item semi-quantitative food frequency questionnaire. The HNFI was calculated from six food groups (fish, cabbage, apples/pears, root vegetables, whole grain bread and oatmeal), scoring 0-6. Three adherence groups were defined: 0-1 points (low), 2-3 points (medium) or 4-6 points (high). Cox regression analyses investigated associations between adherence to the HNFI and outcomes. RESULTS Among 2019 men (79.7%) and women with mean age of 61.7 years, 307 patients experienced an AMI event during a median (25th and 75th percentiles) follow-up of 7.5 (6.3 and 8.7) years. Median follow-up for total mortality was 10.5 (9.3 and 11.7) years; 171 patients died from CVD and 380 from any cause. No association between HNFI and the risk of AMI was detected. However, the HNFI was associated with a reduced risk of all-cause death, both by linear estimates [hazard ratio (95% confidence interval = 0.91 (0.84-0.98)] and by comparison of the highest with the lowest adherence group [hazard ratio (95% confidence interval = 0.70 (0.52-0.95)]. CONCLUSIONS The results of the present study suggest that a Healthy Nordic diet may reduce mortality in patients with established CVD.
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Affiliation(s)
- N G Puaschitz
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - J Assmus
- Department of Research and Development, Haukeland University Hospital, Bergen, Norway
| | - E Strand
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - T Karlsson
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - K J Vinknes
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - V Lysne
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - C A Drevon
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - G S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - J Dierkes
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - O Nygård
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,KG Jebsen Centre for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
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