Association between Meeting Physical Activity Guidelines and Mortality in Korean Adults: An 8-year Prospective Study

Accelerometer-derived physical activity and sedentary behavior patterns among Korean adults

PURPOSE

This study aimed to provide an overview of accelerometer-derived physical activity (PA) and sedentary behavior (SB) patterns among Korean adults. We also investigated the association between participant characteristics and the likelihood of adherence to moderate-to-vigorous physical activity (MVPA), SB, and the MVPA-SB guidelines.

METHODS

Data from the 2014-2017 Korea National Health and Nutrition Examination Survey were used. The study involved a nationally representative sample of 2,260 Korean adults aged ≥20 years. Accelerometers were used to measure PA and SB for seven days. Multivariate logistic regression models were used to assess the association between the participant characteristics and the likelihood of adhering to the MVPA, SB, and MVPA-SB guidelines.

RESULTS

SB (60.61%), light intensity (26.22%), and lifestyle activities (9.4%) accounted for the majority of the participants' days. MVPA and vigorous physical activity (VPA) accounted for 3.72% and 0.06% of the days, respectively. The MVPA guidelines were more likely to be adhered to by men, older adults, participants with higher education, non-smokers, and individuals without multimorbidity. Participants with higher education and household income were less likely to adhere to the SB guidelines. Women (OR=0.51), participants with high education levels (OR=0.54), current smokers (OR=0.47), and patients with multimorbidity (OR=0.46) were less likely to adhere to the MVPA-SB guidelines.

CONCLUSION

This study found that participants were predominantly sedentary, with only a small proportion engaging in VPA. There were differences related to demographic factors and health status. Most Korean adults do not adhere to the recommended MVPA-SB guidelines, and that is a serious public health concern. These findings highlight the need to promote PA and reduce SB through public health policies and interventions, particularly for adults facing PA barriers.

Association between long working hours and physical inactivity in middle-aged and older adults: a Korean longitudinal study (2006-2020)

BACKGROUND

We investigated associations for long working hours in relation to physical inactivity and high-level physical activity among middle-aged and older adults.

METHODS

Our study included 5402 participants and 21 595 observations from the Korean Longitudinal Study of Ageing (2006-2020). Logistic mixed models were used to estimate ORs and 95% CIs. Physical inactivity was defined as not engaging in any type of physical activity, while high-level physical activity was defined as engaging in ≥150 min per week of physical activity.

RESULTS

Working >40 hours weekly was positively related to physical inactivity (OR (95% CI) 1.48 (1.35 to 1.61)) and negatively related to high-level physical activity (0.72 (95% CI 0.65 to 0.79)). Exposure to long working hours consecutively for ≥3 waves was associated with the highest OR for physical inactivity (1.62 (95% CI 1.42 to 1.85)) and the lowest OR for high-level physical activity (0.71 (95% CI 0.62 to 0.82)). Furthermore, compared with persistent short working hours (≤40 hours → ≤40 hours), long working hours in a previous wave (>40 hours → ≤40 hours) were associated with a higher OR of physical inactivity (1.28 (95% CI 1.11 to 1.49)). Exposure to an increase in working hours (≤40 hours → >40 hours) was also associated with a higher OR of physical inactivity (1.53 (95% CI 1.29 to 1.82)).

CONCLUSION

We found that having working long hours was associated with a higher risk of physical inactivity and a lower likelihood of high-level physical activity. Moreover, accumulation of long working hours was associated with a higher risk of physical inactivity.

The art of forming habits: applying habit theory in changing physical activity behaviour

Background

Habits are obtained as a consequence of cue-contingent behavioural repetition. Context cues stimulate strong habits without an individual contemplating that action has been initiated. Because of its health-enhancing effects, making physical activity a part of one’s life is essential. This study examined the associations of physical activity (PA) behaviours with PA habits and the role of autonomous motivation in developing PA habits.

Methods

This study used a cross-sectional design. A structured questionnaire was implemented through emails to 226 university students, where PA levels, habits and autonomous motivation were self-reported.

Results

Binary logistic regression identified age groups, gender and participants who were trying to lose weight as the significant predictors in meeting physical activity guidelines. Path analysis showed that moderate-intensity physical activity (β = 0.045, CI = 0.069–0.248) and strength training exercises (β = 0.133, CI = 0.148–0.674) were significantly associated with PA habits (p < 0.01). Autonomous motivation was directly associated with PA habits (β = 0.062, CI = [0.295–0.541], p < 0.01) and was also significantly related to moderate-intensity physical activity (β = 0.243, CI = [0.078–0.266], p < 0.01) and strength training exercises (β = 0.202, CI = [0.033–0.594], p < 0.05).

Conclusions

The emphasis on experiment-based logic and interest in habit formation in the research community is extensive. As the college years offer an excellent opportunity to establish healthy behavioural interventions, encouraging students in regular PA and exhibiting an autonomous motivation towards PA may be necessary.

Isotemporal Substitution Analysis of Accelerometer-Derived Sedentary Behavior and Physical Activity on Cardiometabolic Health in Korean Adults: A Population-Based Cross-Sectional Study

Reducing sedentary behavior and increasing physical activity may be important for maintaining good cardiometabolic health. However, many studies have focused on the independent effect of sedentary behavior and physical activity, but it is unclear whether replacing time spent in sedentary behavior with physical activity is beneficial for cardiometabolic health. Therefore, this population-based cross-sectional study aimed to investigate the effect of behavioral transformations between sedentary behavior and level of physical activity on cardiometabolic health in Korean adults using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2014-2017. The study participants included 2197 adults from the KNHANES. In the partition model, moderate-to-vigorous physical activity (MVPA) was significantly associated with adverse cardiometabolic health, adjusted for potential confounding factors. The odds ratio for adverse cardiometabolic health significantly decreased with the replacement of sedentary behavior and light intensity activity with MVPA in the isotemporal substitution model (p < 0.05). In the models stratified by sex, we observed significant associations between handgrip strength and cardiometabolic health in women (p < 0.001), but not in men. Thus, our findings suggest that replacing sedentary behavior with MVPA may contribute to improved cardiometabolic health.

Mortality in relation to changes in physical activity in middle-aged to older Chinese: An 8-year follow-up of the Guangzhou Biobank Cohort Study

BACKGROUND

Physical activity (PA) is generally encouraged. Studies from developed countries in the West have shown that maintenance of adequate PA or increasing PA are associated with lower mortality risk. It is unclear whether these associations apply to an older Chinese population. Hence, we examined the changes in PA prospectively among a middle-aged and older Chinese population over an average of 4 years and explored their subsequent mortality risks.

METHODS

Metabolic equivalent scores of PA among participants in the Guangzhou Biobank Cohort Study were calculated. Participants were divided into 3 groups related to PA level, and changes in PA were classified into 9 categories. Information on vital status and causes of death from March 2008 to December 2012 (the first repeated examination) until December 31, 2017, was obtained via record linkage with the Death Registry.

RESULTS

Of 18,104 participants aged 61.21 ± 6.85 years (mean ± SD), 1461 deaths occurred within 141,417 person-years. Compared to participants who maintained moderate PA, those who decreased PA from moderate or high levels to a low level had increased risks for all-cause mortality (hazard ratio (HR) = 1.47, 95% confidence interval (95%CI): 1.11-1.96). Participants who maintained a high level of PA (HR = 0.83, 95%CI: 0.70-0.98) or increased PA from low to high levels (HR = 0.71, 95%CI: 0.52-0.97) showed lower all-cause mortality risks. Those who maintained low PA levels showed a higher all-cause mortality risk, whereas those who increased their PA levels showed a non-significantly lower risk. Similar results were found for cardiovascular disease risk.

CONCLUSION

Even at an older age, maintaining a high PA level or increasing PA from low to high levels results in lower mortality risks, suggesting that substantial health benefits might be achieved by maintaining or increasing engagement in adequate levels of PA. The increased risk of maintaining a low PA level or decreasing PA to a low level warrants the attention of public health officials and clinicians.

The Association of Physical Activity and Mortality Risk Reduction Among Smokers: Results From 1998-2009 National Health Interview Surveys-National Death Index Linkage

BACKGROUND

The mortality benefits of meeting the US federal guidelines for physical activity, which includes recommendations for both aerobic and muscle-strengthening activities, have never been examined among smokers. Our aim was to investigate the association between reporting to meet the guidelines and all-cause, cancer, cardiovascular disease, and respiratory disease mortality among smokers.

METHODS

We pooled data from the 1998-2009 National Health Interview Survey, which were linked to records in the National Death Index (n = 68,706). Hazard ratios (HR) were computed to estimate the effect of meeting the physical activity guidelines on mortality.

RESULTS

Smokers who reported meeting the guidelines for physical activity had 29% lower risk of all-cause mortality (HR: 0.71; 95% confidence interval [CI], 0.62-0.81), 46% lower risk of mortality from cardiovascular disease (HR: 0.54; 95% CI, 0.39-0.76), and 26% lower risk of mortality from cancer (HR: 0.74; 95% CI, 0.59-0.93), compared with those who reported meeting neither the aerobic nor the muscle-strengthening recommendations of the guidelines. Meeting the aerobic recommendation of the guidelines was associated with a 42% decline in that risk (HR: 0.58; 95% CI, 0.44-0.77).

CONCLUSION

Smokers who adhere to physical activity guidelines show a significant reduction in mortality.