AimCardio-metabolic disease and physical activity are closely related but large-scale objective studies which measure physical activity are lacking. Using the largest accelerometer cohort to date, we aimed to investigate whether there is an association between disease status and accelerometer variables after a 5-year follow-up.Methods106,053 UK Biobank participants wore a wrist-worn GENEactiv monitor. Those with acceptable wear time (> 3 days) were split into 4 cardio-metabolic disease groups based on self-report disease status which was collected 5 ± 1 years prior. Multiple linear regression models were used to investigate associations, controlling for confounders and stratified for gender.ResultsAverage daily acceleration was lower in men (‘healthy’-42 ± 15 mg v ‘Type 2 diabetes + cardiovascular disease (CVD)’-31 ± 12 mg) and women (‘healthy’-44 ± 13 mg v ‘Type 2 diabetes + CVD’-31 ± 11 mg) with cardio-metabolic disease and this was consistent across both week and weekend days. Men and women with the worst cardio-metabolic disease perform around half of moderate to vigorous physical activity on a daily basis compared to healthy individuals, and spend almost 7 h per day in 30 min inactivity bouts. Significant associations were seen between cardio-metabolic disease and accelerometer variables 5 years on when controlling for confounders.ConclusionIn the largest accelerometer cohort to date, there are significant associations between cardio-metabolic disease and physical activity variables after 5 years of follow-up. Triaxial accelerometers provide enhanced measurement opportunities for measuring lifestyle behaviours in chronic disease.

We read with interest the letter from Lloyd warning of the danger of colchicine overdose 1 and agree that this can have devastating consequences. However, the majority of overdoses involve analgesics, antidepressants, hypnotics, anxiolytics, and antipsychotic medications whereas colchicine overdose appears to be an uncommon occurrence. 2-4 Colchicine is an effective and useful treatment for both acute attacks of gout and prophylaxis against acute attacks when commencing uratelowering therapies such as allopurinol, particularly in the many patients who are intolerant of or have contraindications to non-steroidal anti-inflammatory drugs. 5,6 Although we concur with Lloyd that assessment of mood and risk of overdose should be considered when prescribing any medication, we urge prescribers not to abandon an effective treatment for this excruciatingly painful and frequently poorly managed condition.

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