Mortality and cause of death in physical activity and insufficient physical activity participants: a longitudinal follow-up study using a national health screening cohort

Abstract

Background Few studies have examined the association between physical activity (PA) and various causes of mortality in Korea. The aim of our study was to evaluate mortality and causes of death between PA and insufficient PA using Korean national cohort data. Methods The health screening cohort data from the Korean National Health Insurance Service-National Sample Cohort from 2009 to 2015 were used. ‘PA’ was determined if participants walked or performed moderate-intensity activity ≥5 d/week for ≥30 min, or vigorous-intensity activity ≥3 d/week for ≥20 min. Other participants were classified as ‘insufficient PA’. The PA and insufficient PA groups were matched by age, sex, income, and region of residence in a 1:1 ratio. Causes of death were classified into 13 categories. Crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for all mortality rates were analyzed using a stratified Cox proportional hazard model. Age, sex, income, and region of residence were stratified. Subgroup analyses were performed according to age, sex, and obesity status. The odds ratio according to the causes of death was calculated by the chi-square test. Results The adjusted HR for mortality in the PA group was 0.85 (95% CI = 0.82–0.88). In subgroup analyses according to age, sex, and obesity status, results were consistent with the main findings in < 60-year-old females, ≥ 60-year-old males and females, and in all subgroups by obesity. The death rate by neoplasm, mental diseases, neurologic disease, circulatory disease, respiratory disease, digestive disease, abnormal finding, and trauma were lower in the PA than the insufficient PA group. Conclusions These results suggest that PA is inversely associated with mortality caused specifically by diseases reflected by mental, respiratory, cancer, and cardiovascular conditions. Additionally, PA is inversely associated with mortality compared to insufficient PA in all obesity status.

Associations between Physical Activity, Sunshine Duration and Osteoporosis According to Obesity and Other Lifestyle Factors: A Nested Case–Control Study

“…The classification of age, income, and region of residence was performed as described in our previous study [ 25 , 31 ]. Age was collected from participants who were ≥ 40 years old in 2002 and 2003 and classified into 9 groups at 5-year intervals.…”

“…Tobacco smoking status (nonsmoker, past smoker, current smoker), alcohol consumption (<1 time a week, ≥1 time a week), and obesity based on BMI (<18.5 for underweight, ≥18.5 to <23 for normal weight, ≥23 to <25 for overweight, ≥25 to <30 for obese I, ≥30 for obese II) were classified in the same way as in the previous study [ 25 , 31 ].…”

“…One of our previous studies investigated whether the combination of PA and serum 25(OH)D is inversely associated with osteopenia or osteoporosis using national population survey data with a cross-sectional study design [ 15 ]. Our study also examined the association between the intensity of PA and various causes of death using longitudinal national cohort data [ 25 ]. Furthermore, the purpose of our current study was to identify the association between PA and osteoporosis and between SD and osteoporosis using the same national cohort data that were used in our previous study [ 25 ].…”

“…Our study also examined the association between the intensity of PA and various causes of death using longitudinal national cohort data [ 25 ]. Furthermore, the purpose of our current study was to identify the association between PA and osteoporosis and between SD and osteoporosis using the same national cohort data that were used in our previous study [ 25 ]. In addition, we performed various subgroup analyses in our study, including age/sex, SD (or intensity of PA), obesity, smoking, and alcohol consumption status.…”

Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study

“…In fact, older adults spent too much time sitting, laying, or sleeping, as shown in our results. SB not only negatively affected bone health in other studies [ 43 ], but was also related to cardiovascular diseases [ 51 ] and frailty [ 52 ] independently of the amount of PA, and SB also represents an important risk factor for mortality [ 53 ]. However, in our study, SB did not seem to be associated with bone health.…”