Abstract 12990: Physical Activity, General and Abdominal Obesity and Mortality in European Men and Women
Background: The higher risk of death due to excess adiposity may be attenuated by physical activity (PA). We examined the independent and combined associations between PA, body mass index (BMI), and waist circumference (WC) and all-cause mortality and estimated the population attributable fraction (PAF) and the years of life gained for these exposures.
Methods and Results: BMI and WC were measured among 334,161 European men and women. PA was assessed by a validated questionnaire and categorised into four groups. The combined associations between PA, general and abdominal obesity with mortality were examined with Cox proportional hazards models, adjusted for age, sex, education, smoking, and alcohol intake. Centre-specific PAF associated with inactivity, obesity (BMI>30) and abdominal obesity (>102 cm for men, >88cm for women) were calculated and combined in random-effects meta-analysis. Life-tables analyses were used to estimate gains in life expectancy for PA, BMI and WC.
Across all centres, the mean follow-up time was 12.4 years, corresponding to 4,154,915 person-years. There were 11,086 deaths among men and 10,352 deaths among women. Compared to active and normal-weight (BMI 18,5 - 25) individuals, active and obese (BMI>30) individuals had a 48% greater hazard of mortality (HR 1.48, 95% CI,1.35-1.63), and normal-weight and inactive individuals had a 56% increased hazard (HR 1.56, 95% CI, 1.46-1.67). Abdominally obese participants, had a 75% higher hazard compared to the reference group (active, abdominally lean) following adjustment for confounders. Avoiding all inactivity would theoretically reduce mortality by 7.35% (95% CI, 5.88-8.83) and increase life expectancy by 0.70 years (95%CI, 0.56-0.84). Corresponding estimates for avoiding obesity (BMI>30) were 3.66% (95% CI, 2.30-5.01) and 0.34 years (95% CI, 0.21- 0.48).
Conclusions: The hypothetical number of premature deaths reduced by avoiding inactivity in European adults may be twice that of an approach that removed generalized obesity. These results suggest that public health programmes should prioritise reductions in inactivity and that even small shifts in activity levels could have major public health benefits.
- © 2013 by American Heart Association, Inc.