More physical activities may prolong life of adults

Adults who engage in leisure time aerobic and muscle strengthening activities at levels recommended by the 2018 physical activity guidelines show a significantly reduced risk of all-cause and cause-specific mortality, suggests a US study.

“Engaging in recommended aerobic physical activity was associated with reduced risk of mortality from all eight causes examined, whereas engaging in muscle strengthening activity was associated with reduced risk of mortality from three causes, including cardiovascular disease (CVD), cancer, and chronic lower respiratory tract diseases,” the researchers said, adding that adults with chronic conditions who meet the said guidelines have larger survival benefits.

A total of 479,856 adults aged ≥18 years were included in this population-based cohort study, which utilized the National Health Interview Survey (NHIS; 1997–2014) with linkage to the National Death Index records through 31 December 2015.

The researchers combined participant self-reports of the amount of leisure time spent in aerobic physical activity and muscle strengthening activity each week and categorized these into four groups: insufficient activity, aerobic activity only, muscle strengthening only, and both aerobic and muscle strengthening activities according to the physical activity guidelines.

All-cause and cause-specific mortality (ie, CVD; cancer; chronic lower respiratory tract diseases (LRTDs); accidents and injuries; Alzheimer’s disease (AD); diabetes mellitus (DM); influenza and pneumonia; and nephritis, nephrotic syndrome, or nephrosis) were obtained from the National Death Index records.

Of the participants, 59,819 died from all causes, 13,509 from CVD, 14,375 from cancer, 3,188 from chronic LRTDs, 2,477 from accidents and injuries, 1,470 from AD, 1,803 from DM, 1,135 from influenza and pneumonia, and 1,129 from nephritis, nephrotic syndrome, or nephrosis during a median follow-up of 8.75 years. [BMJ 2020;370:m2031]

Adults who engaged in recommended muscle strengthening (n=21,428; hazard ratio [HR], 0.89, 95 percent confidence interval [CI], 0.85–0.94) or aerobic activity (n=113,851; HR, 0.71, 95 percent CI, 0.69–0.72) had a lower risk of all-cause mortality than those who did not meet the physical activity guidelines (n=268,193). Notably, those engaged in both activities showed even greater survival benefits (n=76,384; HR, 0.60, 95 percent CI, 0.57–0.62).

Similar patterns were also observed for cause-specific mortality from CVD, cancer, and chronic LRTDs.

“Our findings support that the physical activity levels recommended in the 2018 physical activity guidelines for Americans provide important survival benefits,” the researchers said. “Additionally, in accordance with the guidelines, more physical activity than the minimum recommendation could provide greater health benefits.”

These findings were also consistent with those from the NHIS cohort study, the Women’s Health Study, and the Health Survey for England and Scottish Health Survey, which all showed statistically significant survival benefits for all-cause mortality among adults engaging in recommended aerobic and muscle strengthening activities compared with those who did not. [J Am Heart Assoc 2017;6:e007677; Am J Prev Med 2011;40:514-521; Am J Epidemiol 2018;187:1102-1112]

“Given the clearly established connection between physical activity and health, exercise should be viewed as a cost-effective way of managing underlying chronic diseases, thereby reducing future mortality risk,” the researchers said. [Prog Cardiovasc Dis 2015;57:375-386]

“Our finding could have important implications in clinical practice as it suggests that inclusion of recommended aerobic and muscle strengthening activities or recommended aerobic physical activity alone into chronic disease management of … adults is possible and has survival benefits,” they added.