Eva Rodríguez-Gutiérrez , Ana Torres-Costoso , Borja del Pozo Cruz , Sergio Núñez de Arenas-Arroyo , Carlos Pascual-Morena , Bruno Bizzozero-Peroni , Vicente Martínez-Vizcaíno
{"title":"每日步数与全因死亡率:总体回顾和荟萃分析。","authors":"Eva Rodríguez-Gutiérrez , Ana Torres-Costoso , Borja del Pozo Cruz , Sergio Núñez de Arenas-Arroyo , Carlos Pascual-Morena , Bruno Bizzozero-Peroni , Vicente Martínez-Vizcaíno","doi":"10.1016/j.ypmed.2024.108047","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to describe the variability in estimates of the association of daily steps and all-cause mortality in systematic reviews with meta-analyses, to identify the factors potentially responsible for it, and to provide an updated estimate.</p></div><div><h3>Methods</h3><p>Five databases were systematically searched up to May 2024 to identify systematic reviews with meta-analyses and prospective cohort studies. A qualitative synthesis of previous reviews and an updated meta-analysis of cohort studies were performed. Pooled hazard ratios (HRs) with their 95% confidence intervals (CIs) were calculated using a random-effects model.</p></div><div><h3>Results</h3><p>Eleven systematic reviews with meta-analyses and 14 cohort studies were included, revealing considerable variability in result presentation. Our updated meta-analysis showed a nonlinear association, indicating a lower risk of all-cause mortality with increased daily steps, with a protective threshold at 3143 steps/day, and a pooled HR of 0.91 (95% CI: 0.87, 0.95) per 1000 steps/day increment. Physical activity categories consistently indicated progressively reduced mortality risk, with the highly active category (>12,500 steps/day) exhibiting the lowest risk (0.35 (95% CI: 0.29, 0.42)).</p></div><div><h3>Conclusion</h3><p>Systematic reviews and meta-analyses showed considerable variability in effect estimates due to different methods of quantifying exposure. Despite it, our study underscores the importance of increased daily steps in reducing all-cause mortality, with a minimum protective dose of 3000 steps/day, although the optimal dose differed according to age and sex. It is recommended that future studies categorise daily steps by physical activity category, perform dose-response analyses, and use increments of 1000 steps/day.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0091743524002020/pdfft?md5=55285f440171015a89592af6238398dd&pid=1-s2.0-S0091743524002020-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Daily steps and all-cause mortality: An umbrella review and meta-analysis\",\"authors\":\"Eva Rodríguez-Gutiérrez , Ana Torres-Costoso , Borja del Pozo Cruz , Sergio Núñez de Arenas-Arroyo , Carlos Pascual-Morena , Bruno Bizzozero-Peroni , Vicente Martínez-Vizcaíno\",\"doi\":\"10.1016/j.ypmed.2024.108047\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>This study aimed to describe the variability in estimates of the association of daily steps and all-cause mortality in systematic reviews with meta-analyses, to identify the factors potentially responsible for it, and to provide an updated estimate.</p></div><div><h3>Methods</h3><p>Five databases were systematically searched up to May 2024 to identify systematic reviews with meta-analyses and prospective cohort studies. A qualitative synthesis of previous reviews and an updated meta-analysis of cohort studies were performed. Pooled hazard ratios (HRs) with their 95% confidence intervals (CIs) were calculated using a random-effects model.</p></div><div><h3>Results</h3><p>Eleven systematic reviews with meta-analyses and 14 cohort studies were included, revealing considerable variability in result presentation. Our updated meta-analysis showed a nonlinear association, indicating a lower risk of all-cause mortality with increased daily steps, with a protective threshold at 3143 steps/day, and a pooled HR of 0.91 (95% CI: 0.87, 0.95) per 1000 steps/day increment. Physical activity categories consistently indicated progressively reduced mortality risk, with the highly active category (>12,500 steps/day) exhibiting the lowest risk (0.35 (95% CI: 0.29, 0.42)).</p></div><div><h3>Conclusion</h3><p>Systematic reviews and meta-analyses showed considerable variability in effect estimates due to different methods of quantifying exposure. Despite it, our study underscores the importance of increased daily steps in reducing all-cause mortality, with a minimum protective dose of 3000 steps/day, although the optimal dose differed according to age and sex. It is recommended that future studies categorise daily steps by physical activity category, perform dose-response analyses, and use increments of 1000 steps/day.</p></div>\",\"PeriodicalId\":20339,\"journal\":{\"name\":\"Preventive medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-06-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0091743524002020/pdfft?md5=55285f440171015a89592af6238398dd&pid=1-s2.0-S0091743524002020-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Preventive medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0091743524002020\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Preventive medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0091743524002020","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Daily steps and all-cause mortality: An umbrella review and meta-analysis
Objective
This study aimed to describe the variability in estimates of the association of daily steps and all-cause mortality in systematic reviews with meta-analyses, to identify the factors potentially responsible for it, and to provide an updated estimate.
Methods
Five databases were systematically searched up to May 2024 to identify systematic reviews with meta-analyses and prospective cohort studies. A qualitative synthesis of previous reviews and an updated meta-analysis of cohort studies were performed. Pooled hazard ratios (HRs) with their 95% confidence intervals (CIs) were calculated using a random-effects model.
Results
Eleven systematic reviews with meta-analyses and 14 cohort studies were included, revealing considerable variability in result presentation. Our updated meta-analysis showed a nonlinear association, indicating a lower risk of all-cause mortality with increased daily steps, with a protective threshold at 3143 steps/day, and a pooled HR of 0.91 (95% CI: 0.87, 0.95) per 1000 steps/day increment. Physical activity categories consistently indicated progressively reduced mortality risk, with the highly active category (>12,500 steps/day) exhibiting the lowest risk (0.35 (95% CI: 0.29, 0.42)).
Conclusion
Systematic reviews and meta-analyses showed considerable variability in effect estimates due to different methods of quantifying exposure. Despite it, our study underscores the importance of increased daily steps in reducing all-cause mortality, with a minimum protective dose of 3000 steps/day, although the optimal dose differed according to age and sex. It is recommended that future studies categorise daily steps by physical activity category, perform dose-response analyses, and use increments of 1000 steps/day.
期刊介绍:
Founded in 1972 by Ernst Wynder, Preventive Medicine is an international scholarly journal that provides prompt publication of original articles on the science and practice of disease prevention, health promotion, and public health policymaking. Preventive Medicine aims to reward innovation. It will favor insightful observational studies, thoughtful explorations of health data, unsuspected new angles for existing hypotheses, robust randomized controlled trials, and impartial systematic reviews. Preventive Medicine''s ultimate goal is to publish research that will have an impact on the work of practitioners of disease prevention and health promotion, as well as of related disciplines.