每日步数、活动、久坐和睡眠行为与全因死亡率的关系：ELSA-BRASIL研究

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine Pub Date : 2025-02-07 DOI:10.1016/j.ypmed.2025.108241

Danilo de Paula , Kelly R. Evenson , Natan Feter , Rosane Harter Griep , Ciro Oliveira Queiroz , Rodrigo Citton Padilha dos Reis , Bruce Bartholow Duncan , Maria Inês Schmidt

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引用次数: 0

摘要

背景：尽管运动行为与死亡风险有关，但在低收入和中等收入国家，很少有研究调查每日步数和运动行为与全因死亡率之间的关系。目的：研究步数、总活动量、中高强度体力活动（MVPA）、轻强度体力活动（LPA）、久坐行为、睡眠时间和各种同颞代偿与巴西中老年成年人全因死亡率的关系。方法：elsa -巴西队列研究第三批（2017-2019）参与者在腰部佩戴ActiGraph wgt3g - bt 7天，并完成睡眠日记。我们跟踪参与者到2024年1月1日。使用Cox回归模型，我们估计校正风险比（HR）。使用成分数据分析，我们检查了与等时间替代相关的死亡率变化。结果：总体而言，8832名参与者（55.8% %为女性，年龄59.2 ± 8.6）被随访，中位数为5.43人年（总计46,793.2），其中216人死亡。除睡眠外，所有行为都与死亡率呈曲线关系。在每日总活动量为15.9 m-g （HR 0.36，参考文献（Kraus et al., 2019）.83）、7300步（HR 0.48，参考文献3881）、49.4 MVPA分钟（HR 0.28，参考文献（Paluch et al., n.d）.34）和245.8 LPA分钟（HR 0.67，参考文献135.6）时，死亡率呈平台效应下降。每天坐着的时间少于842分钟，风险比为0.67。将每天从其他行为中抽出的10分钟重新分配到MVPA中，死亡率下降了10 %。结论：在巴西成年人中，步数、总活动量、MVPA、LPA和久坐行为与较低的死亡率呈非线性相关。将其他行为的时间重新分配到MVPA可以降低死亡率。

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Daily steps, activity, sedentary and sleep behaviors associations with all-cause mortality: The ELSA-Brasil study

Background

Although movement behaviors are linked to mortality risk, few studies investigated the associations between daily steps and movement behaviors and all-cause mortality in low- and middle-income countries.

Objective

We investigated associations of step count, total activity volume, moderate-and-vigorous physical activity (MVPA), light-intensity physical activity (LPA), sedentary behavior, sleep duration, and various isotemporal substitutions with all-cause mortality in middle-aged and older Brazilian adults.

Methods

ELSA-Brasil cohort study 3rd wave (2017–2019) participants wore an ActiGraph wGT3X-BT on the waist for seven days and completed a sleep diary. We followed participants to January 1st, 2024. Using Cox regression models, we estimated adjusted hazard ratios (HR). Using compositional data analysis, we examined changes in mortality associated with isotemporal substitutions.

Results

Overall, 8832 participants (55.8 % female, age 59.2 ± 8.6) were followed for a median of 5.43 person-years (total 46,793.2), with 216 deaths. All behaviors except sleep showed curvilinear associations with mortality. Mortality declined with a plateauing effect at a daily total activity volume of 15.9 millii-g (HR 0.36, reference 7.83), 7300 steps (HR 0.48, reference 3881), 49.4 MVPA minutes (HR 0.28, reference 11.34), and 245.8 LPA minutes (HR 0.67, reference 135.6). Engaging in less than 842 sedentary behavior minutes/day was linked with an HR of 0.67. Reallocating 10 daily minutes from other behaviors to MVPA showed a consistent 10 % decrease in mortality.

Conclusion

In Brazilian adults, step count, total activity volume, MVPA, LPA, and sedentary behavior were non-linearly associated with lower mortality. Reallocating any time from other behaviors to MVPA predicted lower mortality.

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来源期刊

Preventive medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.70

自引率

3.90%

发文量

审稿时长

42 days

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.