More steps may lower risk of early death

Charles E. et al. (2020) .Association of Daily Step Count and Step Intensity With Mortality Among US Adults. Journal of Clinical Oncology. 38. 7. P.686-697.

A new, US study used the following research question: What are the associations between daily step counts and step intensity with mortality among US adults? 

The observational study of over 4000 participants, demonstrated a  greater number of steps per day was significantly associated with lower all-cause mortality. There was no significant association between step intensity and all-cause mortality after adjusting for the total number of steps per day.

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Abstract

Importance  It is unclear whether the number of steps per day and the intensity of stepping are associated with lower mortality.

Objective  Describe the dose-response relationship between step count and intensity and mortality.

Design, Setting, and Participants  Representative sample of US adults aged at least 40 years in the National Health and Nutrition Examination Survey who wore an accelerometer for up to 7 days ( from 2003-2006). Mortality was ascertained through December 2015.

Exposures  Accelerometer-measured number of steps per day and 3 step intensity measures (extended bout cadence, peak 30-minute cadence, and peak 1-minute cadence [steps/min]). Accelerometer data were based on measurements obtained during a 7-day period at baseline.

Main Outcomes and Measures  The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular disease (CVD) and cancer mortality. Hazard ratios (HRs), mortality rates, and 95% CIs were estimated using cubic splines and quartile classifications adjusting for age; sex; race/ethnicity; education; diet; smoking status; body mass index; self-reported health; mobility limitations; and diagnoses of diabetes, stroke, heart disease, heart failure, cancer, chronic bronchitis, and emphysema.

Results  A total of 4840 participants (mean age, 56.8 years; 2435 [54%] women; 1732 [36%] individuals with obesity) wore accelerometers for a mean of 5.7 days for a mean of 14.4 hours per day. The mean number of steps per day was 9124. There were 1165 deaths over a mean 10.1 years of follow-up, including 406 CVD and 283 cancer deaths. The unadjusted incidence density for all-cause mortality was 76.7 per 1000 person-years (419 deaths) for the 655 individuals who took less than 4000 steps per day; 21.4 per 1000 person-years (488 deaths) for the 1727 individuals who took 4000 to 7999 steps per day; 6.9 per 1000 person-years (176 deaths) for the 1539 individuals who took 8000 to 11 999 steps per day; and 4.8 per 1000 person-years (82 deaths) for the 919 individuals who took at least 12 000 steps per day. Compared with taking 4000 steps per day, taking 8000 steps per day was associated with significantly lower all-cause mortality (HR, 0.49 [95% CI, 0.44-0.55]), as was taking 12 000 steps per day (HR, 0.35 [95% CI, 0.28-0.45]). Unadjusted incidence density for all-cause mortality by peak 30 cadence was 32.9 per 1000 person-years (406 deaths) for the 1080 individuals who took 18.5 to 56.0 steps per minute; 12.6 per 1000 person-years (207 deaths) for the 1153 individuals who took 56.1 to 69.2 steps per minute; 6.8 per 1000 person-years (124 deaths) for the 1074 individuals who took 69.3 to 82.8 steps per minute; and 5.3 per 1000 person-years (108 deaths) for the 1037 individuals who took 82.9 to 149.5 steps per minute. Greater step intensity was not significantly associated with lower mortality after adjustment for total steps per day (eg, highest vs lowest quartile of peak 30 cadence: HR, 0.90 [95% CI, 0.65-1.27]; P value for trend = .34).

Conclusions and Relevance  Based on a representative sample of US adults, a greater number of daily steps was significantly associated with lower all-cause mortality. There was no significant association between step intensity and mortality after adjusting for total steps per day.

 

JAMA  Association of Daily Step Count and Step Intensity With Mortality Among US Adults

The Guardian Higher step counts could lower risk of early death, study finds

WHO report: New report reveals the role of physical activity in preventing and treating cardiovascular diseases

World Health Organization | December 2019| New report reveals the role of physical activity in preventing and treating cardiovascular diseases

Physical inactivity increases the risk of cardiovascular diseases by more than 20%. Each year, cardiovascular diseases cause 3.9 million deaths in Europe and over 1.8 million deaths in the European Union.

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Image source: ehnheart.org

Image source: ehnheart.org

The report reviews the role of physical activity in preventing and treating cardiovascular diseases across Europe. It provides a concise summary of recent knowledge based on systematic reviews and meta-analyses as well as scientific and policy summary statements (Source: World Health Organization).

Public Health England: Health matters: physical activity – prevention and management of long-term conditions

Public Health England | January  2020 | Health matters: physical activity – prevention and management of long-term conditions

The latest edition of Health Matters focuses on the benefit of physical activity for the prevention and management of long-term conditions in adults.

www.gov.uk
Image source: http://www.gov.uk

 

Access it from PHE here 

Physical activity – prevention and management of Long-Term Conditions

A professional resource for local authorities and healthcare professionals on physical activity for the prevention and management of long-term conditions | Public Health England

This edition of Health Matters focuses on the benefit of physical activity for the prevention and management of long-term conditions in adults.

One in 3 adults in England live with a long-term health condition and they are twice as likely to be amongst the least physically active. However, evidence shows that regular physical activity can help prevent or manage many common conditions such as type 2 diabetes, cardiovascular disease and some cancers. It also helps keep symptoms under control, prevent additional conditions from developing, and reduce inequalities.

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Image source: https://www.gov.uk/

Regular physical activity provides a range of physical and mental health, and social benefits, many of which are increasing issues for individuals, communities and society. These include:

  • reducing the risk of many long-term conditions
  • helping manage existing conditions
  • ensuring good musculoskeletal health
  • developing and maintaining physical and mental function and independence
  • supporting social inclusion
  • helping maintain a healthy weight
  • reducing inequalities for people with long-term conditions

Full detail at Public Health England

Adults who are more active live longer

Findings of a new systematic review confirm the important place of physical activity in a healthy lifestyle, and support the physical activity advice for adults in the UK | BMJ | via National Institute for Health Research

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People who are more physically active in middle age are less likely to die early, whether they do light or moderate to vigorous activity. The largest reductions in death are seen for those who do around 375 minutes a day of light intensity physical activity, such as walking, cooking or gardening, or 24 minutes a day of moderate to vigorous physical activity.

People who did most exercise were 73% less likely to have died early than those who did the least. Whereas, people who were sedentary for 9.5 hours or more were about twice as likely to die early, while enrolled in the studies.

Researchers reviewed data from eight studies (including 36,383 adults aged over 40) in which people wore activity monitors to record their movements. The average follow-up was 5.8 years.

The study strengthens the evidence in support of the current UK guidelines on physical activity for adults.

Further detail at National Institute for Health Research

Full reference: Ekelund U, Tarp J, Steene-Johannessen J et al. |  Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis |  BMJ | 2019 | 366:l4570.

The economic benefits of a physically active population

The aim of this study was to explore the main economic costs of physical inactivity and to identify the key benefits to improving activity rates | RAND

This report looked at the following questions:

  1. What are the potential global economic benefits associated with getting people to be more physically active and how do the economic effects vary by country?
  2. What is the contribution of premature mortality associated with insufficient physical activity?
  3. What is the contribution of insufficient physical activity associated with workplace productivity?
  4. What level of healthcare expenditure could be saved?
  5. What can public policy and private stakeholders do in order to improve physical activity levels at the population level?

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The findings of the study suggest that making people physically more active is associated with economic benefits. The report proposed the following recommendations:

  • Change population behaviours and attitudes to promote the increase of physical activity, supporting and encouraging individuals to shift their beliefs and motivations.
  • Using both community and workplace settings, provide an environment that encourages physical activity and that supports the access to facilities.
  • Encourage the participation in programmes and interventions.
  • Encourage more physical activity across society by interlinking systems-wide programmes and interventions.

Full publication: The economic benefits of a more physically active population
An international analysis | RAND Corporation

Physical activity e-learning course

Health Education England | September 2019| New e-learning programme to champion physical activity for patients launched

A new physical activity e-learning course has been designed by Health Education England, alongside Public Health England and Sport England, to help healthcare professionals to champion physical activity with patients.

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This e-learning course prepares GPs, nurses and other healthcare professionals to champion the benefits of physical activity with their patients and, in doing so, help prevent and manage a range of common physical and mental health conditions

The course includes:

  • Motivational Interviewing [‘how to’ video]
  • A guide to “Promoting Physical Activity in Primary Care” 

It also gives a comprehensive guide to the use of physical activity in the clinical management of long-term conditions including: cancer, cardiovascular conditions, diabetes, musculoskeletal health and mental health.

Full details from HEE e-LfH