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Effects of physical activity, body mass index, waist-to-hip ratio and waist circumference on total mortality risk in the Swedish National March Cohort

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Abstract

The health benefits of physical activity (PA) have been well documented. However, there is less research investigating whether or not these health benefits might differ among males and females or among subjects characterized by different levels of body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). Baseline total PA, BMI, WHR and waist circumference were measured in 14,585 men and 26,144 women who participated in the Swedish National March. Their effects on all-cause mortality were analyzed with a follow-up time of almost 10 years. Sedentary men with a BMI ≥ 30 had a 98% (95% CI: 30–201%) increased risk of mortality compared to normal weight men with a high level of total PA. The same trend was observed for sedentary men with high WHR or waist circumference, compared to lean and highly active men. Sedentary women with a waist circumference of 88 cm or more had almost doubled, i.e. 97% (95% CI: 35–189%) increased mortality risk compared to physically active women with a waist circumference below 80 cm. BMI in men, but waist circumference in women better forecast all-cause mortality. We found no substantial effect modification between different measures of adiposity and physical activity—physical inactivity and obesity seem to increase total mortality risk independently and additively.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

HR:

Hazard ratio

ICD:

International classification of disease

IQR:

Interquartile range

MET:

Metabolic energy turnover

PA:

Physical activity

PAL:

Physical activity level

STEPPS:

Subpopulation treatment effect pattern plot

WC:

Waist circumference

WHR:

Waist-to-hip ratio

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Acknowledgments

This work was supported by the companies ICA AB and Ericsson. We would like to thank Statistics Sweden for scanning the questionnaires. We also would like to express sincere gratitude to the Swedish Cancer Society and volunteers who worked with the National March.

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Authors and Affiliations

  1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Rino Bellocco, Chongqi Jia & Weimin Ye

  2. Department of Statistics, University of Milano-Bicocca, Milan, Italy

    Rino Bellocco

  3. Department of Epidemiology and Health Statistics, Shandong University, Shandong, People’s Republic of China

    Chongqi Jia

  4. Department of Medicine, Unit of Clinical Epidemiology, Karolinska Institutet, T2, 171 76, Stockholm, Sweden

    Ylva Trolle Lagerros

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  1. Rino Bellocco
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  2. Chongqi Jia
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  3. Weimin Ye
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  4. Ylva Trolle Lagerros
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Correspondence to Ylva Trolle Lagerros.

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Rino Bellocco and Chongqi Jia equally share the first authorship.

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Bellocco, R., Jia, C., Ye, W. et al. Effects of physical activity, body mass index, waist-to-hip ratio and waist circumference on total mortality risk in the Swedish National March Cohort. Eur J Epidemiol 25, 777–788 (2010). https://doi.org/10.1007/s10654-010-9497-6

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