Decomposing the effects of physical activity and cardiorespiratory fitness on mortality

Global Epidemiology

Steven D. Stovitz¹  Ian Shrier²  Xuemei Sui³  Steven N. Blair⁴  Julian Wolfson⁵  Duck-chul Lee⁶ 

[1] Corresponding author at: A460 Mayo Building MMC 303, 420 Delaware St. SE, Minneapolis, MN 55455, USA.;Iowa State University, College of Human Sciences, Department of Kinesiology, Ames, USA;Retired from University of South Carolina, Arnold School of Public Health, Departments of Exercise Science and Epidemiology and Biostatistics, Columbia, USA;University of Minnesota, Department of Family Medicine and Community Health, Minneapolis, USA;University of Minnesota, School of Public Health, Division of Biostatistics, Minneapolis, USA;University of South Carolina, Department of Exercise Science, Division of Health Aspects of Physical Activity, Columbia, USA;

关键词: Physical activity;    Cardiorespiratory fitness;    Diabetes;    Hypertension;    Mortality;    Mediation;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Characterizing the effects of physical activity (PA) and cardiorespiratory fitness (CRF) on mortality is challenging because the causal relationship between PA, CRF, and other cardiovascular risk factors is unclear. Methods: To better understand the effects of PA and CRF on mortality, we re-analyzed data from 42,373 participants in the Aerobics Center Longitudinal Study (ACLS) using a modified version of VanderWeele's four-way causal effect decomposition method. The method was applied to decompose the causal effects of PA and CRF on median time to death into parts reflecting mediation, interaction, mediated interaction, and neither interaction nor mediation. Results: We found that 67% of the effect of PA on mortality was mediated by CRF, while the effect of CRF was not significantly mediated by PA. The effects of both PA and CRF were mediated to a small extent by hypertension and diabetes. There were no meaningful interactions. Conclusions: Our findings strengthen the evidence that the benefit on mortality from PA is largely mediated by its effect on CRF, and support efforts to increase longevity by encouraging PA.

【 授权许可】

Unknown