Objectively Measured Physical Activity and Mortality Risk Among American Adults

  • Emily Borgundvaag
    Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
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  • Ian Janssen
    Address correspondence to: Ian Janssen, PhD, School of Kinesiology and Health Studies, Queen’s University, 28 Division St., Kingston, ON, Canada, K7L 3N6
    Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada

    School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
    Search for articles by this author
Published:November 02, 2016DOI:


      One major limitation of prior studies examining the influence of physical activity on mortality is use of self-reported measures. This study examined the association between objectively measured light physical activity (LPA) and moderate to vigorous physical activity (MVPA) and all-cause mortality.


      This study included 5,562 adults from the 2003–2006 National Health and Nutrition Examination Survey. LPA and MVPA were measured over 4–7 days using Actigraph AM-7164 accelerometers. For both activity intensities, the first quintile defined low participation and the remaining quintiles defined modest to high participation. Information on age, sex, race, SES, diet, smoking, and alcohol were collected and controlled for. Survival status through December 31, 2011, was determined. Average follow-up was 6.7 years. Data were analyzed in 2015.


      In women, the all-cause mortality hazard ratio (HR) was 0.58 (95% CI=0.38, 0.88) for modest to high LPA and 0.34 (95% CI=0.20, 0.57) for modest to high MVPA. Corresponding HRs in men were 1.02 (95% CI=0.64, 1.61) and 0.39 (95% CI=0.27, 0.56). Compared with women with a low LPA/low MVPA combination, mortality risk was reduced in the modest to high LPA/low MVPA (HR=0.42, 95% CI=0.26, 0.70), low LPA/modest to high MVPA (HR=0.16, 95% CI=0.07, 0.34), and modest to high LPA/modest to high MVPA (HR=0.17, 95% CI=0.09, 0.36) combinations. In men, mortality risk was not reduced with modest to high LPA/low MVPA.


      MVPA was associated with a substantially lower mortality risk. LPA was associated with lower mortality risk, but only within women with low MVPA.
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        • Janssen I.
        • Carson V.
        • Lee I.M.
        • Katzmarzyk P.T.
        • Blair S.N.
        Years of life gained due to leisure-time physical activity in the U.S.
        Am J Prev Med. 2013; 44: 23-29
        • Warburton D.E.
        • Charlesworth S.
        • Nettlefold L.
        • Ivey A.
        • Bredin S.S.
        A systematic review of the evidence for Canada’s physical activity guidelines for adults.
        Int J Behav Nutr Phys Act. 2010; 7: 39
        • Colley R.C.
        • Garriguet D.
        • Janssen I.
        • Craig C.L.
        • Clarke J.
        • Tremblay M.S.
        Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey.
        Health Rep. 2011; 22: 7-14
        • Troiano R.P.
        • Berrigan D.
        • Dodd K.W.
        • Masse L.C.
        • Tilert T.
        • McDowell M.
        Physical activity in the United States measured by accelerometer.
        Med Sci Sports Exerc. 2008; 40: 181-188
        • Tudor-Locke C.
        • Johnson W.D.
        • Katzmarzyk P.T.
        Frequently reported activities by intensity for U.S. adults: the American Time Use Survey.
        Am J Prev Med. 2010; 39: e13-e20
        • Prince S.A.
        • Adamo K.B.
        • Hamel M.E.
        • Hardt J.
        • Gorber S.C.
        • Tremblay M.
        A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review.
        Int J Behav Nutr Phys Act. 2008; 5: 56
        • Robson J.
        • Janssen I.
        A description of the volume and intensity of sporadic physical activity among adults.
        BMC Sports Sci Med Rehabil. 2015; 7: 2
        • Clarke J.
        • Janssen I.
        Sporadic and bouted physical activity and the metabolic syndrome in adults.
        Med Sci Sports Exerc. 2014; 46: 76-83
        • Glazer N.L.
        • Lyass A.
        • Esliger D.W.
        • et al.
        Sustained and shorter bouts of physical activity are related to cardiovascular health.
        Med Sci Sports Exerc. 2013; 45: 109-115
        • Esliger D.
        • Tremblay M.T.
        Physical activity and inactivity profiling: the next generation.
        Can J Public Health. 2007; 98: S195-S207
        • Morris J.N.
        • Crawford M.D.
        Coronary heart disease and physical activity of work: evidence of a national necropsy survey.
        BMJ. 1958; 30: 1485-1496
        • Chau J.Y.
        • Grunseit A.C.
        • Chey T.
        • et al.
        Daily sitting time and all-cause mortality: a meta-analysis.
        PLoS One. 2013; 8: e80000
        • Koster A.
        • Caserotti P.
        • Patel K.V.
        • et al.
        Association of sedentary time with mortality independent of moderate to vigorous physical activity.
        PLoS One. 2012; 7: e37696
        • Dwyer T.
        • Pezic A.
        • Sun C.
        • et al.
        Objectively measured daily steps and subsequent long term all-cause mortality: the Tasped Prospective Cohort Study.
        PLoS One. 2015; 10: e0141274
        • Masse L.C.
        • Fuemmeler B.F.
        • Anderson C.B.
        • et al.
        Accelerometer data reduction: a comparison of four reduction algorithms on select outcome variables.
        Med Sci Sports Exerc. 2005; 37: S544-S554
        • Colley R.
        • Gorber S.C.
        • Tremblay M.S.
        Quality control and data reduction procedures for accelerometry-derived measures of physical activity.
        Health Rep. 2010; 21: 63-69
        • Choi L.
        • Liu Z.
        • Matthews C.E.
        • Buchowski M.S.
        Validation of accelerometer wear and nonwear time classification algorithm.
        Med Sci Sports Exerc. 2011; 43: 357-364
        • Office of Analysis and Epidemiology
        NCHS 2011 Linked Mortality Files Matching Methodology.
        National Center for Health Statistics, Hyattsville, MDSeptember 2013
        • National Institute on Alcohol Abuse and Alcoholism
        The Physicians’ Guide to Helping Patients with Alcohol Problems (NIH Publication No 95–3796).
        U.S. DHHS, Washington, DC1995
        • U.S. DHHS, U.S. Department of Agriculture
        Dietary Guidelines for Americans 2005 [Publication No. HHS-ODPHP-2005-01-DGA-A].
        U.S. DHHS, Washington, DC2005
        • Short K.
        The research supplemental poverty measure: 2011.
        Curr Popul Rep Consum Income. 2012; (November:P60-244)
        • Manini T.M.
        • Everhart J.E.
        • Patel K.V.
        • et al.
        Daily activity energy expenditure and mortality among older adults.
        JAMA. 2006; 296: 171-179
        • Paffenbarger Jr., R.S.
        • Hyde R.T.
        • Wing A.L.
        • Hsieh C.C.
        Physical activity, all-cause mortality, and longevity of college alumni.
        N Engl J Med. 1986; 314: 605-613
        • Gregg E.W.
        • Cauley J.A.
        • Stone K.
        • et al.
        Relationship of changes in physical activity and mortality among older women.
        JAMA. 2003; 289: 2379-2386
        • Crespo C.J.
        • Palmieri M.R.
        • Perdomo R.P.
        • et al.
        The relationship of physical activity and body weight with all-cause mortality: results from the Puerto Rico Heart Health Program.
        Ann Epidemiol. 2002; 12: 543-552
        • Katzmarzyk P.T.
        Standing and mortality in a prospective cohort of Canadian adults.
        Med Sci Sports Exerc. 2014; 46: 940-946
        • Sabanayagam C.
        • Shankar A.
        Sleep duration and cardiovascular disease: results from the National Health Interview Survey.
        Sleep. 2010; 33: 1037-1042
        • van der Ploeg H.P.
        • Chey T.
        • Korda R.J.
        • Banks E.
        • Bauman A.
        Sitting time and all-cause mortality risk in 222 497 Australian adults.
        Arch Intern Med. 2012; 172: 494-500
        • Siegel P.Z.
        • Brackbill R.M.
        • Heath G.W.
        The epidemiology of walking for exercise: implications for promoting activity among sedentary groups.
        Am J Public Health. 1995; 85: 706-710