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The Importance of Vigorous-Intensity Leisure-Time Physical Activity in Reducing Cardiovascular Disease Mortality Risk in the Obese

  • Gary O'Donovan
    Correspondence
    Correspondence: Address to Gary O'Donovan, PhD, National Centre for Sport and Exercise Medicine – East Midlands, Loughborough University, Loughborough LE11 3TU, United Kingdom.
    Affiliations
    School of Sport, Exercise, and Health Sciences, National Centre for Sport and Exercise Medicine – East Midlands, Loughborough University, Loughborough, United Kingdom
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  • Emmanuel Stamatakis
    Affiliations
    Charles Perkins Centre, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, Australia

    Department of Epidemiology and Public Health, University College London, London, United Kingdom
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  • David J. Stensel
    Affiliations
    School of Sport, Exercise, and Health Sciences, National Centre for Sport and Exercise Medicine – East Midlands, Loughborough University, Loughborough, United Kingdom
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  • Mark Hamer
    Affiliations
    School of Sport, Exercise, and Health Sciences, National Centre for Sport and Exercise Medicine – East Midlands, Loughborough University, Loughborough, United Kingdom

    Department of Epidemiology and Public Health, University College London, London, United Kingdom
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      Abstract

      Objective

      To investigate the role of vigorous-intensity leisure-time physical activity in reducing cardiovascular disease (CVD) mortality risk in the obese.

      Participants and Methods

      Trained interviewers assessed physical activity and body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) in 59,005 adult participants (mean ± SD age, 57±12 years; 46.5% male) in 2 household-based surveillance studies: Health Survey for England and Scottish Health Survey. Mortality was ascertained from death certificates. Data were collected from January 1, 1994, through March 31, 2011. Cox proportional hazards models were adjusted for age, sex, smoking habit, total physical activity, long-standing illness, prevalent CVD, and occupation.

      Results

      There were 2302 CVD deaths during 532,251 person-years of follow-up (mean ± SD, 9±4 years). A total of 15,002 (25%) participants were categorized as obese (BMI ≥30). Leisure-time physical activity was inversely associated and BMI was positively associated with CVD mortality. Compared with those who reported meeting physical activity guidelines including some vigorous-intensity physical activity and who had a normal BMI (18.5-24.9) (reference group), the CVD mortality hazard ratio was not significantly different in the obese who also reported meeting physical activity guidelines including some vigorous-intensity physical activities (1.25; 95% CI, 0.50-3.12). Compared with the reference group, the CVD mortality hazard ratio was more than 2-fold in the obese who reported meeting physical activity guidelines, including only moderate-intensity physical activities (2.52; 95% CI, 1.15-2.53).

      Conclusion

      This large, statistically powerful study suggests that vigorous-intensity leisure-time physical activity is important in reducing CVD mortality risk in the obese.

      Abbreviations and Acronyms:

      BMI (body mass index), CVD (cardiovascular disease), HR (hazard ratio), HSE (Health Survey for England), MET (metabolic equivalent), SHS (Scottish Health Survey)
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