@article{a34a2ff1f81d491f8d8d695dde683b9f,
title = "Association of leisure-time physical activity with total and cause-specific mortality: A pooled analysis of nearly a half million adults in the Asia Cohort Consortium",
abstract = "Background: Most previous studies evaluating the association between leisure-time physical activity (LTPA) and risk of death were conducted among generally healthy individuals of European ancestry. We investigated the association of LTPA with all-cause and cause-specific mortality among East Asian populations, including healthy individuals and those with existing chronic diseases, which has been less well characterized. Methods: We performed pooled analyses among 467 729 East Asian individuals recruited in nine prospective cohorts included in the Asia Cohort Consortium. Cox proportional hazards regressions were used to derive hazard ratios (HRs) and 95% confidence intervals (CIs) associated with LTPA after adjusting for age, sex, education and marital and smoking status. Results: During a mean follow-up period of 13.6 years, 65 858 deaths were identified. Compared with those who reported no or less than 1 h of LTPA per week, an inverse association was observed between the amount of LTPA and all-cause and cause-specific mortality (P for trend < 0.001). The strength of the inverse association was stronger for death due to cardiovascular diseases and causes other than cancer deaths. An inverse association of LTPA with total mortality was observed among individuals with a severe and often life-threatening disease: cancer, stroke or coronary heart disease [hazard ratio (HR) ¼ 0.81, 95% CI ¼ 0.73-0.89 for high vs low LTPA) and those with other chronic diseases such as diabetes or hypertension (HR ¼ 0.86, 95% CI ¼ 0.80-0.93 for high vs low LTPA). No clear modifying effects by sex, body mass index or smoking status were identified. Conclusions: Regular participation in LTPA is associated with reduced mortality in middle-aged and elder Asians regardless pre-existing health conditions.",
keywords = "Asia, Cancer, Cardiovascular, Coronary heart disease, Diabetes, Hypertension, Leisure-time physical activity, Mortality, Stroke",
author = "Ying Liu and Shu, {Xiao Ou} and Wanqing Wen and Eiko Saito and {Shafiur Rahman}, M. and Shoichiro Tsugane and Akiko Tamakoshi and Xiang, {Yong Bing} and Yuan, {Jian Min} and Gao, {Yu Tang} and Ichiro Tsuji and Seiki Kanemura and Chisato Nagata and Shin, {Myung Hee} and Pan, {Wen Harn} and Koh, {Woon Puay} and Norie Sawada and Hui Cai and Li, {Hong Lan} and Yasutake Tomata and Yumi Sugawara and Keiko Wada and Ahn, {Yoon Ok} and Yoo, {Keun Young} and Habibul Ashan and Chia, {Kee Seng} and Paolo Boffetta and Manami Inoue and Daehee Kang and Potter, {John D.} and Wei Zheng",
note = "Funding Information: This work was supported by research funds from the Anne Potter Wilson Chair endowment and National Institutes of Health grants (UM1CA182910 to W.Z. and UM1CA173640 to X.O.S.) at Vanderbilt University Medical Center. The cohorts participating in the pooled analysis were supported by the following grants: Japan Public Health Center-based prospective Study (JPHC Study) 1 and 2, National Cancer Center Research and Development Fund [23-A-31(toku) and 26-A-2] (since 2011) and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010); Japan Collaborative Cohort Study (JACC), National Cancer Center Research and Development Fund, a Grant-in-Aid for Cancer Research; Grant for Health Services and Grant for Comprehensive Research on Cardiovascular and LifeStyle Related Diseases from the Ministry of Health, Labour and Welfare, Japan; Grant for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan; Shanghai Women{\textquoteright}s Health Study (SWHS), the US National Cancer Institute (R37 CA070867, UM1 CA182910); Singapore Chinese Health Study, National Institutes for Health (R01CA144034, U01CA182876); Shanghai Men{\textquoteright}s Health Study (SMHS), the US National Cancer Institute (R01 CA082729, UM1 CA173640); Ohsaki National Health Insurance Cohort Study, Grants-in-Aid for Cancer Research and for the Third Term Comprehensive Ten-Year Strategy for Cancer Control (H21-3jigan-ippan-003), Ministry of Health, Labour and Welfare; Miyagi Cohort, Grants-in-Aid for Cancer Research and for the Third Term Comprehensive Ten-Year Strategy for Cancer Control (H21-3jigan-ippan-003), Ministry of Health, Labour and Welfare; CardioVascular Disease risk FACtor Two-township Study [CVDFACTS; Department of Health, Taiwan (DOH80-27, DOH81-021, DOH8202-1027, DOH83-TD-015, and DOH84-TD-006)]; Takayama Study, National Cancer Center Research and Development Fund; and Seoul Male Cancer Cohort, National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (0520160-1). The authors would like to thank all research team members and participants of each cohort study for their contribution to this research. We also thank Dr Jae Jeong Yang for her assistance in analysing the data, and Ms Kimberly A Kreth for her assistance in preparing the manuscript. Publisher Copyright: {\textcopyright} The Author(s) 2018; all rights reserved.",
year = "2018",
month = jun,
doi = "10.1093/ije/dyy024",
language = "English",
volume = "47",
pages = "771--779",
journal = "International Journal of Epidemiology",
issn = "0300-5771",
publisher = "Oxford University Press",
number = "3",
}