Influence of exercise, walking, cycling, and overall nonexercise physical activity on mortality in Chinese women.

This investigation described the effects of exercise, walking, and cycling for transportation, as well as the effect of overall nonexercise physical activity, on mortality in the Shanghai Women's Health Study (1997-2004). Women without heart disease, stroke, or cancer were followed for an average of 5.7 years (n = 67,143), and there were 1,091 deaths from all causes, 537 deaths from cancer, and 251 deaths from cardiovascular diseases. Information about physical activity and relevant covariates was obtained by interview. Proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals. Exercise and cycling for transportation were both inversely and independently associated with all-cause mortality (p(trend) < 0.05), but walking for transportation was less strongly associated with reduced risk (p(trend) = 0.07). Women reporting no regular exercise but who reported 10 or more metabolic equivalent (MET)-hours/day of nonexercise activity were at 25-50% reduced risk (p(trend) < 0.01) relative to less active women (0-9.9 MET-hours/day). Among women reporting the least nonexercise activity (0-9.9 MET-hours/day) but reporting regular exercise participation, exercise was associated with reduced mortality (hazard ratio = 0.78, 95% confidence interval: 0.62, 0.99). These findings add new evidence that overall physical activity levels are an important determinant of longevity, and that health benefit can be obtained through an active lifestyle, exercise, or combinations of both.

[1]  Tamara B Harris,et al.  Daily activity energy expenditure and mortality among older adults. , 2006, JAMA.

[2]  N. Rothman,et al.  The Shanghai Women's Health Study: rationale, study design, and baseline characteristics. , 2005, American journal of epidemiology.

[3]  Charles E Matthews,et al.  The effect of social desirability and social approval on self-reports of physical activity. , 2005, American journal of epidemiology.

[4]  M. Clark,et al.  Interindividual Variation in Posture Allocation: Possible Role in Human Obesity , 2005, Science.

[5]  J. Tuomilehto,et al.  Low physical activity as a predictor for total and cardiovascular disease mortality in middle-aged men and women in Finland. , 2004, European heart journal.

[6]  X. Shu,et al.  Validity and reproducibility of the food frequency questionnaire used in the Shanghai Women's Health Study , 2004, European Journal of Clinical Nutrition.

[7]  B. Ainsworth,et al.  Reproducibility and validity of the Shanghai Women's Health Study physical activity questionnaire. , 2003, American journal of epidemiology.

[8]  P. Katzmarzyk,et al.  Physical inactivity, excess adiposity and premature mortality , 2003, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[9]  Carl J Caspersen,et al.  Relationship of walking to mortality among US adults with diabetes. , 2003, Archives of internal medicine.

[10]  J. Manson,et al.  Walking compared with vigorous exercise for the prevention of cardiovascular events in women. , 2002, The New England journal of medicine.

[11]  R S Paffenbarger,et al.  Physical activity and all cause mortality in women: a review of the evidence , 2002, British journal of sports medicine.

[12]  J. Manson,et al.  Physical activity and coronary heart disease in women: is "no pain, no gain" passé? , 2001, JAMA.

[13]  P S Freedson,et al.  Sources of variance in daily physical activity levels in the seasonal variation of blood cholesterol study. , 2001, American journal of epidemiology.

[14]  J. Manson,et al.  Physical activity and mortality: a prospective study among women. , 2001, American journal of public health.

[15]  Klaas R. Westerterp,et al.  Pattern and intensity of physical activity , 2001, Nature.

[16]  I-Min Lee,et al.  Physical Activity and Coronary Heart Disease in Women: Is No Pain, No Gain Passé? , 2001 .

[17]  B E Ainsworth,et al.  Compendium of physical activities: an update of activity codes and MET intensities. , 2000, Medicine and science in sports and exercise.

[18]  M. Schroll,et al.  All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. , 2000, Archives of internal medicine.

[19]  P. V. Rao,et al.  Applied Survival Analysis: Regression Modeling of Time to Event Data , 2000 .

[20]  J. Manson,et al.  A Prospective Study of Walking as Compared with Vigorous Exercise in the Prevention of Coronary Heart Disease in Women , 2000 .

[21]  J. Levine,et al.  Role of nonexercise activity thermogenesis in resistance to fat gain in humans. , 1999, Science.

[22]  P Corey,et al.  The Impact of Excluding Non‐Leisure Energy Expenditure on the Relation between Physical Activity and Mortality in Women , 1998, Epidemiology.

[23]  B. Ainsworth,et al.  Measuring physical activity in midlife, older, and minority women: issues from an expert panel. , 1998, Journal of women's health.

[24]  Physical activity and mortality in postmenopausal women. , 1997, JAMA.

[25]  E L Korn,et al.  Time-to-event analysis of longitudinal follow-up of a survey: choice of the time-scale. , 1997, American journal of epidemiology.

[26]  X. Shu,et al.  Occupational physical activity and the incidence of cancer of the breast, corpus uteri, and ovary in shanghai , 1993, Cancer.

[27]  B. Ainsworth,et al.  Gender Differences in Physical Activity , 1993 .

[28]  J F Sallis,et al.  Compendium of physical activities: classification of energy costs of human physical activities. , 1993, Medicine and science in sports and exercise.