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Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: The European prospective investigation into cancer and nutrition study (EPIC)

30 / 01 / 15

Ekelund et al investigated whether overall and abdominal adiposity modified the association between physical activity and all-cause mortality. The population attributable fraction and the years of life gained for these exposures were also estimated. 

The prospective cohort study examined the associations between physical activity, BMI, waist circumference and mortality in 334,161 European men and women. The mean follow up time was 12.4 years. Physical activity was measured using a validated self-reported instrument.

The study found significant interactions between physical activity and BMI and waist circumference in relation to all-cause mortality. The greatest reductions in mortality risk were observed between the two lowest activity groups (going from moderately inactive to inactive) in both the abdominally lean and obese groups. If all inactive individuals were at least moderately inactive, the number of deaths would theoretically be reduced by 7.35% and life expectancy would increase by 0.70 years.

In comparison there was less of a reduction in mortality risk when comparing levels of obesity: the number of deaths would theoretically be reduced by 3.66% and 0.34 years. This suggests that low physical activity may be responsible for more than twice as many deaths as obesity in this European population. 

Limitations: Significant heterogeneity in population attributable fraction was found between centres of different countries within Europe. The study does not represent the European population and is not specific to the Australian population.