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The importance of non-exercise physical activity for cardiovascular health and longevity.
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group. Karolinska institutet.ORCID iD: 0000-0002-3901-7833
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.ORCID iD: 0000-0002-4030-5437
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2014 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 48, 233-238 p.Article in journal (Refereed) Published
Abstract [en]

Background Sedentary time is increasing in all societies and results in limited non-exercise physical activity (NEPA) of daily life. The importance of low NEPA for cardiovascular health and longevity is limited, especially in elderly.                                

Aim To examine the association between NEPA and cardiovascular health at baseline as well as the risk of a first cardiovascular disease (CVD) event and total mortality after 12.5 years.

Study design Cohort study.                                

Material and methods Every third 60-year-old man and woman in Stockholm County was invited to a health screening study; 4232 individuals participated (78% response rate). At baseline, NEPA and exercise habits were assessed from a self-administrated questionnaire and cardiovascular health was established through physical examinations and laboratory tests. The participants were followed for an average of 12.5 years for the assessment of CVD events and mortality.                                

Results At baseline, high NEPA was, regardless of regular exercise and compared with low NEPA, associated with more preferable waist circumference, high-density lipoprotein cholesterol and triglycerides in both sexes and with lower insulin, glucose and fibrinogen levels in men. Moreover, the occurrence of the metabolic syndrome was significantly lower in those with higher NEPA levels in non-exercising and regularly exercising individuals. Furthermore, reporting a high NEPA level, compared with low, was associated with a lower risk of a first CVD event (HR=0.73; 95% CI 0.57 to 0.94) and lower all-cause mortality (0.70; 0.53 to 0.98).                                

Conclusions A generally active daily life was, regardless of exercising regularly or not, associated with cardiovascular health and longevity in older adults.                                

Place, publisher, year, edition, pages
2014. Vol. 48, 233-238 p.
Keyword [en]
NEPA, Health, Exercise, Human
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
URN: urn:nbn:se:gih:diva-2988DOI: 10.1136/bjsports-2012-092038OAI: oai:DiVA.org:gih-2988DiVA: diva2:659502
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Note

At the time of Elin Ekblom Bak's dissertation the article was accepted for publication.

Available from: 2013-10-25 Created: 2013-10-25 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Physical activity, cardiorespiratory fitness, and abdominal obesity in relation to cardiovascular disease risk: epidemiological studies
Open this publication in new window or tab >>Physical activity, cardiorespiratory fitness, and abdominal obesity in relation to cardiovascular disease risk: epidemiological studies
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Although Sweden saw a decline in death rates related to cardiovascular disease (CVD) between 1987 and 2011, it is still the most common cause of death for both women and men. Lifestyle-related factors such as inadequate physical activity (PA), poor cardiorespiratory fitness (CF), and excess body fat are all recognised as important predictors of CVD morbidity and mortality. More recently, studies have highlighted the possible detrimental effects of prolonged sitting, which mainly substitutes for daily non-exercise PA (NEPA). Conversely, more preferable levels of these lifestyle factors are associated with lower CVD risk and increased life expectancy. Despite the extensive research performed within this field, there is still no consensus.

The main objective of this thesis was therefore to examine the interrelationship between different levels of PA, CF, and abdominal adiposity and their association with CVD risk factors, CVD morbidity, and longevity in population-based samples of Swedish men and women of different ages. A second objective was to develop a new and more precise method for estimation of CF in a mixed, healthy, population.

The main findings were

- In a cross-sectional population based random sample of Swedish men (n=781) and women (n=890) aged 20 to 65 years were CF and abdominal obesity each independently and strongly beneficially associated with individual CVD risk factors, as well as to a clustered CVD risk factor profile. For the clustered risk, each unit of fitness (ml·kg-1·min-1) was associated with a 5% decrease in risk and each unit of waist circumference (cm) with a 5% increase in risk. This was seen in women as well as men, younger as well as older people, and daily smokers as well as non-smokers; however, there were some differences within the subgroups.

- In the same population, higher levels of self-reported PA and CF, but mainly the latter, were independently associated in a beneficial way with both individual and clustered CVD risk factors. Furthermore, a notable interaction of excess clustered CVD risk was shown for being insufficiently physical active according to general guidelines in combination with not being fit.

- In a representative cohort of 60-year-old men (n=2039) and women (n=2193) in Stockholm County, a generally active daily life was associated with beneficial metabolic health at baseline and an approximately 30% lower risk for a first-time cardiovascular event and all-cause mortality, respectively, after 12.5 years. These relationships were independent of regular exercise.

- A new submaximal cycle ergometer test for estimation of maximal oxygen uptake was developed. The test is simple, low-risk, and easily administered, and does not require laboratory equipment or expertise. In a mixed population (in terms of age, activity status, and gender), the test showed a significantly increased precision compared with one of the most commonly used submaximal exercise tests today.

In conclusion, these results indicate that in clinical practice it is important to evaluate both PA and CF as well as abdominal obesity status. Regarding PA, it is important to highlight the separate beneficial associations of a daily active life including NEPA on the one hand, and intentional regular exercise on the other.

Place, publisher, year, edition, pages
Karolinska Institutet, 2013
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-2989 (URN)978-91-7549-309-1 (ISBN)
Public defence
2013-11-15, Aulan, GIH, Lidingövägen 1, Stockholm, 09:00 (English)
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Supervisors
Available from: 2013-10-25 Created: 2013-10-25 Last updated: 2015-09-18Bibliographically approved

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