Physical activity, diet quality and all-cause cardiovascular disease and cancer mortality: a prospective study of 346 627 UK Biobank participants

Ding Ding; Joe Van Buskirk; Binh Nguyen; Emmanuel Stamatakis; Mona Elbarbary; Nicola Veronese; Philip J Clare; I-Min Lee; Ulf Ekelund; Luigi Fontana

doi:10.1136/bjsports-2021-105195

Physical activity, diet quality and all-cause cardiovascular disease and cancer mortality: a prospective study of 346 627 UK Biobank participants

Br J Sports Med. 2022 Jul 10:bjsports-2021-105195. doi: 10.1136/bjsports-2021-105195. Online ahead of print.

Authors

Ding Ding^{1

2}, Joe Van Buskirk^{3

4}, Binh Nguyen^{3

2}, Emmanuel Stamatakis^{2

5}, Mona Elbarbary³, Nicola Veronese⁶, Philip J Clare^{3

2

7}, I-Min Lee⁸, Ulf Ekelund^{9

10}, Luigi Fontana^{2

11

12}

Affiliations

¹ Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia melody.ding@sydney.edu.au.
² Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia.
³ Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
⁴ Sydney Local Health District, Camperdown, New South Wales, Australia.
⁵ School of Health Sciences, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
⁶ Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy.
⁷ National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
⁸ Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁹ Norwegian School of Sports Sciences, Oslo, Norway.
¹⁰ Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway.
¹¹ Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
¹² Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

PMID: 35811091
DOI: 10.1136/bjsports-2021-105195

Abstract

Objectives: To examine independent and interactive associations of physical activity and diet with all-cause, cardiovascular disease (CVD) and physical activity, diet and adiposity-related (PDAR) cancer mortality.

Methods: This population-based prospective cohort study (n=346 627) is based on the UK Biobank data with linkage to the National Health Service death records to 30 April 2020. A left-truncated Cox proportional hazards model was fitted to examine the associations between exposures (self-reported total moderate-to-vigorous intensity physical activity (MVPA), vigorous-intensity physical activity (VPA) and a diet quality index (score ranged 0-3)) and outcomes (all-cause, CVD and PDAR cancer mortality).

Results: During a median follow-up of 11.2 years, 13 869 participants died from all causes, 2650 from CVD and 4522 from PDAR cancers. Compared with quartile 1 (Q1, 0-210 min/week), Q2-Q4 of MVPA were associated with lower risks of all-cause (HR ranged from 0.87 (95% CI: 0.83 to 0.91) to 0.91 (95% CI: 0.87 to 0.96)), CVD (HR ranged from 0.85 (95% CI: 0.76 to 0.95) to 0.90 (95% CI: 0.81 to 1.00)) and PDAR cancer mortality (HR ranged from 0.86 (95% CI: 0.79 to 0.93) to 0.94 (95% CI: 0.86 to 1.02)). Compared with no VPA, any VPA was associated with lower risk for all-cause and CVD mortality (HR ranged from 0.85 (95% CI: 0.80 to 0.89) to 0.88 (95% CI: 0.84 to 0.93) and from 0.75 (95% CI: 0.68 to 0.83) to 0.90 (95% CI: 0.80 to 1.02), respectively). Although not reaching statistical significance for all-cause and CVD mortality, being in the best dietary category (diet quality index=2-3) was associated with a reduction in PDAR cancer mortality (HR=0.86, 95% CI: 0.78 to 0.93). No additive or multiplicative interactions between physical activity categories and dietary quality was found. When comparing across physical activity and diet combinations, the lowest risk combinations consistently included the higher levels of physical activity and the highest diet quality score.

Conclusions: Adhering to both quality diet and sufficient physical activity is important for optimally reducing the risk of mortality from all causes, CVD and PDAR cancers.

Keywords: epidemiology; preventive medicine.

Abstract

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