Background: We examined the joint associations of diet and device-measured intensity-specific PA with all-cause mortality (ACM), cardiovascular disease (CVD) and cancer incidence.
Methods: We used data from 79,988 participants from the UK Biobank, a population-based prospective cohort study. Light PA (LPA), moderate-to-vigorous PA (MVPA), vigorous PA (VPA) and total PA (TPA) were measured using a wrist-worn accelerometer. Diet Quality Score (DQS) was based on 10 foods and ranged from 0 (unhealthiest) to 100 (healthiest) points. We derived joint PA and diet variables. Outcomes were all-cause mortality, CVD and cancer incidence including PA, diet and adiposity-related (PDAR) cancer.
Results: During a median follow-up of 8 years, 2,863 deaths occurred, 11,053 participants developed CVD, 7,005 developed cancer and 3,400 developed PDAR cancer. Compared with the least favourable referent group (bottom PA tertile/low DQS), participants with middle and high (total and intensity specific) PA, except for LPA, had lower all-cause mortality risk and incident CVD risk, regardless of DQS. For example, among middle and high VPA and high DQS groups, CVD HR were 0.79 (95%CI 0.74-0.86) and 0.75 (95%CI 0.69-0.82), respectively. The pattern of cancer results was less pronounced but in agreement with the ACM and CVD incidence findings (e.g. HR 0.90, 95%CI 0.81-0.99; 0.88,0.79-0.98 and 0.82,0.74-0.92 among high VPA for low, moderate and high DQS group, respectively).
Conclusions: Device-measured PA reveals novel joint associations with diet on health outcomes.
Impact: Our results emphasize the crucial role of PA in addition to a healthy diet for reducing chronic diseases and mortality risk.