Use of wearable devices that monitor physical activity is projected to increase more than fivefold per half-decade¹. We investigated how device-based physical activity energy expenditure (PAEE) and different intensity profiles were associated with all-cause mortality. We used a network harmonization approach to map dominant-wrist acceleration to PAEE in 96,476 UK Biobank participants (mean age 62 years, 56% female). We also calculated the fraction of PAEE accumulated from moderate-to-vigorous-intensity physical activity (MVPA). Over the median 3.1-year follow-up period (302,526 person-years), 732 deaths were recorded. Higher PAEE was associated with a lower hazard of all-cause mortality for a constant fraction of MVPA (for example, 21% (95% confidence interval 4–35%) lower hazard for 20 versus 15 kJ kg⁻¹ d⁻¹ PAEE with 10% from MVPA). Similarly, a higher MVPA fraction was associated with a lower hazard when PAEE remained constant (for example, 30% (8–47%) lower hazard when 20% versus 10% of a fixed 15 kJ kg⁻¹ d⁻¹ PAEE volume was from MVPA). Our results show that higher volumes of PAEE are associated with reduced mortality rates, and achieving the same volume through higher-intensity activity is associated with greater reductions than through lower-intensity activity. The linkage of device-measured activity to energy expenditure creates a framework for using wearables for personalized prevention.

监测身体活动的可穿戴设备的使用预计每五年将增加五倍以上¹ 。我们研究了基于设备的体力活动能量消耗 (PAEE) 和不同强度概况与全因死亡率的关系。我们使用网络协调方法将 96,476 名英国生物银行参与者（平均年龄 62 岁，56% 为女性）的主导手腕加速度映射到 PAEE。我们还计算了从中等到剧烈强度体力活动 (MVPA) 中积累的 PAEE 比例。在中位 3.1 年的随访期内（302,526 人年），记录了 732 例死亡。对于恒定分数的 MVPA，较高的 PAEE 与较低的全因死亡率风险相关（例如，20 kJ kg −1 d ⁻¹ PAEE 与 15 kJ kg ⁻¹ d −1 相比，风险降低 21%（95% 置信区间 4–35%） 10% 来自 MVPA）。同样，当 PAEE 保持恒定时，较高的 MVPA 分数与较低的危险相关（例如，当固定 15 kJ kg ⁻¹ d ⁻¹ PAEE 体积的 20% 与 10% 相比，危险降低 30% (8–47%)。来自 MVPA）。我们的研究结果表明，较高的 PAEE 量与降低的死亡率相关，并且通过较高强度的活动实现相同的 PAEE 量与通过较低强度的活动相比，死亡率的降低幅度更大。将设备测量的活动与能量消耗联系起来，为使用可穿戴设备进行个性化预防创建了一个框架。