AIMS Continuing physical activity (PA) and maintaining body weight are tightly intertwined; however, no study investigated whether these two factors have interactions in terms of the mortality. The aim of this study is to elucidate whether continuing regular PA and maintaining body weight have interactions in terms of all-cause mortality risk. METHODS AND RESULTS Participants with health screening from both 2009 and 2011 without underlying cancer or cardiovascular disease were included. Physical activity change was grouped as remained active, inactive-to-active, active-to-inactive, or remained inactive. Body weight change was categorized as stable (weight change < 5%), weight gain, or loss. Outcome included all-cause mortality. Of 6 572 984 total participants, 91 347 deaths occurred during a median 7.4-year follow-up. Compared with the remained active and stable weight group, most other groups had a higher mortality risk. The weight loss and remained inactive group [adjusted hazard ratio (aHR), 2.30; 95% confidence interval (CI), 2.22-2.38] and the weight gain and remained inactive group (aHR, 2.17; 95% CI, 2.09-2.25) showed the highest mortality risks. Among stable weight participants, the ranking of the groups from highest to lowest in terms of mortality risk was as follows: remained inactive (aHR, 1.46; 95% CI, 1.41-1.50), active-to-inactive (aHR, 1.24; 95% CI, 1.19-1.29), inactive-to-active (aHR, 1.15; 95% CI, 1.11-1.20), and remained active (reference). Remaining active and maintaining a stable body weight had a synergistic interaction on decreasing all-cause mortality risk (multiplicative P for interaction < 0.001; relative excess risk due to interaction, 0.38; 95% CI, 0.31-0.46; attributable proportion, 0.18; 95% CI, 0.15-0.22). CONCLUSIONS Continuing regular PA as recommended and maintaining body weight have multiplicative and additive interactions on reducing all-cause mortality. Healthcare providers should emphasize the importance of both regular PA and body weight maintenance for the general public.

中文翻译：

---

继续有规律的体育活动和保持体重在提高生存率方面具有协同作用：一项包括 650 万人的基于人群的队列研究。

AIMS 持续的体力活动 (PA) 和保持体重紧密相连；然而，没有研究调查这两个因素在死亡率方面是否存在相互作用。本研究的目的是阐明继续定期 PA 和保持体重在全因死亡风险方面是否存在相互作用。方法和结果 纳入 2009 年和 2011 年进行健康检查且没有潜在癌症或心血管疾病的参与者。身体活动变化分为保持活跃、不活跃到活跃、活跃到不活跃或保持不活跃。体重变化分为稳定（体重变化 < 5%）、体重增加或减轻。结果包括全因死亡率。在 6 572 984 名参与者中，91 347 例死亡发生在中位 7.4 年的随访期间。与保持活跃和稳定体重组相比，大多数其他组的死亡风险更高。体重减轻和保持不活动组[调整后的风险比 (aHR)，2.30；95% 置信区间 (CI), 2.22-2.38] 和体重增加和保持不活动组 (aHR, 2.17; 95% CI, 2.09-2.25) 显示出最高的死亡风险。在体重稳定的参与者中，死亡风险从高到低排列如下：保持不活动（aHR，1.46；95% CI，1.41-1.50），活动到不活动（aHR，1.24；95） % CI，1.19-1.29），非活动到活动（aHR，1.15；95% CI，1.11-1.20），并保持活跃（参考）。保持活跃和保持稳定的体重在降低全因死亡风险方面具有协同作用（交互作用的乘法 P < 0.001；相互作用引起的相对超额风险，0.38；95% CI，0.31-0.46；归属比例，0.18；95% CI，0.15-0.22)。结论 继续推荐的定期 PA 和保持体重对降低全因死亡率具有乘法和加法的相互作用。医疗保健提供者应强调对公众进行定期 PA 和维持体重的重要性。