Background The joint associations of total and intensity-specific physical activity with obesity in relation to all-cause mortality risk are unclear. Methods We included 34 492 adults (72% women, median age 62.1 years, 2034 deaths during follow-up) in a harmonised meta-analysis of eight population-based prospective cohort studies with mean follow-up ranging from 6.0 to 14.5 years. Standard body mass index categories were cross-classified with sample tertiles of device-measured total, light-to-vigorous and moderate-to-vigorous physical activity and sedentary time. In five cohorts with waist circumference available, high and low waist circumference was combined with tertiles of moderate-to-vigorous physical activity. Results There was an inverse dose–response relationship between higher levels of total and intensity-specific physical activity and mortality risk in those who were normal weight and overweight. In individuals with obesity, the inverse dose–response relationship was only observed for total physical activity. Similarly, lower levels of sedentary time were associated with lower mortality risk in normal weight and overweight individuals but there was no association between sedentary time and risk of mortality in those who were obese. Compared with the obese-low total physical activity reference, the HRs were 0.59 (95% CI 0.44 to 0.79) for normal weight-high total activity and 0.67 (95% CI 0.48 to 0.94) for obese-high total activity. In contrast, normal weight-low total physical activity was associated with a higher risk of mortality compared with the obese-low total physical activity reference (1.28; 95% CI 0.99 to 1.67). Conclusions Higher levels of physical activity were associated with lower risk of mortality irrespective of weight status. Compared with obesity-low physical activity, there was no survival benefit of being normal weight if physical activity levels were low. Data ara available on reasonable request. The study-specific summary data included in the meta-analyses can be obtained from the corresponding authors; jtarp@clin.au.dk.

中文翻译：

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设备测量的体力活动、肥胖和死亡率：八项前瞻性队列研究的统一荟萃分析


背景 总的和特定强度的体力活动与肥胖和全因死亡风险的联合关系尚不清楚。方法 我们对 8 项基于人群的前瞻性队列研究进行统一荟萃分析，纳入了 34 492 名成年人（72% 为女性，中位年龄 62.1 岁，随访期间死亡 2034 人），平均随访时间为 6.0 至 14.5 年。标准体重指数类别与设备测量的总体力活动、轻度至剧烈和中度至剧烈体力活动以及久坐时间的样本三分位数进行交叉分类。在五个具有可用腰围的队列中，将高腰围和低腰围与中度至剧烈体力活动的三分位数相结合。结果在正常体重和超重人群中，较高水平的总体力活动和特定强度体力活动与死亡风险之间存在反剂量反应关系。在肥胖个体中，仅在总体力活动中观察到反剂量反应关系。同样，在正常体重和超重个体中，较低的久坐时间与较低的死亡风险相关，但对于肥胖者来说，久坐时间与死亡风险之间没有关联。与肥胖-低总体力活动参考相比，正常体重-高总活动的HR为0.59（95% CI 0.44至0.79），肥胖-高总活动的HR为0.67（95% CI 0.48至0.94）。相反，与肥胖-低总体力活动参考值相比，正常体重-低总体力活动与更高的死亡风险相关（1.28；95% CI 0.99至1.67）。结论 无论体重状况如何，较高水平的体力活动与较低的死亡风险相关。 与肥胖和低体力活动相比，如果体力活动水平较低，正常体重不会带来生存益处。可根据合理要求提供数据。荟萃分析中包含的特定于研究的摘要数据可以从相应作者处获得； jtarp@clin.au.dk。