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. Data may be obtained from a third party upon approval and payment. UK Biobank data could be obtained on application from .

中文翻译：

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身体活动、饮食质量和全因心血管疾病和癌症死亡率：一项对 346 627 名英国生物银行参与者的前瞻性研究

目的 研究体力活动和饮食与全因心血管疾病 (CVD) 和体力活动、饮食和肥胖相关 (PDAR) 癌症死亡率的独立和交互关联。方暴露（自我报告的总中等到高强度体育活动 (MVPA)、高强度体育活动 (VPA) 和饮食质量指数（分数范围为 0-3））和结果（全因、CVD 和 PDAR 癌症）死亡）。结果 在 11.2 年的中位随访期间，13869 名参与者死于各种原因，2650 名死于 CVD，4522 名死于 PDAR 癌症。与四分位数 1（Q1，0-210 分钟/周）相比，MVPA 的 Q2-Q4 与较低的全因风险相关（HR 范围为 0.87（95% CI：0.83 至 0.91）至 0.91（95% CI： 0.87 至 0.96))、CVD（HR 范围为 0.85（95% CI：0.76 至 0.95）至 0.90（95% CI：0.81 至 1.00））和 PDAR 癌症死亡率（HR 范围为 0.86（95% CI：0.79 至 0.93） ) 至 0.94（95% CI：0.86 至 1.02））。与无 VPA 相比，任何 VPA 均与较低的全因和 CVD 死亡率风险相关（HR 范围为 0.85（95% CI：0.80 至 0.89）至 0.88（95% CI：0.84 至 0.93）和 0.75（95% CI：0.68 至 0.83) 至 0.90（95% CI：0.80 至 1.02）。尽管在全因死亡率和 CVD 死亡率方面未达到统计学显着性，但处于最佳饮食类别（饮食质量指数 = 2–3）与 PDAR 癌症死亡率降低相关（HR = 0.86，95% CI：0.78 至 0.93） . 没有发现身体活动类别和饮食质量之间的加法或乘法相互作用。在比较身体活动和饮食组合时，风险最低的组合始终包括较高水平的身体活动和最高饮食质量得分。结论 坚持优质饮食和充足的身体活动对于最佳降低全因死亡、CVD 和 PDAR 癌症的风险非常重要。经批准并付款后，可从第三方获取数据。UK Biobank 数据可以通过申请获得 风险最低的组合始终包括较高水平的身体活动和最高饮食质量得分。结论 坚持优质饮食和充足的身体活动对于最佳降低全因死亡、CVD 和 PDAR 癌症的风险非常重要。经批准并付款后，可从第三方获取数据。UK Biobank 数据可以通过申请获得 风险最低的组合始终包括较高水平的身体活动和最高饮食质量得分。结论 坚持优质饮食和充足的身体活动对于最佳降低全因死亡、CVD 和 PDAR 癌症的风险非常重要。经批准并付款后，可从第三方获取数据。UK Biobank 数据可以通过申请获得.