Decomposing the effects of physical activity and cardiorespiratory fitness on mortality
Background: Characterizing the effects of physical activity (PA) and cardiorespiratory fitness (CRF) on mortality is challenging because the causal relationship between PA, CRF, and other cardiovascular risk factors is unclear. Methods: To better understand the effects of PA and CRF on mortality, we...
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doaj-bfb7cc7e610d444e812b74f68c20e10a2020-11-25T02:11:12ZengElsevierGlobal Epidemiology2590-11332019-11-011Decomposing the effects of physical activity and cardiorespiratory fitness on mortalityJulian Wolfson0Steven D. Stovitz1Steven N. Blair2Xuemei Sui3Duck-chul Lee4Ian Shrier5University of Minnesota, School of Public Health, Division of Biostatistics, Minneapolis, USA; Corresponding author at: A460 Mayo Building MMC 303, 420 Delaware St. SE, Minneapolis, MN 55455, USA.University of Minnesota, Department of Family Medicine and Community Health, Minneapolis, USARetired from University of South Carolina, Arnold School of Public Health, Departments of Exercise Science and Epidemiology and Biostatistics, Columbia, USAUniversity of South Carolina, Department of Exercise Science, Division of Health Aspects of Physical Activity, Columbia, USAIowa State University, College of Human Sciences, Department of Kinesiology, Ames, USACentre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, CanadaBackground: Characterizing the effects of physical activity (PA) and cardiorespiratory fitness (CRF) on mortality is challenging because the causal relationship between PA, CRF, and other cardiovascular risk factors is unclear. Methods: To better understand the effects of PA and CRF on mortality, we re-analyzed data from 42,373 participants in the Aerobics Center Longitudinal Study (ACLS) using a modified version of VanderWeele's four-way causal effect decomposition method. The method was applied to decompose the causal effects of PA and CRF on median time to death into parts reflecting mediation, interaction, mediated interaction, and neither interaction nor mediation. Results: We found that 67% of the effect of PA on mortality was mediated by CRF, while the effect of CRF was not significantly mediated by PA. The effects of both PA and CRF were mediated to a small extent by hypertension and diabetes. There were no meaningful interactions. Conclusions: Our findings strengthen the evidence that the benefit on mortality from PA is largely mediated by its effect on CRF, and support efforts to increase longevity by encouraging PA.http://www.sciencedirect.com/science/article/pii/S2590113319300094Physical activityCardiorespiratory fitnessDiabetesHypertensionMortalityMediation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Julian Wolfson Steven D. Stovitz Steven N. Blair Xuemei Sui Duck-chul Lee Ian Shrier |
spellingShingle |
Julian Wolfson Steven D. Stovitz Steven N. Blair Xuemei Sui Duck-chul Lee Ian Shrier Decomposing the effects of physical activity and cardiorespiratory fitness on mortality Global Epidemiology Physical activity Cardiorespiratory fitness Diabetes Hypertension Mortality Mediation |
author_facet |
Julian Wolfson Steven D. Stovitz Steven N. Blair Xuemei Sui Duck-chul Lee Ian Shrier |
author_sort |
Julian Wolfson |
title |
Decomposing the effects of physical activity and cardiorespiratory fitness on mortality |
title_short |
Decomposing the effects of physical activity and cardiorespiratory fitness on mortality |
title_full |
Decomposing the effects of physical activity and cardiorespiratory fitness on mortality |
title_fullStr |
Decomposing the effects of physical activity and cardiorespiratory fitness on mortality |
title_full_unstemmed |
Decomposing the effects of physical activity and cardiorespiratory fitness on mortality |
title_sort |
decomposing the effects of physical activity and cardiorespiratory fitness on mortality |
publisher |
Elsevier |
series |
Global Epidemiology |
issn |
2590-1133 |
publishDate |
2019-11-01 |
description |
Background: Characterizing the effects of physical activity (PA) and cardiorespiratory fitness (CRF) on mortality is challenging because the causal relationship between PA, CRF, and other cardiovascular risk factors is unclear. Methods: To better understand the effects of PA and CRF on mortality, we re-analyzed data from 42,373 participants in the Aerobics Center Longitudinal Study (ACLS) using a modified version of VanderWeele's four-way causal effect decomposition method. The method was applied to decompose the causal effects of PA and CRF on median time to death into parts reflecting mediation, interaction, mediated interaction, and neither interaction nor mediation. Results: We found that 67% of the effect of PA on mortality was mediated by CRF, while the effect of CRF was not significantly mediated by PA. The effects of both PA and CRF were mediated to a small extent by hypertension and diabetes. There were no meaningful interactions. Conclusions: Our findings strengthen the evidence that the benefit on mortality from PA is largely mediated by its effect on CRF, and support efforts to increase longevity by encouraging PA. |
topic |
Physical activity Cardiorespiratory fitness Diabetes Hypertension Mortality Mediation |
url |
http://www.sciencedirect.com/science/article/pii/S2590113319300094 |
work_keys_str_mv |
AT julianwolfson decomposingtheeffectsofphysicalactivityandcardiorespiratoryfitnessonmortality AT stevendstovitz decomposingtheeffectsofphysicalactivityandcardiorespiratoryfitnessonmortality AT stevennblair decomposingtheeffectsofphysicalactivityandcardiorespiratoryfitnessonmortality AT xuemeisui decomposingtheeffectsofphysicalactivityandcardiorespiratoryfitnessonmortality AT duckchullee decomposingtheeffectsofphysicalactivityandcardiorespiratoryfitnessonmortality AT ianshrier decomposingtheeffectsofphysicalactivityandcardiorespiratoryfitnessonmortality |
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