Any increment in physical activity reduces mortality of primary care inactive patients

Abstract

Background: It is unclear how returning to physical activity (PA) after long periods of inactivity gives expected health benefits. Aim: To determine whether the inactive primary care population reduce their mortality by increasing PA, even in low doses. Design and setting: Prospective cohort of 3,357 inactive patients attending 11 Spanish public primary healthcare centers. Method: Change in PA was repeatedly measured during their participation in the ‘Experimental Program for Physical Activity Promotion’ clinical trial in 2003-2006, using the ‘7-day PA Recall’. Mortality until December 31, 2018, (312 deaths) has been recorded from national statistics and survival time from the end of the clinical trial analyzed using proportional hazard models. Results: After 46,191 person-years follow-up, compared with individuals that remained completely inactive, the mortality of those who achieved minimal recommendations of 150-300 minutes/week (M/W) of moderate or 75-150 M/W of vigorous intensity, was reduced by 45% (adjusted Hazard Ratio –aHR-= 0.55; 95% confidence interval -95%CI: 0.41 to 0.74); those who did not meet these recommendations but increased PA in low doses, i.e. 50 M/W of moderate PA, showed a 31% reduced mortality (aHR=0.69; 98%CI: 0.51 to 0.93); and those who surpassed the recommendation saw a 49% reduction in mortality (aHR= 0.51; 95%CI: 0.32 to 0.81). The inverse association between increased PA and mortality follows a continuous curvilinear dose-response relationship. Conclusion: Inactive primary care patients reduce mortality by increasing PA even in doses below the recommended. Greater reduction is achieved through meeting PA recommendations or adopting levels of PA higher than recommended.