Comparative Relevance of Physical Fitness and Adiposity on Life Expectancy: A UK Biobank Observational Study

To investigate the extent to which 2 measures of physical fitness-walking pace and handgrip strength-are associated with life expectancy across different levels of adiposity, as the relative importance of physical fitness and adiposity on health outcomes is still debated. Usual walking pace (self-de...

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Published inMayo Clinic proceedings Vol. 94; no. 6; pp. 985 - 994
Main Authors Zaccardi, Francesco, Davies, Melanie J, Khunti, Kamlesh, Yates, Tom
Format Journal Article
LanguageEnglish
Published England Frontline Medical Communications Inc 01.06.2019
Elsevier Limited
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Abstract To investigate the extent to which 2 measures of physical fitness-walking pace and handgrip strength-are associated with life expectancy across different levels of adiposity, as the relative importance of physical fitness and adiposity on health outcomes is still debated. Usual walking pace (self-defined as slow, steady/average, brisk), dynamometer-assessed handgrip strength, body mass index (BMI), waist circumference, and body-fat percentage determined at baseline in the UK Biobank prospective cohort study (March 13, 2006, to January 31, 2016). Life expectancy was estimated at 45 years of age. The median age and BMI of the 474,919 participants included in this analysis were 58.2 years and 26.7 kg/m , respectively; over a median follow-up of 6.97 years, 12,823 deaths occurred. Participants reporting brisk walking pace had longer life expectancies across all levels of BMIs, ranging from 86.7 to 87.8 years in women and 85.2 to 86.8 years in men. Conversely, subjects reporting slow walking pace had shorter life expectancies, being the lowest observed in slow walkers with a BMI less than 20 kg/m (women: 72.4 years; men: 64.8 years). Smaller, less consistent differences in life expectancy were observed between participants with high and low handgrip strength, particularly in women. The same pattern of results was observed for waist circumference or body-fat percentage. Brisk walkers were found to have longer life expectancies, which was constant across different levels and indices of adiposity. These findings could help clarify the relative importance of physical fitness and adiposity on mortality.
AbstractList To investigate the extent to which 2 measures of physical fitness-walking pace and handgrip strength-are associated with life expectancy across different levels of adiposity, as the relative importance of physical fitness and adiposity on health outcomes is still debated. Usual walking pace (self-defined as slow, steady/average, brisk), dynamometer-assessed handgrip strength, body mass index (BMI), waist circumference, and body-fat percentage determined at baseline in the UK Biobank prospective cohort study (March 13, 2006, to January 31, 2016). Life expectancy was estimated at 45 years of age. The median age and BMI of the 474,919 participants included in this analysis were 58.2 years and 26.7 kg/m , respectively; over a median follow-up of 6.97 years, 12,823 deaths occurred. Participants reporting brisk walking pace had longer life expectancies across all levels of BMIs, ranging from 86.7 to 87.8 years in women and 85.2 to 86.8 years in men. Conversely, subjects reporting slow walking pace had shorter life expectancies, being the lowest observed in slow walkers with a BMI less than 20 kg/m (women: 72.4 years; men: 64.8 years). Smaller, less consistent differences in life expectancy were observed between participants with high and low handgrip strength, particularly in women. The same pattern of results was observed for waist circumference or body-fat percentage. Brisk walkers were found to have longer life expectancies, which was constant across different levels and indices of adiposity. These findings could help clarify the relative importance of physical fitness and adiposity on mortality.
To investigate the extent to which 2 measures of physical fitness-walking pace and handgrip strength-are associated with life expectancy across different levels of adiposity, as the relative importance of physical fitness and adiposity on health outcomes is still debated.OBJECTIVETo investigate the extent to which 2 measures of physical fitness-walking pace and handgrip strength-are associated with life expectancy across different levels of adiposity, as the relative importance of physical fitness and adiposity on health outcomes is still debated.Usual walking pace (self-defined as slow, steady/average, brisk), dynamometer-assessed handgrip strength, body mass index (BMI), waist circumference, and body-fat percentage determined at baseline in the UK Biobank prospective cohort study (March 13, 2006, to January 31, 2016). Life expectancy was estimated at 45 years of age.PATIENTS AND METHODSUsual walking pace (self-defined as slow, steady/average, brisk), dynamometer-assessed handgrip strength, body mass index (BMI), waist circumference, and body-fat percentage determined at baseline in the UK Biobank prospective cohort study (March 13, 2006, to January 31, 2016). Life expectancy was estimated at 45 years of age.The median age and BMI of the 474,919 participants included in this analysis were 58.2 years and 26.7 kg/m2, respectively; over a median follow-up of 6.97 years, 12,823 deaths occurred. Participants reporting brisk walking pace had longer life expectancies across all levels of BMIs, ranging from 86.7 to 87.8 years in women and 85.2 to 86.8 years in men. Conversely, subjects reporting slow walking pace had shorter life expectancies, being the lowest observed in slow walkers with a BMI less than 20 kg/m2 (women: 72.4 years; men: 64.8 years). Smaller, less consistent differences in life expectancy were observed between participants with high and low handgrip strength, particularly in women. The same pattern of results was observed for waist circumference or body-fat percentage.RESULTSThe median age and BMI of the 474,919 participants included in this analysis were 58.2 years and 26.7 kg/m2, respectively; over a median follow-up of 6.97 years, 12,823 deaths occurred. Participants reporting brisk walking pace had longer life expectancies across all levels of BMIs, ranging from 86.7 to 87.8 years in women and 85.2 to 86.8 years in men. Conversely, subjects reporting slow walking pace had shorter life expectancies, being the lowest observed in slow walkers with a BMI less than 20 kg/m2 (women: 72.4 years; men: 64.8 years). Smaller, less consistent differences in life expectancy were observed between participants with high and low handgrip strength, particularly in women. The same pattern of results was observed for waist circumference or body-fat percentage.Brisk walkers were found to have longer life expectancies, which was constant across different levels and indices of adiposity. These findings could help clarify the relative importance of physical fitness and adiposity on mortality.CONCLUSIONBrisk walkers were found to have longer life expectancies, which was constant across different levels and indices of adiposity. These findings could help clarify the relative importance of physical fitness and adiposity on mortality.
[...]model estimates were used to predict age-specific mortality rates within each combination of BMI and walking-pace group (overall 24 groups, 8 for BMI and 3 for walking pace). [...]survival curves were obtained from predicted cumulative mortality rates and residual life calculated as the area under the survival curve up to 90 years of age, conditional on surviving to age 45. Previous studies have consistently reported an association between indices of physical fitness and all-cause and cardiovascular mortality, - 1 including a UK Biobank analysis, which showed that the association between walking pace and handgrip strength is modified by BMI.32 It is interesting that the 50% reduction of all-cause mortality in brisk walkers is within the ranges reported in other cohorts and consistent since initial observations from the 1950s in the studies of Morris.3 However, as far as we know, this is the first study to quantify how the associations between indices of physical fitness and all-cause mortality translate into life expectancy across categories of adiposity measured by BMI, waist circumference, and body-fat percentage. The large contemporary and wellphenotyped nature of the UK Biobank cohort-along with robust mortality linkage-are important strengths of this study. [...]we estimated survival curves and their differences directly from our data without any comparison with synthetic population mortality rates and used complementary indices of obesity.
Audience Academic
Author Khunti, Kamlesh
Davies, Melanie J
Yates, Tom
Zaccardi, Francesco
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Snippet To investigate the extent to which 2 measures of physical fitness-walking pace and handgrip strength-are associated with life expectancy across different...
[...]model estimates were used to predict age-specific mortality rates within each combination of BMI and walking-pace group (overall 24 groups, 8 for BMI and...
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SubjectTerms Adipose tissue
Adiposity - physiology
Age
Biological Specimen Banks
Body Mass Index
Cardiovascular diseases
Epidemiology
Female
Hand Strength - physiology
Health
Health aspects
Health risk assessment
Humans
Life expectancy
Life Expectancy - trends
Life span
Male
Middle Aged
Mortality
Obesity
Observational studies
Pharmaceutical industry
Physical fitness
Prospective Studies
Studies
Survival
Systematic review
United Kingdom
Walking
Walking - statistics & numerical data
Title Comparative Relevance of Physical Fitness and Adiposity on Life Expectancy: A UK Biobank Observational Study
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