Trends in the association between meeting the physical activity guidelines and risk of mortality in US adults

Objective: To examine the trends in the association between meeting the physical activity (PA) guidelines and mortality in adults. Methods: We included seventeen annual representative samples of US adults 1998 -2014 ( n = 482,756) and allcause and cause -specific mortality ascertained through December 2019. Participants were grouped according to PA Guidelines: 150 or more min/week in aerobic PA and muscle -strengthening activities 2 or more times/week. To provide further context, we also examined the trends in mortality risk associated with other modifiable health factors. Results: Meeting the PA guidelines was associated with lower 5 -year mortality risk (HR = 0.59, 95%CI, 0.55, 0.63) based on the pooled analyses. We consistently observed an inverse association in all years, but there was a nonsignificant trend association (P for trend = 0.305) between meeting PA guidelines and 5 -year mortality across the seventeen annual surveys. Meeting aerobic (HR = 0.58, 95%CI, 0.56, 0.61) and muscle -strengthening (HR = 0.86, 95%CI, 0.81, 0.90) guidelines were independently associated with 5 -year mortality risk in pooled analyses, without any evidence for trends in the associations. Similar results were found with cause -specific mortality and 10 -year mortality risk. In pooled analyses, attaining a high educational level, body mass index <30 kg/m2, being noncurrent smoker, nonheavy drinker, and living without history of hypertension and diabetes with 5 -year mortality were 0.70 (95%CI, 0.67, 0.73), 1.19 (95%CI, 1.15, 1.23), 0.56 (95%CI, 0.54, 0.59), 0.85 (95% CI,0.79, 0.92), 0.91 (95%CI, 0.88 -0.94) and 0.65 (95%CI, 0.88, 0.94), respectively. Only no history of diabetes showed a significant trend analysis (B = 0.77, 95%CI, 0.46, 0.91, P for trend <0.001). Conclusion: Meeting PA guidelines lower mortality risk and this association does not seem to have varied over time. Encouraging adults to meet the PA guidelines may provide substantial health benefits, despite social, demographic and lifestyle changes, as well as the advances in medical technology and pharmacological treatments.