Work, household, and leisure-time physical activity and risk of mortality in the EPIC-Spain cohort
Menée en Espagne à partir de questionnaires auprès de 14 433 hommes et 23 946 femmes inclus dans la cohorte EPIC (âge : 30 à 65 ans ; durée moyenne de suivi : 13,6 ans), cette étude évalue, en fonction du sexe, l'association entre trois types d'activité physique (domestique, professionnelle ou de loisir) et le risque de décès, notamment par cancer
Large-scale longitudinal data on the association of domain-specific physical activity (PA) and mortality is limited. In this study, the association of work, household (HPA), and leisure time PA (LTPA) with overall and cause-specific mortality was evaluated in 38379 EPIC-Spain participants (62.4% women), 30-65 years-old, and free of chronic disease at baseline. Participants were followed-up from 1992-1996 and December 31st, 2008 to ascertain vital status and cause of death. PA was evaluated at baseline and at 3-year follow-up with a validated questionnaire (EPIC-PAQ) and combined variables were used to classify participants by sub-domains of PA. Associations with overall, cancer, and cardiovascular mortality risks were assessed using competing-risks Cox regression models adjusted by potential confounders. After 13.6 years of mean follow-up, 1371 deaths were available for analyses. HPA was strongly associated to reduced overall (hazard ratio (HR) for Q4 vs. Q1 = 0.47 (0.34, 0.64)) and cause-specific mortality in women and to lower cancer mortality in men (P for trend = 0.004), irrespective of age, education, and lifestyle and morbidity variables. LTPA was associated with lower mortality in women (HR for Q4 vs. Q1 = 0.71 (0.52, 0.98)), but not men. No relationships were found between sedentariness at work and overall mortality. In conclusion, HPA was associated to lower mortality risk in men and women from the EPIC-Spain cohort, whereas LTPA also contributed to reduce risk of death in women. Considering the large proportion of total daily PA that HPA represents in some population groups, these results are of public health importance.