Mortality effects of hypothetical interventions on physical activity and TV viewing

Article

Yang, Yi, Hodge, Allison M., Dugue, Pierre-Antoine, Williamson, Elizabeth J., Gardiner, Paul A., Barr, Elizabeth L. M., Owen, Neville, Dunstan, David W., Lynch, Brigid M. and English, Dallas R.. 2021. "Mortality effects of hypothetical interventions on physical activity and TV viewing." Medicine and Science in Sports and Exercise. 53 (2), pp. 316-323. https://doi.org/10.1249/MSS.0000000000002479
Article Title

Mortality effects of hypothetical interventions on physical activity and TV viewing

ERA Journal ID9788
Article CategoryArticle
AuthorsYang, Yi (Author), Hodge, Allison M. (Author), Dugue, Pierre-Antoine (Author), Williamson, Elizabeth J. (Author), Gardiner, Paul A. (Author), Barr, Elizabeth L. M. (Author), Owen, Neville (Author), Dunstan, David W. (Author), Lynch, Brigid M. (Author) and English, Dallas R. (Author)
Journal TitleMedicine and Science in Sports and Exercise
Journal Citation53 (2), pp. 316-323
Number of Pages8
Year2021
PublisherLippincott Williams & Wilkins
Place of PublicationUnited States
ISSN0195-9131
1530-0315
Digital Object Identifier (DOI)https://doi.org/10.1249/MSS.0000000000002479
Web Address (URL)https://journals.lww.com/acsm-msse/Fulltext/2021/02000/Mortality_Effects_of_Hypothetical_Interventions_on.8.aspx
Abstract

Introduction: Long-term effects of physical activity and television (TV) viewing on mortality have been inferred from observational studies. The associations observed do not allow for inferences about the effects of population interventions and could be subject to bias due to time-varying confounding.

Methods: Using data from the Australian Diabetes, Obesity and Lifestyle Study, collected in 1999-2000 (T0), 2004-2005 (T1), and 2011-2012 (T2), we applied the parametric g-formula to estimate cumulative risks of death under hypothetical interventions on physical activity and/or TV viewing determined from self-report while adjusting for time-varying confounding.

Results: In the 6377 participants followed up for 13 yr from 2004 to 2005 to death or censoring in 2017, 781 participants died. The observed cumulative risk of death was 12.2%. The most effective hypothetical intervention was to increase weekly physical activity to >300 min (risk ratio (RR), 0.66 (0.46-0.86) compared with a 'worst-case' scenario; RR, 0.83 (0.73-0.94) compared with no intervention). Reducing daily TV viewing to <2 h in addition to physical activity interventions did not show added survival benefits. Reducing TV viewing alone was least effective in reducing mortality (RR, 0.85 (0.60-1.10) compared with the worst-case scenario; RR, 1.06 (0.93-1.20) compared with no intervention).

Conclusions: Our findings suggested that sustained interventions to increase physical activity could lower all-cause mortality over a 13-yr period, and there might be limited gain from intervening to reduce TV viewing time in a relatively healthy population.

Keywordscohort study; g-formula; hypothetical interventions; time-varying confounding
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020420201. Behavioural epidemiology
420699. Public health not elsewhere classified
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Institution of OriginUniversity of Southern Queensland
Byline AffiliationsCancer Council Australia, Australia
London School of Hygiene and Tropical Medicine, United Kingdom
University of Queensland
Charles Darwin University
Baker Heart and Diabetes Institute, Australia
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