TY - JOUR
T1 - Should workers be physically active after work? Associations of leisure-time physical activity with cardiovascular and all-cause mortality across occupational physical activity levels—An individual participant data meta-analysis
AU - Cillekens, Bart
AU - Coenen, Pieter
AU - Huysmans, Maaike A.
AU - Holtermann, Andreas
AU - Troiano, Richard P.
AU - Mork, Paul Jarle
AU - Krokstad, Steinar
AU - Clays, Els
AU - De Bacquer, Dirk
AU - Aadahl, Mette
AU - Kårhus, Line Lund
AU - Sjøl, Anette
AU - Bo Andersen, Lars
AU - Kauhanen, Jussi
AU - Voutilainen, Ari
AU - Pulsford, Richard
AU - Stamatakis, Emmanuel
AU - Goldbourt, Uri
AU - Peters, Annette
AU - Thorand, Barbara
AU - Rosengren, Annika
AU - Björck, Lena
AU - Sprow, Kyle
AU - Franzon, Kristin
AU - Rodriguez-Barranco, Miguel
AU - Luján-Barroso, Leila
AU - Alfredsson, Lars
AU - Bahls, Martin
AU - Ittermann, Till
AU - Wanner, Miriam
AU - Bopp, Matthias
AU - Marott, Jacob Louis
AU - Schnohr, Peter
AU - Nordestgaarda, Børge G.
AU - Dalene, Knut Eirik
AU - Ekelund, Ulf
AU - Clausen, Johan
AU - Jensen, Magnus T.
AU - Petersen, Christina Bjørk
AU - Krause, Niklas
AU - Twisk, Jos
AU - van Mechelen, Willem
AU - van der Beek, Allard J.
PY - 2025/12
Y1 - 2025/12
N2 - BackgroundThere is insufficient evidence to provide recommendations for leisure-time physical activity among workers across various occupational physical activity levels. This study aimed to assess the association of leisure-time physical activity with cardiovascular and all-cause mortality across occupational physical activity levels. MethodsThis study utilized individual participant data from 21 cohort studies, comprising both published and unpublished data. Eligibility criteria included individual-level data on leisure-time and occupational physical activity (categorized as sedentary, low, moderate, and high) along with data on all-cause and/or cardiovascular mortality. A 2-stage individual participant data meta-analysis was conducted, with separate analysis of each study using Cox proportional hazards models (Stage 1). These results were combined using random-effects models (Stage 2). ResultsHigher leisure-time physical activity levels were associated with lower all-cause and cardiovascular mortality risk across most occupational physical activity levels, for both males and females. Among males with sedentary work, high compared to sedentary leisure-time physical activity was associated with lower all-cause (hazard ratios (HR) = 0.77, 95% confidence interval (95%CI): 0.70–0.85) and cardiovascular mortality (HR = 0.76, 95%CI: 0.66–0.87) risk. Among males with high levels of occupational physical activity, high compared to sedentary leisure-time physical activity was associated with lower all-cause (HR = 0.84, 95%CI: 0.74–0.97) and cardiovascular mortality (HR = 0.79, 95%CI: 0.60–1.04) risk, while HRs for low and moderate levels of leisure-time physical activity ranged between 0.87 and 0.97 and were not statistically significant. Among females, most effects were similar but more imprecise, especially in the higher occupational physical activity levels. ConclusionHigher levels of leisure-time physical activity were generally associated with lower mortality risks. However, results for workers with moderate and high occupational physical activity levels, especially women, were more imprecise. Our findings suggests that workers may benefit from engaging in high levels of leisure-time physical activity, irrespective of their level of occupational physical activity.
AB - BackgroundThere is insufficient evidence to provide recommendations for leisure-time physical activity among workers across various occupational physical activity levels. This study aimed to assess the association of leisure-time physical activity with cardiovascular and all-cause mortality across occupational physical activity levels. MethodsThis study utilized individual participant data from 21 cohort studies, comprising both published and unpublished data. Eligibility criteria included individual-level data on leisure-time and occupational physical activity (categorized as sedentary, low, moderate, and high) along with data on all-cause and/or cardiovascular mortality. A 2-stage individual participant data meta-analysis was conducted, with separate analysis of each study using Cox proportional hazards models (Stage 1). These results were combined using random-effects models (Stage 2). ResultsHigher leisure-time physical activity levels were associated with lower all-cause and cardiovascular mortality risk across most occupational physical activity levels, for both males and females. Among males with sedentary work, high compared to sedentary leisure-time physical activity was associated with lower all-cause (hazard ratios (HR) = 0.77, 95% confidence interval (95%CI): 0.70–0.85) and cardiovascular mortality (HR = 0.76, 95%CI: 0.66–0.87) risk. Among males with high levels of occupational physical activity, high compared to sedentary leisure-time physical activity was associated with lower all-cause (HR = 0.84, 95%CI: 0.74–0.97) and cardiovascular mortality (HR = 0.79, 95%CI: 0.60–1.04) risk, while HRs for low and moderate levels of leisure-time physical activity ranged between 0.87 and 0.97 and were not statistically significant. Among females, most effects were similar but more imprecise, especially in the higher occupational physical activity levels. ConclusionHigher levels of leisure-time physical activity were generally associated with lower mortality risks. However, results for workers with moderate and high occupational physical activity levels, especially women, were more imprecise. Our findings suggests that workers may benefit from engaging in high levels of leisure-time physical activity, irrespective of their level of occupational physical activity.
KW - Individual participant data
KW - Job demands
KW - Mortality
KW - Physical activity paradox
U2 - 10.1016/j.jshs.2024.100987
DO - 10.1016/j.jshs.2024.100987
M3 - Journal article
C2 - 39277081
AN - SCOPUS:85211146484
SN - 2095-2546
VL - 14
JO - Journal of Sport and Health Science
JF - Journal of Sport and Health Science
M1 - 100987
ER -