Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study

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Paper Summary

Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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Move Your Body, Live Longer: Following Exercise Guidelines Linked to Lower Mortality Risk in US Adults

US adults who met the 2018 physical activity guidelines, particularly those engaging in both aerobic and muscle-strengthening exercises, showed a significantly reduced risk of all-cause and cause-specific mortality, including deaths from cardiovascular disease, cancer, and respiratory diseases. These benefits were even more pronounced in individuals with chronic conditions.

Possible Conflicts of Interest

The study received funding from academic and health organizations, but the authors declared no competing interests. One author is affiliated with a research center partially funded by a pharmaceutical company. This potential conflict requires further scrutiny but doesn't invalidate the findings.

Identified Weaknesses

Self-reported data

Self-reported physical activity data can be subject to recall bias and may not accurately reflect true activity levels.

Limited scope of physical activity measurement

The study only measured leisure-time physical activity and did not account for other domains like occupational or household activity, potentially underestimating the total effect of physical activity.

Lack of severity data

Information on the severity of chronic conditions was not available, limiting the ability to assess the relationship between guideline adherence and mortality for different severities of diseases.

Exclusion of participants

A substantial portion of participants were excluded due to missing data, potentially introducing selection bias if excluded individuals differ systematically from those included.

Single baseline measurement

Physical activity was measured at baseline only. Changes in exercise patterns over time were not considered and may have influenced results.

Limited generalizability

The study focused on a US population, and its generalizability to other races and ethnicities outside the US needs further investigation.

Limited assessment of muscle-strengthening

The survey question regarding muscle-strengthening activity may not have captured the full range of recommended muscle-strengthening activities, affecting the assessment of adherence.

Potential for residual confounding

While the study adjusted for many confounders, residual or unmeasured confounding could still influence the results.

Rating Explanation

This large prospective study used a nationally representative sample and adjusted for several confounders, strengthening the evidence linking physical activity to mortality. While the reliance on self-reported data and other limitations exist, the findings are robust and have important public health implications. The rating is downgraded from 5 to 4 due to the potential undeclared conflict of interest of one author.

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