Diurnal patterns of accelerometer-measured physical activity and sleep and risk of all-cause mortality: a follow-up of the National Health and Nutrition Examination Surveys (NHANES).

IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS International Journal of Behavioral Nutrition and Physical Activity Pub Date : 2024-10-18 DOI:10.1186/s12966-024-01673-9
Yue Zhang, Mika Kivimäki, Rodrigo M Carrillo-Larco, Yangyang Cheng, Yaguan Zhou, Hui Wang, Changzheng Yuan, Xiaolin Xu
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Abstract

Background: Physical activity and sleep are established modifiable lifestyle factors, but the optimal time of the day of these behaviours for health is unknown. This study examined the independent and joint associations of diurnal patterns of physical activity and sleep with all-cause mortality.

Methods: This prospective cohort study included 6,673 participants who have attended the accelerometer assessment in the 2011-2014 National Health and Nutrition Examination Surveys (NHANES). Diurnal patterns of accelerometer-measured physical activity and sleep were identified using K-means clustering analysis. All-cause mortality was ascertained from the accelerometer measurement to December 31, 2019 (median follow-up 6.8 years). Survey-weighted Cox proportional hazard models were performed to estimate the independent and joint associations of diurnal patterns of physical activity and sleep with all-cause mortality.

Results: Diurnal patterns identified were: early-morning (32.4%), midday (42.5%), and late-afternoon (25.1%) for physical activity; and irregular sleep (37.4%), morning lark (33.6%), and night owl (29.0%) for sleep. After adjusting for volume of physical activity, sleep duration and other potential covariates, the early-morning physical activity pattern (hazard ratio 1.36, 95% confidence interval 1.13-1.64) and irregular sleep pattern (1.42, 1.01-1.99) were independently associated with higher risk of all-cause mortality, compared with midday physical activity and morning lark sleep patterns, respectively. In addition, participants with the combined pattern of early-morning physical activity and irregular sleep had higher risk of all-cause mortality compared to those with midday physical activity combined with a morning lark sleep pattern (1.92, 1.33-2.78). Several sociodemographic differences were observed in the strength of these associations.

Conclusions: Wearable activity-rest monitoring data showed that peak physical activity in the early morning and irregular sleep diurnal patterns are associated with increased mortality risk, and the combination of these patterns further exaggerated the risk. Public health program should acknowledge that the diurnal patterns of physical activity and sleep, in addition to their duration and frequency, may play a crucial role in lifestyle-based health promotion and management strategies.

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加速计测量的体力活动和睡眠的昼夜模式与全因死亡风险:国家健康与营养调查(NHANES)的后续研究。
背景:体育锻炼和睡眠是公认的可改变生活方式的因素,但一天中这些行为对健康的最佳时间尚不清楚。本研究探讨了体育锻炼和睡眠的昼夜模式与全因死亡率之间的独立和联合关系:这项前瞻性队列研究纳入了 6,673 名参加过 2011-2014 年美国国家健康与营养调查(NHANES)加速度计评估的参与者。研究人员利用K-均值聚类分析确定了加速度计测量的体力活动和睡眠的昼夜模式。确定了从加速度计测量到 2019 年 12 月 31 日的全因死亡率(中位数随访 6.8 年)。采用调查加权的 Cox 比例危险模型来估算体育锻炼和睡眠的昼夜模式与全因死亡率的独立和联合关联:结果显示:体力活动的昼夜模式为:清晨(32.4%)、中午(42.5%)和午后(25.1%);睡眠模式为:不规律睡眠(37.4%)、晨云雀(33.6%)和夜猫子(29.0%)。在对体力活动量、睡眠时间和其他潜在协变量进行调整后,清晨体力活动模式(危险比 1.36,95% 置信区间 1.13-1.64)和不规律睡眠模式(1.42,1.01-1.99)分别与较高的全因死亡风险独立相关,而正午体力活动模式和晨间云雀睡眠模式则分别与较高的全因死亡风险独立相关。此外,与正午体育锻炼和早晨云雀睡眠模式相结合的参与者相比,清晨体育锻炼和不规律睡眠模式相结合的参与者全因死亡风险更高(1.92,1.33-2.78)。在这些关联的强度方面观察到了一些社会人口学差异:可穿戴活动-休息监测数据显示,清晨的体力活动高峰和不规则的睡眠昼夜模式与死亡风险增加有关,而这些模式的组合进一步增加了死亡风险。公共卫生计划应认识到,除了持续时间和频率外,体力活动和睡眠的昼夜模式在以生活方式为基础的健康促进和管理策略中可能起着至关重要的作用。
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来源期刊
CiteScore
13.80
自引率
3.40%
发文量
138
审稿时长
4-8 weeks
期刊介绍: International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) is an open access, peer-reviewed journal offering high quality articles, rapid publication and wide diffusion in the public domain. IJBNPA is devoted to furthering the understanding of the behavioral aspects of diet and physical activity and is unique in its inclusion of multiple levels of analysis, including populations, groups and individuals and its inclusion of epidemiology, and behavioral, theoretical and measurement research areas.
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