Minimum and optimal variations in sleep, physical activity, and nutrition for lowering mortality risk
Abstract Overview
Background: Sleep, physical activity, and nutrition (SPAN) are critical behaviours for health, although they have traditionally been studied separately.
Purpose: To examine the combined associations of SPAN and establish the minimum variations needed to meaningfully reduce all-cause mortality risk.
Methods: This was a prospective cohort analysis of 59,078 participants from the UK Biobank (median age: 64.0 years; 45.4% male) who wore trackers for 7 days and self-reported dietary data. Wearable-measured sleep duration (hours/day) and moderate to vigorous physical activity duration (MVPA; mins/day) were calculated using a machine learning based schema. A 10-item diet quality score (DQS) assessed the intake of vegetables, fruits, fish, dairy, whole grains, vegetable oils, refined grains, processed and unprocessed meats, and sugary beverages (range 0-100 for all components with higher values indicating higher quality). Cox proportional hazards models were used to estimate hazard ratios (HR) for all-cause mortality risk across 27 separate joint tertile combinations of SPAN behaviours.
Results: Compared to the referent group of combined SPAN exposure (lowest tertiles for all three), the optimal SPAN combination involving moderate sleep duration (7.2-8.0 hours/day), high MVPA (42-103 mins/day), and a DQS between 57.5 and 72.5 was associated with an HR of 0.36 (95% CI: 0.26-0.50). Relative to the 5th percentile of sleep (5.5 hours/day), MVPA (7.3 mins/day), and nutrition (36.9 DQS), a minimum increase of 15 mins/day of sleep, 1.6 min/day MVPA, and 5 DQS points was associated with a 10% reduction in all-cause mortality risk (0.90; 0.88-0.93). An additional 75 mins/day of sleep, 12.5 min/day MVPA, and 25 DQS points were associated with a 50% reduction in all-cause mortality risk (0.50; 0.44-0.58).
Conclusions: This study highlights the potential health value of subtle combined lifestyle modification for reducing mortality risk.
Practical implications: These results expand feasible options for more holistic lifestyle recommendations.
Funding: NHMRC Investigator Grant (APP1194510).
Additional Authors
Name: Emmanuel Stamatakis
Affiliation: The University of Sydney
Presenting Author: no
Name: Nicholas Koemel
Affiliation: The University of Sydney
Presenting Author: no
Name: Raaj Biswas
Affiliation: The University of Sydney
Presenting Author: yes
Name: Matthew Ahmadi
Affiliation: The University of Sydney
Presenting Author: no
Name: Margaret Allman-Farinelli
Affiliation: The University of Sydney
Presenting Author: no
Name: Stewart Trost
Affiliation: The University of Queensland
Presenting Author: no
Name: Elif Inan-Eroglu
Affiliation: German Institute of Human Nutrition Potsdam-Rehbruecke
Presenting Author: no
Name: Borja del Pozo Cruz
Affiliation: University of Cádiz
Presenting Author: no
Name: Yu Bin
Affiliation: The University of Sydney
Presenting Author: no
Name: Svetlana Postnova
Affiliation: The University of Sydney
Presenting Author: no
Name: Mitch Duncan
Affiliation: The University of Newcastle
Presenting Author: no
Name: Dorothea Dumuid
Affiliation: University of South Australia
Presenting Author: no
Name: Helen Brown
Affiliation: Deakin University
Presenting Author: no
Name: Carol Maher
Affiliation: University of South Australia
Presenting Author: no
Name: Luigi Fontana
Affiliation: The University of Sydney
Presenting Author: no
Name: Stephen Simpson
Affiliation: The University of Sydney
Presenting Author: no
Name: Peter Cistulli
Affiliation: The University of Sydney
Presenting Author: no
Information
Study Type: Epidemiology
Subtheme: Other (please specify)
Subtheme other Title: Lifestyle
Population Group: Adults
Setting: Whole System
Submitting Author
Nicholas Koemel
Postdoctoral Research Fellow
The University of Sydney
Australia
