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Table 2 Description of studies with a validated physical activity measure and 8+ years of follow-up (n = 11)

From: The impact of physical activity and an additional behavioural risk factor on cardiovascular disease, cancer and all-cause mortality: a systematic review

Author(s), year Physical activity (PA) in best group Best Group Worst Group Main Finding Effect of increasing PA on risk
Shaw and Agahi, 2014 [18] Participants needed 2 PA points. Received 1 point if they reported that they ‘sometimes’ did gardening, hunting, and dancing and 2 points if they reported ‘often’ during the past 12 months. Any sports participation (often or sometimes) was rewarded 2 points. Active/Non-smoking (reference) Discontinued activity/
Persistent smoking
All participants with high PA who were non-smokers had a significantly reduced mortality risk compared to no PA and smokers, 0.48 (CI = 0.36–0.67)a. ↓ Mortality risk
Hulsegge et al., 2016 [24] PA ≥3.5 h/week at both waves. 4 to 5 healthy factors at baseline and follow-up 0 to 1 factors at baseline and follow-up Each increase in number of healthy lifestyle factors at a later date led to a reduced risk of CVD and all-cause mortality. Individuals who maintained a healthy lifestyle profile had a 57% lower risk of CVD, 0.43 (CI = 0.25–0.63)a, and 60% lower risk of all-cause mortality, 0.40 (CI = 0.22–0.73)a compared to those with an unhealthy lifestyle. ↓ All-cause mortality and CVD
Yun et al., 2012 [20] PA ≥3 times/week 0 lifestyle factor points 4 lifestyle factor points In men and women, compared to those having all 4 of the poor lifestyle factor points, those with 0 poor lifestyle factor points and high PA men had a 0.42 (CI = 0.35–0.69)a reduced risk of cancer mortality and women had a 0.50 (0.23–1.08)a reduced risk. For all-cause mortality, men had a 0.50 (CI = 0.40–0.63)a reduced risk, and women had a 0.48 (CI = 0.28–0.82)a reduced risk. ↓ All-cause mortality and Cancer mortality
Kvaavik et al., 2010 [19] PA ≥2 h/week 0 lifestyle factor points 4 lifestyle factor points Compared to those in the least healthy group (4 points and no PA) those with all healthy lifestyle beahviours and high PA (0 points) was associated with a reduced risk of death (all—cause mortality, CVD, and cancer). Morality risk was 0.29 (CI = 0.19–0.43)a for death by all-causes, 0.32 (CI = 0.15–0.69a for CVD and 0.29 (CI = 0.15–0.60)a for cancer in the healthiest group (0 points) group at baseline compared to the least healthy (4 points). ↓ Mortality for all-causes, CVD, and Cancer
Larsson et al., 2016 [25] PA ≥150 min/week 4 lifestyle factor points 0 lifestyle factor points Compared with those with no healthy lifestyle factors, the multivariable relative risks of heart failure for those with all 4 lifestyle factors were 0.38 (CI = 0.28–0.53)a in men and 0.28 (CI = 0.19–0.41)a in women ↓ Risk of heart failure
Åkesson et al., 2014 [26] Walking/bicycling ≥40 min/day and exercising ≥1 h/week 5 lifestyle factor points 0 lifestyle factor points Compared with those with 0 lifestyle factor points, men with all 5 lifestyle factor points had a relative risk of 0.14 (95%CI: 0.04–0.43)a. This profile could prevent 79% (CI = 34–93%) of all myocardial events based on this study population’s characteristics. ↓ Myocardial infarction risk
Kirkegaard et al., 2010 [27] > 30 mins of moderate activity/day or light or heavy occupational activity each day 5 lifestyle factor points 0 lifestyle factor points Compared with the worst lifestyle behavior’s, participants who had the best behaviors had a 58% lower risk of developing colorectal cancer, but this was non-significant due to the wide confidence intervals (0.42, CI: 0.13–1.32)a. NS Colorectal cancer incidence
Nomura et al., 2016 [28] ≥3–4 h/week vigorous PA or ≥ 5–6 h/week walking. 7 lifestyle factor points 0 lifestyle factor points Regardless of the modeling approach used, adherence to a greater number of recommendations was not significantly associated with reduced colorectal cancer risk, 1.01 (95%CI = 0.82–1.24). Similar results were observed for colon cancer, 1.06 (95%CI = 0.84–1.35). NS Colorectal cancer risk
NS Colon cancer risk
Zhang et al., 2017 [21] ≥150 min/week of moderate-to-vigorous-intensity PA 4–5 lifestyle factor points 0 lifestyle factor points Compared with the least healthy lifestyle group, those in the healthies lifestyle group had a hazard ratio of 0.65 (95%CI = 0.47–0.90)a for colon cancer, 0.35 (95%CI = 0.24–0.52)a for rectal cancer, and 0.50 (95%CI = 0.39–0.65)a for colorectal cancer. NS colon cancer risk
↓ Rectal cancer risk
↓ Colorectal cancer risk
O’Donovan et al., 2017 [22] ≥60 min/week of PA ≥60 min/week of PA and non-smokers No exercise and current smokers Those who exercised for over 60 min/week and were never smokers compared to those who did no exercise and were current smokers had a 0.29 (CI = 0.24–0.36)a reduced risk for all-cause mortality, 0.27 (CI = 0.18–0.42)a for CVD mortality and 0.30 (CI = 0.22–0.41)a for cancer mortality. ↓ All-cause mortality, ↓ CVD mortality, and ↓ cancer mortality
Larsson et al., 2017 [23] ≥150 min/week of PA 4 lifestyle factor points 0 lifestyle factor points Compared to the least healthy group, those in the healthiest group the hazard ratio for all-cause mortality for men was 0.47 (95%CI = 0.44–0.51)a and for women this was 0.39 (95%CI = 0.35–0.44)a. ↓ All-cause mortality
  1. CVD cardiovascular disease, PA physical activity, NS non-significant
  2. acomputed the inverse risk and confidence intervals for Forest plot