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      Can leisure-time physical activity improve health checkup results? Evidence from Japanese occupational panel data

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          Abstract

          Objectives:

          We examined the extent to which changes in worker health, as measured by health checkup items, were associated with increased intensity of leisure-time physical activity (LTPA) after controlling for individual time-invariant attributes.

          Methods:

          We used panel data from two to four waves of a Japanese occupational cohort survey, focusing on 30,206 observations of 10,106 individuals (7,669 men and 2,437 women) aged 18-76 years. We estimated first-difference and mean-centered fixed effects models to examine how changes in 10 health checkup items were associated with changes in LTPA intensity. We considered four LTPA intensity levels (none, low, moderate, and vigorous), based on self-reported assessments.

          Results:

          For men, low-density lipoprotein cholesterol levels, glycated hemoglobin levels, body mass index, and waist circumference improved when LTPA intensity was increased even at a low level, whereas triglyceride, high-density lipoprotein cholesterol, and fasting blood glucose levels improved when LTPA intensity was increased to moderate or vigorous levels. Blood pressure (both systolic and diastolic) and total cholesterol levels were only modestly responsive to changes in LTPA intensity. For women, blood pressure (both systolic and diastolic) and waist circumference were negatively associated with LTPA intensity, whereas the other variables showed more modest effects.

          Conclusions:

          The results suggest that even low- to moderate-intensity LTPA can improve health checkup results; however, the lowest LTPA intensity associated with improvement in health depends on health-risk factors as well as gender.

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          Most cited references19

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          Non-vigorous physical activity and all-cause mortality: systematic review and meta-analysis of cohort studies.

          Although previous studies have found physical activity to be associated with lower mortality, the dose-response relationship remains unclear. In this systematic review and meta-analysis we quantify the dose-response relationship of non-vigorous physical activity and all-cause mortality. We aimed to include all cohort studies in adult populations with a sample size of more than 10 000 participants that estimated the effect of different levels of light or moderate physical activity on all-cause mortality. We searched Medline, Embase, Cochrane (DARE), Web of Science and Global Health (June 2009). We used dose-response meta-regression models to estimate the relation between non-vigorous physical activity and mortality. We identified 22 studies that met our inclusion criteria, containing 977 925 (334 738 men and 643 187 women) people. There was considerable variation between the studies in their categorization of physical activity and adjustment for potential confounders. We found that 2.5 h/week (equivalent to 30 min daily of moderate intensity activity on 5 days a week) compared with no activity was associated with a reduction in mortality risk of 19% [95% confidence interval (CI) 15-24], while 7 h/week of moderate activity compared with no activity reduced the mortality risk by 24% (95% CI 19-29). We found a smaller effect in studies that looked at walking alone. Being physically active reduces the risk of all-cause mortality. The largest benefit was found from moving from no activity to low levels of activity, but even at high levels of activity benefits accrue from additional activity.
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            Physical activity and sedentary leisure time and their associations with BMI, waist circumference, and percentage body fat in 0.5 million adults: the China Kadoorie Biobank study.

            Few large studies in China have investigated total physical activity and sedentary leisure time and their associations with adiposity. We investigated determinants of physical activity and sedentary leisure time and their associations with adiposity in China. A total of 466,605 generally healthy participants (age: 30-79 y, 60% female) in the China Kadoorie Biobank were included in this cross-sectional analysis. Self-reported information on a range of activities was collected by interviewer-administered questionnaire. Physical activity was calculated as metabolic equivalent task hours per day (MET-h/d) spent on work, transportation, housework, and nonsedentary recreation. Sedentary leisure time was quantified as hours per day. Adiposity measures included BMI, waist circumference, and percentage body fat (by bioimpedance analysis). Associations were estimated by linear and logistic regression. The mean physical activity was 22 MET-h/d, and the mean sedentary leisure time was 3.0 h/d. For each sex, physical activity was about one-third lower among professionals/administrators than among factory workers, with intermediate levels for other occupational categories. A 1-SD (14 MET-h/d) greater physical activity was associated with a 0.15-unit (95% CI: 0.14, 0.16) lower BMI (in kg/m(2)), a 0.58-cm (95% CI: 0.55, 0.61) smaller waist circumference, and 0.48 (95% CI: 0.45, 0.50) percentage points less body fat. In contrast, a 1-SD (1.5 h/d) greater sedentary leisure time was associated with a 0.19-unit higher BMI (95% CI: 0.18, 0.20), a 0.57-cm larger waist circumference (95% CI: 0.54, 0.59), and 0.44 (95% CI: 0.42, 0.46) percentage points more body fat. For any given physical activity level, greater sedentary leisure time was associated with a greater prevalence of increased BMI, as was lower physical activity for any given sedentary leisure time. In adult Chinese, physical activity varies substantially by occupation, and lack of physical activity and excess sedentary leisure time are independently and jointly associated with greater adiposity.
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              Relationship of leisure-time physical activity and mortality: the Finnish twin cohort.

              Physical activity and fitness are believed to reduce premature mortality, but whether genetic factors modify this effect is not known. To investigate leisure physical activity and mortality with respect to familial aggregation of health habits during childhood and factors that may enable some individuals to achieve higher levels of fitness. Prospective twin cohort study. Finland. In 1975, at baseline, 7925 healthy men and 7977 healthy women of the Finnish Twin Cohort aged 25 to 64 years who responded to a questionnaire on physical activity habits and known predictors of mortality. Those who reported exercising at least 6 times per month with an intensity corresponding to at least vigorous walking for a mean duration of 30 minutes were classified as conditioning exercisers, those who reported no leisure physical activity were classified as sedentary, and other subjects were classified as occasional exercisers. All-cause mortality and discordant deaths among same-sex twin pairs from 1977 through 1994. Among the entire cohort, 1253 subjects died. The hazard ratio for death adjusted for age and sex was 0.71 (95% confidence interval [CI], 0.62-0.81) in occasional exercisers and 0.57 (95% CI, 0.45-0.74) in conditioning exercisers, compared with those who were sedentary (Pfor trend <.001). Among the twin pairs who were healthy at baseline and discordant for death (n=434), the odds ratio for death was 0.66 (95% CI, 0.46-0.94) in occasional exercisers and 0.44 (95% CI, 0.23-0.83) in conditioning exercisers compared with those who were sedentary (P for trend, .005). The beneficial effect of physical activity remained after controlling for other predictors of mortality. Leisure-time physical activity is associated with reduced mortality, even after genetic and other familial factors are taken into account.
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                Author and article information

                Journal
                J Occup Health
                J Occup Health
                Journal of Occupational Health
                Japan Society for Occupational Health
                1341-9145
                1348-9585
                6 June 2016
                20 July 2016
                : 58
                : 4
                : 354-364
                Affiliations
                [1 ]Institute of Economic Research, Hitotsubashi University
                [2 ]Department of Public Health, Kitasato University School of Medicine
                [3 ]Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health
                Author notes
                Correspondence to: T. Oshio, Institute of Economic Research, Hitotsubashi University, 2-1 Naka, Kunitachi-shi, Tokyo 186-8603, Japan ( oshio@ 123456ier.hit-u.ac.jp )
                Article
                15-0336-OA
                5356943
                27265532
                c1696b8d-57da-4782-9350-4c9b09be74ae

                Journal of Occupational Health is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view the details of this license, please visit ( https://creativecommons.org/licenses/by-nc-sa/4.0/).

                History
                : 27 December 2015
                : 4 April 2016
                Categories
                Original

                fixed effects model,health surveys,leisure,physical activity

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