Leisure time physical activity and mortality in Hong Kong: Case-control study of all adult deaths in 1998

Abstract

Purpose Physical activity is associated with longevity; however, whether these beneficial effects extend to Chinese populations is unclear. We examined the relationship between leisure time physical activity (LTPA) and mortality in Hong Kong. Methods Using a case-control study, past (10 years prior) levels of LTPA were ascertained via proxy informants for 24,079 dead cases (81% of all registered deaths) and 13,054 live controls aged ≥35 years and were analyzed by unmatched logistic regression to determine their association with all-cause and cause-specific mortality. Results Compared with an exercise frequency of <1 episode per month, ≥1 episode of LTPA per month was inversely associated with all-cause mortality [multivariable odds ratio (OR) = 0.63, 95% confidence interval (CI), 0.59, 0.68 for males; OR = 0.75, 95% CI, 0.70, 0.80 for females; adjusted for age, education, smoking status, alcohol consumption, and physical demand at work]. Each activity level above the reference level of <1 episode per month (i.e., 1 episode per month to 1-3 episodes per week, ≥4 episodes per week) had approximately the same level of risk reduction and no dose-response gradient was observed. The inverse association was stronger for cardiovascular than cancer deaths, particularly in males and was strongest for respiratory mortality. One-fifth of all 31,349 registered deaths in those aged 35 years and over in Hong Kong in 1998 were attributable to physical inactivity. Conclusion The present data confirm and extend previous findings in Caucasian populations on the association between leisure time physical activity and longevity. The population attributable risk from physical inactivity exceeds that due to tobacco smoking in this Hong Kong Chinese population. We predict mainland China will witness a similarly large mortality burden as it undergoes further socioeconomic development in the next few decades. © 2004 Elsevier Inc. All rights reserved.