Research in high-income countries has established the health benefits of physical activity(PA),but evidence from low-and middle-income countries,including China,where PA patterns vary from those in high-income countri...Research in high-income countries has established the health benefits of physical activity(PA),but evidence from low-and middle-income countries,including China,where PA patterns vary from those in high-income countries,remains limited.Moreover,previous research,mainly focused on specific diseases,failing to fully capture the health impacts of PA.We investigated the associations of PA with 425 distinct diseases and 53 causes of death using data from 511,088 participants aged 30–79 years in the China Kadoorie Biobank.Baseline PA was assessed using a questionnaire between 2004 and 2008,and usual PA levels were estimated using the resurvey data in 2013–2014.Cox regression was employed to estimate the associations between PA and outcomes,adjusting for potential confounders.During a median follow-up time of 12 years,722,183 incident events and 39,320 deaths were recorded across 18 chapters of the International Classification of Diseases,10th Revision(ICD-10).Total PA was significantly and inversely associated with incidence risks of 14 ICD-10 chapters,specifically 65 diseases and 19 causes of death,with the highest quintile group of PA showing a 14%lower disease incidence and 40%lower all-cause mortality compared with the lowest group.Of these diseases,54 were not highlighted in World Health Organization PA guidelines.Dose-response analyses revealed L-shaped associations for most PA types,except moderate-tovigorous intensity PA,which showed a U-shaped relationship.In this population,physical inactivity accounted for 12.8%of PA-related deaths.The findings underscore the broad health benefits of PA across a variety of body systems and the significant disease burden due to inactivity in China,highlighting the urgent need for PA promotion.展开更多
Prospective evidence on the relationship of greenness with cardiovascular disease(CVD)incidence is limited in low-and middle-income countries.In 512,691 participants of the China Kadoorie Biobank cohort across 10 regi...Prospective evidence on the relationship of greenness with cardiovascular disease(CVD)incidence is limited in low-and middle-income countries.In 512,691 participants of the China Kadoorie Biobank cohort across 10 regions in China,we calculated the levels of greenness exposure based on satellite-retrieved Normalized Difference Vegetation Index(NDVI)data.Annual maximum NDVI(NDVImax)values were estimated within 500 m and 1000 m buffers around the locations for the participants during the follow-up periods.Record linkages to healthcare databases provided incidence data of total CVD,ischemic heart disease and stroke during 2005–2017.Timevarying Cox proportional hazards regression was used to assess the associations between greenness exposure and CVD incidence.After 5.08 million person-years of follow-up,148,032 incident CVD events were recorded.The overall average level of NDVImax was 0.543 for all participants.We observed significant inverse associations of greenness with the incidence of CVD and its subtypes.Specifically,the hazard ratio for total CVD incidence was 0.976(95%confidence interval:0.958,0.994)per 0.1 increase in NDVImax within a 500 m buffer.As the 5 rural regions have achieved the WHO recommended greenness goal values,we compared the greenness levels in the 5 urban regions with the WHO's goal for greenness and found that,on average,3.81%of total CVD incidence might be averted if the recommended greenness values could be achieved.Exposure to a higher level of greenness was associated with a lower risk of CVD incidence in Chinese adults.展开更多
基金supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project(2023ZD0510100)supported by the Kadoorie Charitable Foundation in Hong Kong.The long-term follow-up has been supported by Wellcome grants to Oxford University(212946/Z/18/Z,202922/Z/16/Z,104085/Z/14/Z,088158/Z/09/Z)and grants(2016YFC0900500)+4 种基金the National Key Research and Development Programof China,theNational Natural Science Foundation of China(82192900,82388102,81390540,91846303,81941018)the ChineseMinistry of Science and Technology(2011BAI09B01)The UK Medical Research Council(MC_UU_00017/1,MC_UU_12026/2,MC_U137686851),Cancer Research UK(C16077/A29186C500/A16896)the British Heart Foundation(CH/1996001/9454),provide core funding to the Clinical Trial Service Unit and Epidemiological Studies Unit at Oxford University for the project.
文摘Research in high-income countries has established the health benefits of physical activity(PA),but evidence from low-and middle-income countries,including China,where PA patterns vary from those in high-income countries,remains limited.Moreover,previous research,mainly focused on specific diseases,failing to fully capture the health impacts of PA.We investigated the associations of PA with 425 distinct diseases and 53 causes of death using data from 511,088 participants aged 30–79 years in the China Kadoorie Biobank.Baseline PA was assessed using a questionnaire between 2004 and 2008,and usual PA levels were estimated using the resurvey data in 2013–2014.Cox regression was employed to estimate the associations between PA and outcomes,adjusting for potential confounders.During a median follow-up time of 12 years,722,183 incident events and 39,320 deaths were recorded across 18 chapters of the International Classification of Diseases,10th Revision(ICD-10).Total PA was significantly and inversely associated with incidence risks of 14 ICD-10 chapters,specifically 65 diseases and 19 causes of death,with the highest quintile group of PA showing a 14%lower disease incidence and 40%lower all-cause mortality compared with the lowest group.Of these diseases,54 were not highlighted in World Health Organization PA guidelines.Dose-response analyses revealed L-shaped associations for most PA types,except moderate-tovigorous intensity PA,which showed a U-shaped relationship.In this population,physical inactivity accounted for 12.8%of PA-related deaths.The findings underscore the broad health benefits of PA across a variety of body systems and the significant disease burden due to inactivity in China,highlighting the urgent need for PA promotion.
基金Grants from the National Natural Science Foundation of China(82388102,82192901,82192900)from the National Key Research and Development Program of China(2016YFC0900500).
文摘Prospective evidence on the relationship of greenness with cardiovascular disease(CVD)incidence is limited in low-and middle-income countries.In 512,691 participants of the China Kadoorie Biobank cohort across 10 regions in China,we calculated the levels of greenness exposure based on satellite-retrieved Normalized Difference Vegetation Index(NDVI)data.Annual maximum NDVI(NDVImax)values were estimated within 500 m and 1000 m buffers around the locations for the participants during the follow-up periods.Record linkages to healthcare databases provided incidence data of total CVD,ischemic heart disease and stroke during 2005–2017.Timevarying Cox proportional hazards regression was used to assess the associations between greenness exposure and CVD incidence.After 5.08 million person-years of follow-up,148,032 incident CVD events were recorded.The overall average level of NDVImax was 0.543 for all participants.We observed significant inverse associations of greenness with the incidence of CVD and its subtypes.Specifically,the hazard ratio for total CVD incidence was 0.976(95%confidence interval:0.958,0.994)per 0.1 increase in NDVImax within a 500 m buffer.As the 5 rural regions have achieved the WHO recommended greenness goal values,we compared the greenness levels in the 5 urban regions with the WHO's goal for greenness and found that,on average,3.81%of total CVD incidence might be averted if the recommended greenness values could be achieved.Exposure to a higher level of greenness was associated with a lower risk of CVD incidence in Chinese adults.
