The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence

Nidhi Gupta; Sofie Dencker-Larsen; Charlotte Lund Rasmussen; Duncan McGregor; Charlotte Diana Nørregaard Rasmussen; Sannie Vester Thorsen; Marie Birk Jørgensen; Sebastien Chastin; Andreas Holtermann

doi:10.1186/s12966-020-00988-7

The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence

Nidhi Gupta^*, Sofie Dencker-Larsen, Charlotte Lund Rasmussen, Duncan McGregor, Charlotte Diana Nørregaard Rasmussen, Sannie Vester Thorsen, Marie Birk Jørgensen, Sebastien Chastin, Andreas Holtermann

^*Corresponding author for this work

Physiotherapy

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND: The 'physical activity paradox' advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies-self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations.

METHODS: Time spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios (ilrs). LTSA was register-based first event of ≥6 consecutive weeks of sickness absence during 4-year follow-up. The association between ilrs and LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work.

RESULTS: During the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA, p = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA, p = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work.

CONCLUSION: These findings provide further support to the 'PA paradox'.

Original language	English
Article number	93
Number of pages	9
Journal	International Journal of Behavioral Nutrition and Physical Activity
Volume	17
DOIs	https://doi.org/10.1186/s12966-020-00988-7
Publication status	Published - 20 Jul 2020

Keywords

accelerometry/instrumentation
adult
Denmark/epidemiology
exercise
female
humans
leisure activities
male
middle aged
proportional hazards models
prospective studies
sedentary behavior
sick Leave/statistics & numerical data
social class
wearable electronic devices
workplace
Accelerometers
Sedentary behavior
Physical activity
Register-based sickness absence
Occupational health
Sick leave
Time-use epidemiology

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10.1186/s12966-020-00988-7

Gupta, N. et al (2020) The physical activity paradox revisited a prospective study on compositional accelerometer data and long-term sickness absence
© The Author(s). 2020 Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Final published version, 777 KBLicence: CC BY

Cite this

Gupta, N., Dencker-Larsen, S., Lund Rasmussen, C., McGregor, D., Rasmussen, C. D. N., Thorsen, S. V., Jørgensen, M. B., Chastin, S., & Holtermann, A. (2020). The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence. International Journal of Behavioral Nutrition and Physical Activity, 17, [93]. https://doi.org/10.1186/s12966-020-00988-7

Gupta, Nidhi ; Dencker-Larsen, Sofie ; Lund Rasmussen, Charlotte ; McGregor, Duncan ; Rasmussen, Charlotte Diana Nørregaard ; Thorsen, Sannie Vester ; Jørgensen, Marie Birk ; Chastin, Sebastien ; Holtermann, Andreas. / The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence. In: International Journal of Behavioral Nutrition and Physical Activity. 2020 ; Vol. 17.

@article{190276dfba234357a7743c1a8a1cf396,

title = "The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence",

abstract = "BACKGROUND: The 'physical activity paradox' advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies-self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations.METHODS: Time spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios (ilrs). LTSA was register-based first event of ≥6 consecutive weeks of sickness absence during 4-year follow-up. The association between ilrs and LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work.RESULTS: During the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA, p = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA, p = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work.CONCLUSION: These findings provide further support to the 'PA paradox'.",

keywords = "accelerometry/instrumentation, adult, Denmark/epidemiology, exercise, female, humans, leisure activities, male, middle aged, proportional hazards models, prospective studies, sedentary behavior, sick Leave/statistics & numerical data, social class, wearable electronic devices, workplace, Accelerometers, Sedentary behavior, Physical activity, Register-based sickness absence, Occupational health, Sick leave, Time-use epidemiology",

author = "Nidhi Gupta and Sofie Dencker-Larsen and {Lund Rasmussen}, Charlotte and Duncan McGregor and Rasmussen, {Charlotte Diana N{\o}rregaard} and Thorsen, {Sannie Vester} and J{\o}rgensen, {Marie Birk} and Sebastien Chastin and Andreas Holtermann",

note = "Acceptance from webpage OA article",

year = "2020",

month = jul,

day = "20",

doi = "10.1186/s12966-020-00988-7",

language = "English",

volume = "17",

journal = "International Journal of Behavioral Nutrition and Physical Activity",

issn = "1479-5868",

publisher = "BMC (part of Springer Nature)",

}

Gupta, N, Dencker-Larsen, S, Lund Rasmussen, C, McGregor, D, Rasmussen, CDN, Thorsen, SV, Jørgensen, MB, Chastin, S & Holtermann, A 2020, 'The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence', International Journal of Behavioral Nutrition and Physical Activity, vol. 17, 93. https://doi.org/10.1186/s12966-020-00988-7

The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence. / Gupta, Nidhi; Dencker-Larsen, Sofie; Lund Rasmussen, Charlotte; McGregor, Duncan; Rasmussen, Charlotte Diana Nørregaard; Thorsen, Sannie Vester; Jørgensen, Marie Birk; Chastin, Sebastien; Holtermann, Andreas.

In: International Journal of Behavioral Nutrition and Physical Activity, Vol. 17, 93, 20.07.2020.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence

AU - Gupta, Nidhi

AU - Dencker-Larsen, Sofie

AU - Lund Rasmussen, Charlotte

AU - McGregor, Duncan

AU - Rasmussen, Charlotte Diana Nørregaard

AU - Thorsen, Sannie Vester

AU - Jørgensen, Marie Birk

AU - Chastin, Sebastien

AU - Holtermann, Andreas

N1 - Acceptance from webpage OA article

PY - 2020/7/20

Y1 - 2020/7/20

N2 - BACKGROUND: The 'physical activity paradox' advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies-self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations.METHODS: Time spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios (ilrs). LTSA was register-based first event of ≥6 consecutive weeks of sickness absence during 4-year follow-up. The association between ilrs and LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work.RESULTS: During the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA, p = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA, p = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work.CONCLUSION: These findings provide further support to the 'PA paradox'.

AB - BACKGROUND: The 'physical activity paradox' advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies-self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations.METHODS: Time spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios (ilrs). LTSA was register-based first event of ≥6 consecutive weeks of sickness absence during 4-year follow-up. The association between ilrs and LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work.RESULTS: During the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA, p = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA, p = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work.CONCLUSION: These findings provide further support to the 'PA paradox'.

KW - accelerometry/instrumentation

KW - adult

KW - Denmark/epidemiology

KW - exercise

KW - female

KW - humans

KW - leisure activities

KW - male

KW - middle aged

KW - proportional hazards models

KW - prospective studies

KW - sedentary behavior

KW - sick Leave/statistics & numerical data

KW - social class

KW - wearable electronic devices

KW - workplace

KW - Accelerometers

KW - Sedentary behavior

KW - Physical activity

KW - Register-based sickness absence

KW - Occupational health

KW - Sick leave

KW - Time-use epidemiology

U2 - 10.1186/s12966-020-00988-7

DO - 10.1186/s12966-020-00988-7

M3 - Article

C2 - 32690043

VL - 17

JO - International Journal of Behavioral Nutrition and Physical Activity

JF - International Journal of Behavioral Nutrition and Physical Activity

SN - 1479-5868

M1 - 93

ER -

The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence

Abstract

Keywords

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