Being physically active and having a high-quality dietary pattern are two key features of our lifestyle associated with a healthier cardiometabolic risk profile, contributing to longer and healthier lives. However, beyond their individual influence on cardiometabolic risk, what about the mortality risk associated with these two important markers of our lifestyle when they are simultaneously examined?
In a paper recently published in the British Journal of Sports Medicine, the authors quantified the risk of all-cause and cardiovascular disease (CVD) mortality as well as physical activity, diet and adiposity-related (PDAR) cancer mortality associated with diet quality and physical activity examined both individually and in combination. Participants (n=346,627) were from the UK Biobank and they were followed for a mean follow-up of 11.2 years. Not surprisingly, moderate-to-vigorous intensity physical activity (MVPA), vigorous-intensity physical activity (VPA) and diet quality score were significantly associated with a reduced all-cause, CVD and PDAR cancer mortality. In adjusted models, most associations were attenuated but MVPA remained associated with a reduced all-cause, CVD and PDAR cancer mortality risk while VPA was associated with a reduced all-cause and CVD mortality risk. Regarding diet quality, only the highest diet quality score category was associated with a reduced PDAR cancer mortality risk. When both lifestyle factors were considered simultaneously, most combinations yielded a lower risk of all-cause, CVD and PDAR cancer mortality compared to the highest-risk combination (first quartile of MVPA or no VPA and diet quality index=0). Globally, the message is clear: the more physically active you are and the higher quality your diet is, the greater is the benefit on your mortality risk. Finally, no evidence of multiplicative or additive interactions between physical activity and diet quality on mortality was found.
These results further emphasise the importance of both being physically active and having a high nutritional quality diet to reduce all-cause, CVD and PDAR cancer mortality risk. Although progress has been made to document the key role played by these two “lifestyle vital signs” in order to combat the burden associated with chronic societal diseases, additional efforts should be devoted at the population level to target these key behaviors as only a small proportion of individuals adopt these healthy habits over the long term.