Exercise Habits Are Associated with Improved Long-Term Mortality Risks in the Nationwide General Japanese Population: A 20-Year Follow-Up of the NIPPON DATA90 Study

Exercise Habits Are Associated with Improved Long-Term Mortality Risks in the Nationwide General Japanese Population: A 20-Year Follow-Up of the NIPPON DATA90 Study

YUKO TAKATSUJI,¹ AYA ISHIGURO,¹ KEI ASAYAMA,¹ TAKAYOSHI OHKUBO,¹ KATSUYUKI MIURA,^2,3 AYA KADOTA,^2,3 MASAHIKO YANAGITA,⁴ AKIRA FUJIYOSHI,⁵ HISATOMI ARIMA,⁶ NAOKO MIYAGAWA,⁷ NAOYUKI TAKASHIMA,⁸ YOSHIKUNI KITA,⁹ TAKEHITO HAYAKAWA ,¹⁰ MASAHIRO KIKUYA,¹ YASUYUKI NAKAMURA,^2,11 AKIRA OKAYAMA,¹² TOMONORI OKAMURA¹³ and HIROTSUGU UESHIMA;^2,3 NIPPON DATA90 RESEARCH GROUP

¹Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
²Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
³Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Shiga, Japan
⁴Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Kyoto, Japan
⁵Department of Hygiene, Wakayama Medical University, Wakayama, Wakayama, Japan
⁶Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka, Fukuoka, Japan
⁷International Center for Nutrition and Information, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
⁸Department of Public Health, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
⁹Faculty of Nursing Science, Tsuruga Nursing University, Tsuruga, Fukui, Japan
¹⁰The Kinugasa Research Organization, Research Center for Social Studies of Health and Community, Ritsumeikan University, Kyoto, Kyoto, Japan
¹¹Yamashina Racto Clinic and Medical Examination Center, Kyoto, Kyoto, Japan
¹²Research Institute of Strategy for Prevention, Tokyo, Japan
¹³Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan

Exercise habits are known as a protective factor for a variety of diseases and thus recommended worldwide; however, few studies have examined long-term effects of exercise habits on mortality. We continuously monitored death status in a nationwide population sample of 7,709 eligible persons from the National Integrated Project for Prospective Observation of Noncommunicable Disease and its Trends in the Aged in 1990 (NIPPON DATA90), for which baseline data were obtained in 1990. To investigate the long-term impact of baseline exercise habits, we calculated the relative risk of non-exercisers (participants without regular voluntary exercise habits) in reference to exercisers (those with these habits) for all-cause or cause-specific mortality using a Cox proportional hazard model, in which the following confounding factors were appropriately adjusted: sex, age, body mass index, total energy intake, smoking, drinking, and history of cardiovascular disease. During a median 20 years of follow-up, 1,747 participants died, 99 of heart failure. The risk for all-cause mortality was 12% higher in non-exercisers than in exercisers (95% confidence interval, 1%-24%), which was also observed for mortality from heart failure, as 68% higher in non-exercisers than in exercises (95% confidence interval, 3%-173%). These associations were similarly observed when the participants were divided to subgroups by sex, age, and the light, moderate, or vigorous intensity of physical activity, without any significant heterogeneities (P > 0.1). The present study has revealed significant impact of exercise habits on long-term mortality risks, supporting worldwide recommendations for improvement of exercise habits.

Keywords —— cardiovascular mortality; cohort study; exercise habits; mortality; population science

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Tohoku J. Exp. Med., 2020 252, 253-262.

Correspondence: Kei Asayama, M.D., Ph.D., Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.

e-mail: kei@asayama.org