Journal Article

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

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

2020

Overview

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’.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Absenteeism (Labor) / Accelerometers / accelerometry / Accelerometry - instrumentation / Adult / Behavior / Behavioral Sciences / Chronic illnesses / Clinical Nutrition / Denmark - epidemiology / education / Epidemiology / Exercise / Female / Health Promotion and Disease Prevention / Humans / Labor unions / Leisure / Leisure Activities / Male / Medicine / Medicine & Public Health / Middle Aged / Mortality / nutrition / Occupational health / Physical activity / Physical fitness / Proportional Hazards Models / Prospective Studies / risk / Sedentary Behavior / sedentary lifestyle / Sick leave / Sick Leave - statistics & numerical data / Social Class / Socioeconomic factors / Studies / Time-use epidemiology / Wearable Electronic Devices / Workers / Workplace