American Journal of Epidemiology Advance Access published online on May 10, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwm132
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Original Contribution |
Physical Activity and Mortality: Is the Association Explained by Genetic Selection?
1 Division of Epidemiology, Stockholm Centre of Public Health, Stockholm, Sweden
2 Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
4 Department of Surgical Sciences, Section of Orthopaedics, University Hospital, Uppsala, Sweden
Correspondence to Dr. Sofia Carlsson, Division of Epidemiology, Stockholm County Council, Norrbacka, S-171 76 Stockholm, Sweden (e-mail: sofia.carlsson{at}ki.se).
Received for publication July 22, 2006. Accepted for publication November 21, 2006.
Public health recommendations promote physical activity to improve health and longevity. Recent data suggest that the association between physical activity and mortality may be due to genetic selection. Using data on twins, the authors investigated whether genetic selection explains the association between physical activity and mortality. Data were based on a postal questionnaire answered by 13,109 Swedish twin pairs in 1972. The national Cause of Death Register was used for information about all-cause mortality (n = 1,800) and cardiovascular disease mortality (n = 638) during 1975–2004. The risk of death was reduced by 34% for men (relative risk = 0.64, 95% confidence interval: 0.50, 0.83) and by 25% for women (relative risk = 0.75, 95% confidence interval: 0.50, 1.14) reporting high physical activity levels. Within-pair comparisons of monozygotic twins showed that, compared with their less active co-twin, the more active twin had a 20% (odds ratio = 0.80, 95% confidence interval: 0.65, 0.99) reduced risk of all-cause mortality and a 32% (odds ratio = 0.68, 95% confidence interval: 0.49, 0.95) reduced risk of cardiovascular disease mortality. Results indicate that physical activity is associated with a reduced risk of mortality not due to genetic selection. This finding supports a causal link between physical activity and mortality.
mortality; motor activity; questionnaires; selection (genetics); Sweden; twins
Abbreviations: CI, confidence interval; CVD, cardiovascular disease
Editor's note: An invited commentary on this article is published on page 000.
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