Participation in Household Physical Activity Lowers Mortality Risk in Chinese Women and Men

The health benefits of sport and physical exercise (SPE) have been well documented, while the influence of household physical activity (HPA) on health has received much less research attention. This study aims to provide epidemiologic insight into the role HPA plays in the development of all-cause, cardiovascular disease (CVD), respiratory disease (RESP), and cancer mortality in a nationwide cohort of Chinese adults. We conceived a prospective cohort comprising 30,791 participants aged ≥16 years from 25 provinces of China using data derived from baseline (2010) and 4 waves of follow-up (2012-2018) investigations of the China Family Panel Studies. Self-reported times of HPA and SPE were collected by interviewing participants with a standard questionnaire. Cox proportional hazard models were used to assess the associations of HPA and SPE with all-cause, CVD, RESP, and cancer mortality, adjusting for demographic and socioeconomic factors, lifestyle behaviors, and health status. A restricted cubic spline smoother was used to investigate the dose-response relationships of HPA and SPE with mortality outcomes. Sex subgroup analyses were conducted to examine the potential effect disparity between men and women. To investigate the interactive effects of HPA and SPE, we calculated the relative excess risk due to the interaction and attributable proportion of additive effects to the total observed effects. During a median follow-up of 7.2 years, a total of 1,649 deaths occurred, with 209 cases from CVD, 123 from RESP, and 323 from cancer. HPA was identified to be associated with reduced mortality outcomes, suggesting remarkably reduced risks of 43-60% in all-cause mortality, 42-50% in CVD mortality, 36-71% in RESP mortality, and 38-46% in cancer mortality. In general, higher levels of HPA tended to be associated with lower risks. An approximately inverted J-shape association was identified between HPA and all-cause and cause-specific mortality, suggesting strong evidence for potential nonlinearity. Women performing HPA had a lower risk of all-cause, CVD, and cancer mortality. We did not identify significant evidence for additive interaction between HPA and SPE. HPA is independently associated with a reduced risk of mortality in Chinese women and men. More biological studies are needed to validate our findings and clarify the mechanisms underlying the association.