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Correspondence to Dr Pekka Oja, UKK Institute, P.O. Box 30, Tampere 33501, Finland; [email protected]
Background
It is well established that physical activity (PA) has multiple cardiometabolic health benefits.1 This evidence comes largely from studies focusing on leisure-time PAs and active travel.2–5
Epidemiological cohort studies have suggested that sports participation is associated with reduced mortality among middle-aged and older adults. Samitz et al6 systematically reviewed 80 studies with 1 338 143 participants for associations between PA and risk of all-cause mortality. The domain ‘vigorous exercise and sports’ showed the largest reduction in risk of all-cause mortality (RR=0.78) followed by ‘moderate and vigorous leisure-time activities’ (RR 0.86), ‘moderate activities of daily living’ (RR=0.90), ‘walking’ (RR=0.93) and ‘PA for transportation’ (RR=0.92).
It has been suggested that vigorous-intensity PA, that is inherent to many types of sports and exercise, may have a higher impact on reducing all-cause mortality risk than nonvigorous activities.7 Although sport is often cited as a contributor to public health, the nature and scope of this relationship remains unclear, particularly with regard to specific sport disciplines.
A recent systematic review of cross-sectional, cohort and intervention studies examined the health benefits of 26 specific sport disciplines.8 The most commonly studied sport disciplines were jogging/running, football, gymnastics, recreational cycling and swimming. According to established criteria for assessing the strength of evidence,9 there was moderate evidence for health benefits of jogging/running and recreational football and less than moderate evidence for all other sport disciplines. This review concluded that the existing evidence remains fragmentary and is compromised by weak study designs.
The aim of the present study was to examine: (1) the independent associations between participation in common types of sports and exercise and all-cause and cardiovascular disease (CVD) mortality; and (2) the graded exposure–response characteristics of these associations in a pooled analysis of 10 general population cohorts of adults in England and Scotland.
Methods
Sample
The Health Survey for England (HSE) and the Scottish Health Survey (SHeS) are household-based general population studies recruiting independent samples annually since 1991 (HSE) and periodically (SHeS) since 1995. Sampling is based on a multistage, stratified probability design aimed at a nationally representative sample of individuals living in households.10 11 Interviewers visited the sampled households and administered the...