It is never too late to start: adherence to physical activity recommendations for 11-22 years and risk of all-cause and cardiovascular disease mortality. The HUNT Study

Objectives To examine associations between long-term (11-22 years) adherence to physical activity recommendations and mortality from all causes and from cardiovascular disease. Design Prospective population-based study with repeated assessments of self-reported physical activity (1984-86, 1995-97 and 2006-08) and follow-up until the end of 2013. Setting County of Nord-Trondelag, Norway. Participants Men and women aged >= 20 years; 32 811 who participated in 1984-86 and 1995-97; 22 058 in 1984-86 and 2006-08; 31 948 in 1995-97 and 2006-09 and 19 349 in all three examinations (1984-1986, 1995-95 and 2006-08). Main outcome measures All-cause mortality and cardiovascular disease mortality from the national Cause of Death Registry. Results Compared with the reference category comprising individuals who adhered to the physical activity recommendations (>= 150 min of moderate intensity or >= 60 min of vigorous intensity physical activity per week) over time, individuals who remained inactive (reporting no or very little physical activity) from 1984-86 to 1995-97 had HRs (95% CI) of 1.56 (1.40 to 1.73) for all-cause mortality and 1.94 (1.62 to 2.32) for cardiovascular disease mortality. Individuals who were inactive in 1984-86 and then adhered to recommendations in 2006-08 had HRs of 1.07 (0.85 to 1.35) for all-cause mortality and 1.31 (0.87 to 1.98) for cardiovascular disease mortality. In a subsample of individuals who participated at all three time points, those who were inactive or physically active below the recommended level across three decades (1984-86, 1995-97 and 2006-2008) had an HR of 1.57 (1.22 to 2.03) for all-cause mortality and 1.72 (1.08 to 2.73) for cardiovascular disease mortality. Conclusion Individuals who remained, or became, physically inactive had substantially greater risk of all-cause and cardiovascular disease mortality compared with those who met the physical activity recommendations throughout the lifespan.