Daily activity energy expenditure and mortality among older adults

Todd M. Manini, James E. Everhart, Kushang V. Patel, Dale A. Schoeller, Lisa H. Colbert, Marjolein Visser, Frances Tylavsky, Douglas C. Bauer, Bret H. Goodpaster, Tamara B. Harris

Research output: Contribution to journalArticle

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Abstract

Context: Exercise is associated with mortality benefits but simply expending energy through any activity in an individual's free-living environment may confer survival advantages. Objective: To determine whether free-living activity energy expenditure is associated with all-cause mortality among older adults. Design, Setting, and Participants: Free-living activity energy expenditure was assessed in 302 high-functioning, community-dwelling older adults (aged 70-82 years). Total energy expenditure was assessed over 2 weeks using doubly labeled water. Resting metabolic rate was measured using indirect calorimetry and the thermic effect of meals was estimated at 10% of total energy expenditure. Free-living activity energy expenditure was calculated as: (total energy expenditure x 0.90) - resting metabolic rate. Participants were followed up over a mean of 6.15 years (1998-2006). Main Outcome Measures: Free-living activity energy expenditure (3 tertiles: low, <521 kcal/d; middle, 521-770 kcal/d; high, >770 kcal/d) and all-cause mortality. Results: Fifty-five participants (18.2%) died during follow-up. As a continuous risk factor, an SD increase in free-living activity energy expenditure (287 kcal/d) was associated with a 32% lower risk of mortality after adjusting for age, sex, race, study site, weight, height, percentage of body fat, and sleep duration (hazard ratio, 0.68; 95% confidence interval, 0.48-0.96). Using the same adjustments, individuals in the highest tertile of free-living activity energy expenditure were at a significantly lower mortality risk compared with the lowest tertile (hazard ratio, 0.31; 95% confidence interval, 0.14-0.69). Absolute risk of death was 12.1% in the highest tertile of activity energy expenditure vs 24.7% in the lowest tertile; absolute risks were similar to these for tertiles of physical activity level. The effect of free-living activity energy expenditure changed little after further adjustment for self-rated health, education, prevalent health conditions, and smoking behavior. According to self-reports, individuals expending higher levels of free-living activity energy were more likely to work for pay (P = .004) and climb stairs (P = .01) but self-reported high-intensity exercise, walking for exercise, walking other than for exercise, volunteering, and caregiving did not differ significantly across the activity energy expenditure tertiles. Conclusions: Objectively measured free-living activity energy expenditure was strongly associated with lower risk of mortality in healthy older adults. Simply expending energy through any activity may influence survival in older adults.

Original languageEnglish (US)
Pages (from-to)171-179
Number of pages9
JournalJournal of the American Medical Association
Volume296
Issue number2
DOIs
StatePublished - Jul 12 2006

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Energy Metabolism
Mortality
Exercise
Basal Metabolism
Walking
Confidence Intervals
Independent Living
Social Adjustment
Indirect Calorimetry
Health Education
Self Report
Meals
Adipose Tissue
Sleep
Hot Temperature
Smoking
Outcome Assessment (Health Care)
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Manini, T. M., Everhart, J. E., Patel, K. V., Schoeller, D. A., Colbert, L. H., Visser, M., ... Harris, T. B. (2006). Daily activity energy expenditure and mortality among older adults. Journal of the American Medical Association, 296(2), 171-179. https://doi.org/10.1001/jama.296.2.171

Daily activity energy expenditure and mortality among older adults. / Manini, Todd M.; Everhart, James E.; Patel, Kushang V.; Schoeller, Dale A.; Colbert, Lisa H.; Visser, Marjolein; Tylavsky, Frances; Bauer, Douglas C.; Goodpaster, Bret H.; Harris, Tamara B.

In: Journal of the American Medical Association, Vol. 296, No. 2, 12.07.2006, p. 171-179.

Research output: Contribution to journalArticle

Manini, TM, Everhart, JE, Patel, KV, Schoeller, DA, Colbert, LH, Visser, M, Tylavsky, F, Bauer, DC, Goodpaster, BH & Harris, TB 2006, 'Daily activity energy expenditure and mortality among older adults', Journal of the American Medical Association, vol. 296, no. 2, pp. 171-179. https://doi.org/10.1001/jama.296.2.171
Manini TM, Everhart JE, Patel KV, Schoeller DA, Colbert LH, Visser M et al. Daily activity energy expenditure and mortality among older adults. Journal of the American Medical Association. 2006 Jul 12;296(2):171-179. https://doi.org/10.1001/jama.296.2.171
Manini, Todd M. ; Everhart, James E. ; Patel, Kushang V. ; Schoeller, Dale A. ; Colbert, Lisa H. ; Visser, Marjolein ; Tylavsky, Frances ; Bauer, Douglas C. ; Goodpaster, Bret H. ; Harris, Tamara B. / Daily activity energy expenditure and mortality among older adults. In: Journal of the American Medical Association. 2006 ; Vol. 296, No. 2. pp. 171-179.
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AU - Manini, Todd M.

AU - Everhart, James E.

AU - Patel, Kushang V.

AU - Schoeller, Dale A.

AU - Colbert, Lisa H.

AU - Visser, Marjolein

AU - Tylavsky, Frances

AU - Bauer, Douglas C.

AU - Goodpaster, Bret H.

AU - Harris, Tamara B.

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N2 - Context: Exercise is associated with mortality benefits but simply expending energy through any activity in an individual's free-living environment may confer survival advantages. Objective: To determine whether free-living activity energy expenditure is associated with all-cause mortality among older adults. Design, Setting, and Participants: Free-living activity energy expenditure was assessed in 302 high-functioning, community-dwelling older adults (aged 70-82 years). Total energy expenditure was assessed over 2 weeks using doubly labeled water. Resting metabolic rate was measured using indirect calorimetry and the thermic effect of meals was estimated at 10% of total energy expenditure. Free-living activity energy expenditure was calculated as: (total energy expenditure x 0.90) - resting metabolic rate. Participants were followed up over a mean of 6.15 years (1998-2006). Main Outcome Measures: Free-living activity energy expenditure (3 tertiles: low, <521 kcal/d; middle, 521-770 kcal/d; high, >770 kcal/d) and all-cause mortality. Results: Fifty-five participants (18.2%) died during follow-up. As a continuous risk factor, an SD increase in free-living activity energy expenditure (287 kcal/d) was associated with a 32% lower risk of mortality after adjusting for age, sex, race, study site, weight, height, percentage of body fat, and sleep duration (hazard ratio, 0.68; 95% confidence interval, 0.48-0.96). Using the same adjustments, individuals in the highest tertile of free-living activity energy expenditure were at a significantly lower mortality risk compared with the lowest tertile (hazard ratio, 0.31; 95% confidence interval, 0.14-0.69). Absolute risk of death was 12.1% in the highest tertile of activity energy expenditure vs 24.7% in the lowest tertile; absolute risks were similar to these for tertiles of physical activity level. The effect of free-living activity energy expenditure changed little after further adjustment for self-rated health, education, prevalent health conditions, and smoking behavior. According to self-reports, individuals expending higher levels of free-living activity energy were more likely to work for pay (P = .004) and climb stairs (P = .01) but self-reported high-intensity exercise, walking for exercise, walking other than for exercise, volunteering, and caregiving did not differ significantly across the activity energy expenditure tertiles. Conclusions: Objectively measured free-living activity energy expenditure was strongly associated with lower risk of mortality in healthy older adults. Simply expending energy through any activity may influence survival in older adults.

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