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Associations Between Exercise Training, Physical Activity, Sedentary Behaviour and Mortality: An Umbrella Review of Meta-Analyses of Observational Studies

Umbrella review (48 meta-analyses; AMSTAR-2 graded): no highly convincing mortality claims, but suggestive pooled associations for higher physical activity and lower all-cause/CVD/cancer mortality—including device-measured steps—and higher sedentary time with higher mortality in weaker-evidence tiers.

Design

  • Umbrella review of meta-analyses of observational studies (PubMed/Embase/Web of Science through 30 Apr 2024)
  • 48 meta-analyses (AMSTAR-2: 25 high, 10 moderate, 2 low, 11 critically low)
  • Credibility framework: significance, n, heterogeneity, small-study effects, prediction intervals

Headline (abstract)

  • No evidence reached highly suggestive / convincing tiers in this umbrella’s grading
  • Suggestive lower mortality with any PA and higher mortality with sedentary behaviour
  • Examples (suggestive tier; abstract): device-measured total PA eHR 0.50 (0.38–0.65); daily steps eHR 0.44 (0.35–0.56); aerobic + resistance training eHR 0.60 (0.56–0.64)
  • Weaker evidence for high sedentary time ↔ higher mortality (eHR ~1.3 self-report; ~2.16 device with wide PI noted)

Evidence hygiene

Umbrella-of-meta-analyses on observations—use for calibrating certainty language, not replacing RCT mechanisms or intervention effect sizes.

Publication

Rahmati M, et al. J Cachexia Sarcopenia Muscle. 2025 Apr;16(2):e70006. doi: 10.1002/jcsm.70006. PMID 40042073.

Outcomes

  • All-Cause Mortality Risk
    Events: /
  • All-Cause Mortality Risk
    Events: /
  • Umbrella reported no highly suggestive or convincing evidence under its grading rules; suggestive tier included leisure-time PA and combined aerobic+resistance training associations with lower all-cause mortality (see abstract eHRs).
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