ArticleThe Lancet regional health. Western Pacific2022
Revisiting the 'physical activity paradox' in a Chinese context: Occupational physical activity and mortality in 142,302 urban working adults from the China Kadoorie Biobank study.
Article in The Lancet regional health. Western Pacific, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- High occupational physical activity and its combined effect with leisure-time physical activity on cardiovascular disease and mortality: systematic reviews and meta-analyses.Occupational and environmental medicine · 2025Pooled it
- Bidirectional reallocations of sitting time, physical activity, and sleep in relation to risk of all-cause mortality and cardiovascular disease: An analysis of the Prospective Urban Rural Epidemiology (PURE)-China cohort study.Journal of sport and health science · 2026Article
- Interruption in physical activity behavior among Chinese adults in 2015 and 2020: trends and multilevel correlates based on two national surveys.BMC public health · 2026Article
- Domain-Specific Physical Activity and Obesity Risk among Black Men in the United States: Evidence of a Physical Activity Paradox.Journal of racial and ethnic health disparities · 2026Article
- Adolescent sports participation and social-class health inequalities: evidence from CHNS.Frontiers in public health · 2026Article
- Physical activity, chronic disease, depression, and health-related quality of life among Chinese older adults: a two-wave longitudinal panel study before and during COVID-19.Frontiers in public health · 2026Article
- Prospective associations between 24-h device-measured occupational and leisure-time physical activity and register-based musculoskeletal-related primary healthcare utilization among Danish workers.Scientific reports · 2025Article
- Sex differences in the association of physical activity patterns with all-cause and cardiovascular mortality: a prospective cohort study from NHANES 2007-2018.Scientific reports · 2025Article
- From Single Movement Behaviors to Complete 24-h Behaviors Profiles and Multiple Health Outcomes-A Cross-Sectional Study Using Accelerometry.Scandinavian journal of medicine & science in sports · 2025Article
- Article
- Identifying Community-Built Environment's Effect on Physical Activity and Depressive Symptoms Trajectories Among Middle-aged and Older Adults: Chinese National Longitudinal Study.JMIR public health and surveillance · 2025Article
- Article
- Association between weekend warrior physical activity pattern and all-cause mortality among adults living with type 2 diabetes: a prospective cohort study from NHANES 2007 to 2018.Diabetology & metabolic syndrome · 2024Article
- Occupational physical activity, all-cause, cardiovascular disease, and cancer mortality in 349,248 adults: Prospective and longitudinal analyses of the MJ Cohort.Journal of sport and health science · 2024Article
- Urban-rural differences in the association between occupational physical activity and mortality in Chinese working population: evidence from a nationwide cohort study.The Lancet regional health. Western Pacific · 2024Article
- Mood profile in men and women of all ages is improved by leisure-time physical activity rather than work-related physical activity.BMC public health · 2024Article
- Sex disparities in physical activity domains and hypertension prevalence.Clinical hypertension · 2024Article
- Association between physical activity domains and depressive symptoms among Brazilian adults: does every move count?Cadernos de saude publica · 2024Article
- Leisure-time physical activity improves happiness, health, and mood profile better than work-related physical activity.PloS one · 2024Article
- Occupational physical activity, all-cause mortality and incidence of cardiovascular diseases: results from three Italian cohorts.International archives of occupational and environmental health · 2024Article
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5 authors.
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Abstract
Background: Previous research suggests that while leisure-time physical activity (LTPA) is beneficial, occupational physical activity (OPA) may be detrimental to health, known as the 'physical activity paradox'. However, the current evidence is primarily based on data from Western countries. We examined the association of OPA with all-cause and cardiovascular disease mortality in working adults in urban China. Methods: This prospective longitudinal study was based on a sample of 142,302 urban working adults aged 30-79 years from the China Kadoorie Biobank study. Self-reported OPA (mainly sedentary, standing occupation, and manual work) was collected at baseline (year 2004-2008) and linked to death registries until 31st December 2016. Multivariable Cox proportional hazards models were used to examine the relationship between OPA and mortality outcomes, with further tests for effect modification by sex, educational attainment and LTPA. Findings: During a median follow-up of 10·2 years, 4,077 deaths occurred, of which cardiovascular disease was the primary cause for 727 deaths. Crude modelling showed that compared with the sedentary workers, manual work was associated with increased risk of all-cause mortality. However, after adjusting for socio-demographic and lifestyle variables, the association was attenuated to null (HR=1·00, 95%CI: 0·93-1·08). In subgroup analysis, higher OPA was associated with lower risk of all-cause mortality in the least educated group (HR=0·84, 95%CI: 0·75-0·95 for manual work, and HR=0·86, 95%CI: 0·75-0·99 for standing occupation), but harmful in the most educated group (HR=1·17, 95%CI: 1·01-1·36) and in those who reported regular LTPA (HR=1·20, 95%CI: 1·01-1·43). Interpretation: OPA was not associated with mortality risk in the overall sample. However, findings support the 'physical activity paradox' within better educated Chinese workers. Funding: None.
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