Associations of Physical Activity and Diet Quality With Mortality and Cardiovascular Disease in Cardiovascular-Kidney-Metabolic Syndrome
- UK Biobank
Authors' conclusion
Beyond individual benefits, joint PA-diet modification was associated with lower risk of mortality and CVD across CKM stages, highlighting the value of integrated behavioral strategies.
Study context
- Population
- UK Biobank participants with cardiovascular-kidney-metabolic (CKM) syndrome stage 0 to 451.3% women, mean age 56.4 years
- Participants
- 339,074 participants
- Comparison
- Independent and joint associations of physical activity (PA) and/or diet quality with mortality and incident cardiovascular disease (CVD) across CKM stages
Main finding
As reported in the abstract
All-cause mortality, composite CVD mortality, incident composite CVD with high PA
High PAHazard ratio (95% CI)
all-cause mortality; lower risk
0.76(0.74–0.79)
composite CVD mortality
0.74(0.70–0.77)
incident composite CVD
0.90(0.88–0.92)
Further findings
All-cause mortality, composite CVD mortality, incident composite CVD with high diet quality
| Comparison | HR (95% CI) | |
|---|---|---|
| High diet quality · all-cause mortality | 0.81 (0.77–0.85) | |
| High diet quality · composite CVD mortality | 0.81 (0.75–0.88) | |
| High diet quality · incident composite CVD | 0.87 (0.84–0.90) | |
| 0.512Hazard ratio (log scale) |
All-cause mortality, composite CVD mortality, incident composite CVD with high PA combined with high diet quality
| Comparison | HR (95% CI) | |
|---|---|---|
| High PA combined with high diet quality · all-cause mortality | 0.64 (0.60–0.68) | |
| High PA combined with high diet quality · composite CVD mortality | 0.61 (0.54–0.68) | |
| High PA combined with high diet quality · incident composite CVD | 0.83 (0.79–0.88) | |
| 0.512Hazard ratio (log scale) |
Dose-response of PA
- PA showed nonlinear associations with these outcomes, plateauing at approximately 2,500 metabolic equivalent min/wk
- 2,500 metabolic equivalent min/wk
Multiplicative interaction between PA and diet quality
- Significant multiplicative interactions for stroke mortality, composite CVD, and heart failure
- Joint associations stronger at more advanced CKM syndrome stages
Original publication
Associations of Physical Activity and Diet Quality With Mortality and Cardiovascular Disease in Cardiovascular-Kidney-Metabolic Syndrome. JACC Adv. Published 13 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it