Combined variations in sleep, physical activity, and nutrition and the risk of major adverse cardiovascular events
Authors' conclusion
Modest differences in combined SPAN behaviour levels were associated with meaningful reductions in MACE risk.
Study context
- Population
- UK Biobank participants with wearable-measured sleep and moderate to vigorous physical activity (MVPA) and diet quality score (median age 63.0 years; 56.8% male)2,034 major adverse cardiovascular events (MACE) events
- Participants
- 53,242 participants
- Exposure
- Combined sleep, physical activity, and nutrition (SPAN) behaviour levels
- Outcome
- MACE and its subtypes (myocardial infarction (MI), heart failure (HF), stroke)
- Follow-up
- 8.0-year follow-up
Main finding
As reported in the abstract
MACE
Each group vs lowest tertile for all SPAN behavioursHR
Optimal SPAN combination57% lower risk
0.43(95% CI 0.30–0.62)
Median SPAN score (52.8)41% lower risk
0.59(95% CI 0.49–0.70)
Additional 11 min/day sleep, 4.5 min/day MVPA and 3 DQS points10% lower MACE risk
0.90(CI 0.88–0.94)
Observational data: associations, not effects.
Further findings
| Outcome | HR | |
|---|---|---|
| MACE subtypes, median SPAN score — Median SPAN score vs Lowest tertile for all SPAN behaviours · HF | 0.53 (CI 0.38–0.75) | |
| MACE subtypes, median SPAN score — Median SPAN score vs Lowest tertile for all SPAN behaviours · MI | 0.65 (95% CI 0.50–0.84) | |
| MACE subtypes, median SPAN score — Median SPAN score vs Lowest tertile for all SPAN behaviours · stroke | 0.52 (95% CI 0.38–0.71) | |
| 0.20.5125Hazard ratio (log scale) |
Synergistic interaction between SPAN behaviours for MACE
- No synergistic interaction observed; RERI
- 0.003 (95% CI: −0.03, 0.04)
- Attributable proportion (AP)
- 0.4% (95% CI: −6 to 7%)
- S
- 1.03 (95% CI: −3.32, 5.29)
Original publication
Combined variations in sleep, physical activity, and nutrition and the risk of major adverse cardiovascular events. Eur J Prev Cardiol. Published 23 March 2026. doi:10.
Summarised from the published abstract; every number is checked against it