{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T21:08:32Z","timestamp":1794344912646,"version":"4.9.0"},"reference-count":47,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1194510"],"award-info":[{"award-number":["APP1194510"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["25813"],"award-info":[{"award-number":["25813"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thelancet.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["eClinicalMedicine"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1016\/j.eclinm.2025.103741","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T23:45:51Z","timestamp":1768347951000},"page":"103741","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":24,"special_numbering":"C","title":["Minimum combined sleep, physical activity, and nutrition variations associated with lifeSPAN and healthSPAN improvements: a population cohort study"],"prefix":"10.1016","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5463-6894","authenticated-orcid":false,"given":"Nicholas A.","family":"Koemel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raaj K.","family":"Biswas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew N.","family":"Ahmadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Teixeira-Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hamer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7469-1399","authenticated-orcid":false,"given":"Leandro F.M.","family":"Rezende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5333-0164","authenticated-orcid":false,"given":"Rebecca M.","family":"Leech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouna","family":"Sawan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Allman-Farinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothea","family":"Dumuid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Bauman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Maher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Chow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice A.","family":"Gibson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Raubenheimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha L.","family":"Hocking","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1922-3058","authenticated-orcid":false,"given":"Kathryn","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7920-4924","authenticated-orcid":false,"given":"Peter A.","family":"Cistulli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7323-3225","authenticated-orcid":false,"given":"Emmanuel","family":"Stamatakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"Suppl. 2","key":"10.1016\/j.eclinm.2025.103741_bib1","doi-asserted-by":"crossref","first-page":"S218","DOI":"10.1139\/apnm-2020-0034","article-title":"Sleep duration and health in adults: an overview of systematic reviews","volume":"45","author":"Chaput","year":"2020","journal-title":"Appl Physiol Nutr Metab"},{"key":"10.1016\/j.eclinm.2025.103741_bib2","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br J Sports Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib4","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1038\/s41574-022-00747-7","article-title":"The role of insufficient sleep and circadian misalignment in obesity","volume":"19","author":"Chaput","year":"2023","journal-title":"Nat Rev Endocrinol"},{"key":"10.1016\/j.eclinm.2025.103741_bib6","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1038\/s41591-023-02235-5","article-title":"Optimal dietary patterns for prevention of chronic disease","volume":"29","author":"Wang","year":"2023","journal-title":"Nat Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib7","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1038\/s41574-019-0176-8","article-title":"Obesity: global epidemiology and pathogenesis","volume":"15","author":"Bl\u00fcher","year":"2019","journal-title":"Nat Rev Endocrinol"},{"key":"10.1016\/j.eclinm.2025.103741_bib8","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1093\/ije\/dyz078","article-title":"Smoking, drinking, diet and physical activity\u2014modifiable lifestyle risk factors and their associations with age to first chronic disease","volume":"49","author":"Ng","year":"2019","journal-title":"Int J Epidemiol"},{"key":"10.1016\/j.eclinm.2025.103741_bib9","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","volume":"403","author":"Ferrari","year":"2024","journal-title":"Lancet"},{"key":"10.1016\/j.eclinm.2025.103741_bib10","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.50241","article-title":"Global healthspan-lifespan gaps among 183 World Health Organization member states","volume":"7","author":"Garmany","year":"2024","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.eclinm.2025.103741_bib11","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1093\/ageing\/afx201","article-title":"Projections of multi-morbidity in the older population in England to 2035: estimates from the population ageing and care simulation (PACSim) model","volume":"47","author":"Kingston","year":"2018","journal-title":"Age Ageing"},{"key":"10.1016\/j.eclinm.2025.103741_bib12","doi-asserted-by":"crossref","first-page":"e514","DOI":"10.1016\/S2666-7568(24)00108-9","article-title":"The economic burden of cancer, coronary heart disease, dementia, and stroke in England in 2018, with projection to 2050: an evaluation of two cohort studies","volume":"5","author":"Landeiro","year":"2024","journal-title":"Lancet Healthy Longev"},{"key":"10.1016\/j.eclinm.2025.103741_bib13","article-title":"Interrelationship between sleep and exercise: a systematic review","volume":"2017","author":"Dolezal","year":"2017","journal-title":"Adv Prev Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib14","doi-asserted-by":"crossref","DOI":"10.1016\/j.smrv.2021.101430","article-title":"Association between diet and sleep quality: a systematic review","volume":"57","author":"Godos","year":"2021","journal-title":"Sleep Med Rev"},{"key":"10.1016\/j.eclinm.2025.103741_bib15","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/s12916-024-03833-x","article-title":"Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk","volume":"23","author":"Stamatakis","year":"2025","journal-title":"BMC Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1741-7015-12-59","article-title":"Lifestyle risk factors and residual life expectancy at age 40: a German cohort study","volume":"12","author":"Li","year":"2014","journal-title":"BMC Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib17","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1161\/CIRCULATIONAHA.117.032047","article-title":"Impact of healthy lifestyle factors on life expectancies in the US population","volume":"138","author":"Li","year":"2018","journal-title":"Circulation"},{"key":"10.1016\/j.eclinm.2025.103741_bib18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002082","article-title":"Measuring burden of unhealthy behaviours using a multivariable predictive approach: life expectancy lost in Canada attributable to smoking, alcohol, physical inactivity, and diet","volume":"13","author":"Manuel","year":"2016","journal-title":"PLoS Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib19","doi-asserted-by":"crossref","first-page":"e535","DOI":"10.1016\/S2666-7568(23)00140-X","article-title":"Healthy lifestyle in late-life, longevity genes, and life expectancy among older adults: a 20-year, population-based, prospective cohort study","volume":"4","author":"Wang","year":"2023","journal-title":"Lancet Healthy Longev"},{"key":"10.1016\/j.eclinm.2025.103741_bib20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003332","article-title":"Healthy lifestyle and life expectancy in people with multimorbidity in the UK biobank: a longitudinal cohort study","volume":"17","author":"Chudasama","year":"2020","journal-title":"PLoS Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib21","article-title":"Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study","volume":"368","author":"Li","year":"2020","journal-title":"BMJ"},{"key":"10.1016\/j.eclinm.2025.103741_bib22","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1001\/jamainternmed.2020.0618","article-title":"Association of healthy lifestyle with years lived without major chronic diseases","volume":"180","author":"Nyberg","year":"2020","journal-title":"JAMA Intern Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib23","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1038\/s41562-023-01624-7","article-title":"Healthy lifestyle and life expectancy free of major chronic diseases at age 40 in China","volume":"7","author":"Sun","year":"2023","journal-title":"Nat Hum Behav"},{"key":"10.1016\/j.eclinm.2025.103741_bib24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0169649","article-title":"Large scale population assessment of physical activity using wrist worn accelerometers: the UK biobank study","volume":"12","author":"Doherty","year":"2017","journal-title":"PLoS One"},{"key":"10.1016\/j.eclinm.2025.103741_bib25","doi-asserted-by":"crossref","first-page":"e800","DOI":"10.1016\/S2468-2667(23)00183-4","article-title":"Brief bouts of device-measured intermittent lifestyle physical activity and its association with major adverse cardiovascular events and mortality in people who do not exercise: a prospective cohort study","volume":"8","author":"Ahmadi","year":"2023","journal-title":"Lancet Public Health"},{"key":"10.1016\/j.eclinm.2025.103741_bib26","article-title":"Vigorous intermittent lifestyle physical activity and cancer incidence among nonexercising adults: the UK biobank accelerometry study","volume":"9:1255-1259","author":"Stamatakis","year":"2023","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.eclinm.2025.103741_bib27","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1093\/eurjpc\/zwae316","article-title":"Can incidental physical activity offset the deleterious associations of sedentary behaviour with major adverse cardiovascular events?","volume":"32","author":"Koemel","year":"2025","journal-title":"Eur J Prev Cardiol"},{"key":"10.1016\/j.eclinm.2025.103741_bib28","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/02640414.2019.1703301","article-title":"Non-wear or sleep? Evaluation of five non-wear detection algorithms for raw accelerometer data","volume":"38","author":"Ahmadi","year":"2020","journal-title":"J Sports Sci"},{"key":"10.1016\/j.eclinm.2025.103741_bib29","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.jsams.2016.06.003","article-title":"Field evaluation of a random forest activity classifier for wrist-worn accelerometer data","volume":"20","author":"Pavey","year":"2017","journal-title":"J Sci Med Sport"},{"key":"10.1016\/j.eclinm.2025.103741_bib30","doi-asserted-by":"crossref","first-page":"2521","DOI":"10.1038\/s41591-022-02100-x","article-title":"Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality","volume":"28","author":"Stamatakis","year":"2022","journal-title":"Nat Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib31","doi-asserted-by":"crossref","first-page":"e994","DOI":"10.1016\/S2468-2667(22)00110-4","article-title":"Healthy lifestyle and life expectancy at age 30 years in the Chinese population: an observational study","volume":"7","author":"Sun","year":"2022","journal-title":"Lancet Public Health"},{"key":"10.1016\/j.eclinm.2025.103741_bib32","doi-asserted-by":"crossref","first-page":"8315","DOI":"10.1038\/s41467-025-63475-2","article-title":"Wearable device-based health equivalence of different physical activity intensities against mortality, cardiometabolic disease, and cancer","volume":"16","author":"Biswas","year":"2025","journal-title":"Nat Commun"},{"key":"10.1016\/j.eclinm.2025.103741_bib33","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1093\/aje\/kwn411","article-title":"Estimation of the relative excess risk due to interaction and associated confidence bounds","volume":"169","author":"Richardson","year":"2009","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.eclinm.2025.103741_bib34","first-page":"2470","article-title":"Estimating the relative excess risk due to interaction in clustered-data settings","volume":"187","author":"Correia","year":"2018","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.eclinm.2025.103741_bib35","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12966-018-0766-1","article-title":"Daily domain-specific time-use composition of physical behaviors and blood pressure","volume":"16","author":"Gupta","year":"2019","journal-title":"Int J Behav Nutr Phys Activ"},{"key":"10.1016\/j.eclinm.2025.103741_bib36","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0139984","article-title":"Combined effects of time spent in physical activity, sedentary behaviors and sleep on obesity and cardio-metabolic health markers: a novel compositional data analysis approach","volume":"10","author":"Chastin","year":"2015","journal-title":"PLoS One"},{"key":"10.1016\/j.eclinm.2025.103741_bib37","series-title":"Exploratory Data Analysis","author":"Tukey","year":"1977"},{"key":"10.1016\/j.eclinm.2025.103741_bib38","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1093\/aje\/kwx349","article-title":"Multiple imputation for incomplete data in epidemiologic studies","volume":"187","author":"Harel","year":"2017","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.eclinm.2025.103741_bib39","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1038\/s41467-023-36546-5","article-title":"Associations of timing of physical activity with all-cause and cause-specific mortality in a prospective cohort study","volume":"14","author":"Feng","year":"2023","journal-title":"Nat Commun"},{"key":"10.1016\/j.eclinm.2025.103741_bib40","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003757","article-title":"Association of physical activity intensity and bout length with mortality: an observational study of 79,503 UK biobank participants","volume":"18","author":"Millard","year":"2021","journal-title":"PLoS Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib41","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s12916-019-1339-0","article-title":"Physical activity, multimorbidity, and life expectancy: a UK biobank longitudinal study","volume":"17","author":"Chudasama","year":"2019","journal-title":"BMC Med"},{"key":"10.1016\/j.eclinm.2025.103741_bib42","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1093\/ije\/dyad082","article-title":"Exploring regression dilution bias using repeat measurements of 2858 variables in \u226449 000 UK biobank participants","volume":"52","author":"Rutter","year":"2023","journal-title":"Int J Epidemiol"},{"key":"10.1016\/j.eclinm.2025.103741_bib43","doi-asserted-by":"crossref","DOI":"10.1093\/ageing\/afac098","article-title":"Patterns of unplanned hospital admissions among people with dementia: from diagnosis to the end of life","volume":"51","author":"Yorganci","year":"2022","journal-title":"Age Ageing"},{"key":"10.1016\/j.eclinm.2025.103741_bib44","article-title":"Factors associated with undiagnosed COPD in patients hospitalised for severe COPD exacerbation","volume":"11","author":"Guecamburu","year":"2024","journal-title":"BMJ Open Respir Res"},{"key":"10.1016\/j.eclinm.2025.103741_bib45","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S2213-8587(24)00072-X","article-title":"Undiagnosed type 2 diabetes: an invisible risk factor","volume":"12","year":"2024","journal-title":"Lancet Diabetes Endocrinol"},{"key":"10.1016\/j.eclinm.2025.103741_bib46","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0313877","article-title":"Estimating the burden of underdiagnosis within England: a modelling study of linked primary care data","volume":"20","author":"Anosova","year":"2025","journal-title":"PLoS One"},{"key":"10.1016\/j.eclinm.2025.103741_bib47","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","article-title":"Dementia prevention, intervention, and care: 2020 report of the Lancet commission","volume":"396","author":"Livingston","year":"2020","journal-title":"Lancet"},{"key":"10.1016\/j.eclinm.2025.103741_bib48","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1093\/aje\/kwx246","article-title":"Comparison of sociodemographic and health-related characteristics of UK biobank participants with those of the general population","volume":"186","author":"Fry","year":"2017","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.eclinm.2025.103741_bib49","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1097\/EDE.0000000000001316","article-title":"Is cohort representativeness Pass\u00e9? Poststratified associations of lifestyle risk factors with mortality in the UK biobank","volume":"32","author":"Stamatakis","year":"2021","journal-title":"Epidemiology"}],"container-title":["eClinicalMedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537025006765?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537025006765?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T20:29:56Z","timestamp":1784579396000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2589537025006765"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":47,"alternative-id":["S2589537025006765"],"URL":"https:\/\/doi.org\/10.1016\/j.eclinm.2025.103741","relation":{},"ISSN":["2589-5370"],"issn-type":[{"value":"2589-5370","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Minimum combined sleep, physical activity, and nutrition variations associated with lifeSPAN and healthSPAN improvements: a population cohort study","name":"articletitle","label":"Article Title"},{"value":"eClinicalMedicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.eclinm.2025.103741","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"103741"}}