{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:52:06Z","timestamp":1792788726544,"version":"4.5.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["#2017T051"],"award-info":[{"award-number":["#2017T051"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002999","name":"Ministerie van Volksgezondheid, Welzijn en Sport","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002999","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003195","name":"Ministerie van Economische Zaken","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003195","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005075","name":"Universitair Medisch Centrum Groningen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005075","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001721","name":"Rijksuniversiteit Groningen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001721","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Northern Provinces of the Netherlands"}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Moderate to vigorous physical activity (MVPA) is strongly associated with risk reductions of noncommunicable diseases and mortality. Cardiovascular health status may influence the benefits of MVPA. We compare the association between MVPA and incident major adverse cardiovascular events (MACE) and mortality between healthy individuals, individuals with elevated levels of cardiovascular risk factors (CVRF), and cardiovascular disease (CVD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>\n                      A cohort study was performed in the 3 northern provinces of the Netherlands, in which data were collected between 2006 and 2018, with a median follow-up of 6.8 years (Q\n                      <jats:sub>25<\/jats:sub>\n                      5.7; Q\n                      <jats:sub>75<\/jats:sub>\n                      7.9). A total of 142,493 participants of the Lifelines Cohort Study were stratified at baseline as (1) healthy; (2) CVRF; or (3) CVD. Individuals were categorized into \u201cinactive\u201d and 4 quartiles of least (Q1) to most (Q4) active based on self-reported MVPA volumes. Primary outcome was a composite of incident MACE and all-cause mortality during follow-up. Cox regression was used to estimate hazard ratios (HRs), 95% confidence intervals (CIs) and\n                      <jats:italic>P<\/jats:italic>\n                      values. The main analyses were stratified on baseline health status and adjusted for age, sex, income, education, alcohol consumption, smoking, protein, fat and carbohydrate intake, kidney function, arrhythmias, hypothyroid, lung disease, osteoarthritis, and rheumatoid arthritis. The event rates were 2.2% in healthy individuals (\n                      <jats:italic>n<\/jats:italic>\n                      = 2,485 of\n                      <jats:italic>n<\/jats:italic>\n                      = 112,018), 7.9% in those with CVRF (\n                      <jats:italic>n<\/jats:italic>\n                      = 2,214 of\n                      <jats:italic>n<\/jats:italic>\n                      = 27,982) and 40.9% in those with CVD (\n                      <jats:italic>n<\/jats:italic>\n                      = 1,019 of\n                      <jats:italic>n<\/jats:italic>\n                      = 2,493). No linear association between MVPA and all-cause mortality or MACE was found for healthy individuals (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.36) and individuals with CVRF (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.86), but a linear association was demonstrated for individuals with CVD (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.04). Adjusted HRs in healthy individuals were 0.81 (95% CI 0.64 to 1.02,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.07), 0.71 (95% CI 0.56 to 0.89,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.004), 0.72 (95% CI 0.57 to 0.91,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.006), and 0.76 (95% CI 0.60 to 0.96,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02) for MVPA Q1 to Q4, respectively, compared to inactive individuals. In individuals with CVRF, HRs were 0.69 (95% CI 0.57 to 0.82,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), 0.66 (95% CI 0.55 to 0.80,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), 0.64 (95% CI 0.53 to 0.77,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), and 0.69 (95% CI 0.57 to 0.84,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) for MVPA Q1 to Q4, respectively, compared to inactive individuals. Finally, HRs for MVPA Q1 to Q4 compared to inactive individuals were 0.80 (95% CI 0.62 to 1.03,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.09), 0.82 (95% CI 0.63 to 1.06,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.13), 0.74 (95% CI 0.57 to 0.95,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02), and 0.70 (95% CI 0.53 to 0.93,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.01) in CVD patients. Leisure MVPA was associated with the most health benefits, nonleisure MVPA with little health benefits, and occupational MVPA with no health benefits. Study limitations include its observational nature, self-report data about MVPA, and potentially residual confounding despite extensive adjustment for lifestyle risk factors and health-related factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MVPA is beneficial for reducing adverse outcomes, but the shape of the association depends on cardiovascular health status. A curvilinear association was found in healthy and CVRF individuals with a steep risk reduction at low to moderate MVPA volumes and benefits plateauing at high(er) MVPA volumes. CVD patients demonstrated a linear association, suggesting a constant reduction of risk with higher volumes of MVPA. Therefore, individuals with CVDs should be encouraged that \u201cmore is better\u201d regarding MVPA. These findings may help to optimize exercise prescription to gain maximal benefits of a physically active lifestyle.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pmed.1003845","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T13:39:52Z","timestamp":1638452392000},"page":"e1003845","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":86,"title":["Dose\u2013response association between moderate to vigorous physical activity and incident morbidity and mortality for individuals with a different cardiovascular health status: A cohort study among 142,493 adults from the Netherlands"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3899-471X","authenticated-orcid":true,"given":"Esm\u00e9e A.","family":"Bakker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6423-5341","authenticated-orcid":true,"given":"Duck-chul","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria T. E.","family":"Hopman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3383-3044","authenticated-orcid":true,"given":"Eline J.","family":"Oymans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1575-246X","authenticated-orcid":true,"given":"Paula M.","family":"Watson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0365-2149","authenticated-orcid":true,"given":"Paul D.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7707-5567","authenticated-orcid":true,"given":"Dick H. J.","family":"Thijssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0747-4471","authenticated-orcid":true,"given":"Thijs. M. H.","family":"Eijsvogels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"issue":"3","key":"pmed.1003845.ref001","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.jacc.2015.11.034","article-title":"Exercise at the Extremes: The Amount of Exercise to Reduce Cardiovascular Events","volume":"67","author":"TM Eijsvogels","year":"2016","journal-title":"J Am Coll Cardiol"},{"issue":"9838","key":"pmed.1003845.ref002","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S0140-6736(12)61031-9","article-title":"Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy","volume":"380","author":"IM Lee","year":"2012","journal-title":"Lancet"},{"issue":"11","key":"pmed.1003845.ref003","doi-asserted-by":"crossref","first-page":"e1001335","DOI":"10.1371\/journal.pmed.1001335","article-title":"Leisure time physical activity of moderate to vigorous intensity and mortality: a large pooled cohort analysis","volume":"9","author":"SC Moore","year":"2012","journal-title":"PLoS Med"},{"issue":"6","key":"pmed.1003845.ref004","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1249\/MSS.0000000000001939","article-title":"Physical Activity, All-Cause and Cardiovascular Mortality, and Cardiovascular Disease","volume":"51","author":"WE Kraus","year":"2019","journal-title":"Med Sci Sports Exerc"},{"issue":"6","key":"pmed.1003845.ref005","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1001\/jamainternmed.2015.0533","article-title":"Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship","volume":"175","author":"H Arem","year":"2015","journal-title":"JAMA Intern Med"},{"issue":"6","key":"pmed.1003845.ref006","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1097\/HJR.0b013e3283101671","article-title":"Physical activity and mortality in men and women with coronary heart disease: a prospective population-based cohort study in Norway (the HUNT study)","volume":"15","author":"T Moholdt","year":"2008","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"issue":"14","key":"pmed.1003845.ref007","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1016\/j.jacc.2017.08.017","article-title":"Physical Activity and Mortality in Patients With Stable Coronary Heart Disease","volume":"70","author":"RAH Stewart","year":"2017","journal-title":"J Am Coll Cardiol"},{"issue":"43","key":"pmed.1003845.ref008","doi-asserted-by":"crossref","first-page":"3547","DOI":"10.1093\/eurheartj\/ehz564","article-title":"Mortality reduction with physical activity in patients with and without cardiovascular disease","volume":"40","author":"SW Jeong","year":"2019","journal-title":"Eur Heart J"},{"issue":"13","key":"pmed.1003845.ref009","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1136\/heartjnl-2013-305242","article-title":"A reverse J-shaped association of leisure time physical activity with prognosis in patients with stable coronary heart disease: evidence from a large cohort with repeated measurements","volume":"100","author":"U Mons","year":"2014","journal-title":"Heart"},{"issue":"12","key":"pmed.1003845.ref010","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1161\/01.CIR.102.12.1358","article-title":"Physical activity and mortality in older men with diagnosed coronary heart disease","volume":"102","author":"SG Wannamethee","year":"2000","journal-title":"Circulation"},{"issue":"9","key":"pmed.1003845.ref011","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.mayocp.2014.05.006","article-title":"Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors","volume":"89","author":"PT Williams","year":"2014","journal-title":"Mayo Clin Proc"},{"issue":"19","key":"pmed.1003845.ref012","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1016\/j.jacc.2012.08.958","article-title":"Relation between volume of exercise and clinical outcomes in patients with heart failure","volume":"60","author":"SJ Keteyian","year":"2012","journal-title":"J Am Coll Cardiol"},{"issue":"20","key":"pmed.1003845.ref013","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1136\/bjsports-2017-098540","article-title":"Do highly physically active workers die early? A systematic review with meta-analysis of data from 193 696 participants.","volume":"52","author":"P Coenen","year":"2018","journal-title":"Br J Sports Med"},{"issue":"4","key":"pmed.1003845.ref014","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1093\/ije\/dyu229","article-title":"Cohort Profile: LifeLines, a three-generation cohort study and biobank","volume":"44","author":"S Scholtens","year":"2015","journal-title":"Int J Epidemiol"},{"issue":"1","key":"pmed.1003845.ref015","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s10654-007-9204-4","article-title":"Universal risk factors for multifactorial diseases: LifeLines: a three-generation population-based study","volume":"23","author":"RP Stolk","year":"2008","journal-title":"Eur J Epidemiol"},{"issue":"2","key":"pmed.1003845.ref016","first-page":"S1","article-title":"K\/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification","volume":"39","author":"F. National Kidney","year":"2002","journal-title":"Am J Kidney Dis"},{"key":"pmed.1003845.ref017","unstructured":"Statistics Netherlands 2020 [19\u201311\u20132020]. Available from: https:\/\/www.cbs.nl\/en-gb."},{"key":"pmed.1003845.ref018","article-title":"Screening and Brief Intervention in Primary Care Settings","author":"MF Fleming","journal-title":"National institute on alcohols abuse and alcoholism"},{"issue":"2","key":"pmed.1003845.ref019","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1017\/S0007114511000067","article-title":"Self-reported energy intake by FFQ compared with actual energy intake to maintain body weight in 516 adults","volume":"106","author":"E Siebelink","year":"2011","journal-title":"Br J Nutr"},{"issue":"12","key":"pmed.1003845.ref020","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/S0895-4356(03)00220-8","article-title":"Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity","volume":"56","author":"GC Wendel-Vos","year":"2003","journal-title":"J Clin Epidemiol"},{"issue":"8","key":"pmed.1003845.ref021","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1249\/MSS.0b013e31821ece12","article-title":"2011 Compendium of Physical Activities: a second update of codes and MET values","volume":"43","author":"BE Ainsworth","year":"2011","journal-title":"Med Sci Sports Exerc"},{"key":"pmed.1003845.ref022","volume-title":"WHO guidelines on physical activity and sedentary behaviour","author":"World Health Organization.","year":"2020"},{"issue":"25","key":"pmed.1003845.ref023","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1161\/circ.106.25.3143","article-title":"Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults","volume":"106","author":"National Cholesterol Education Program Expert Panel on Detection E","year":"2002","journal-title":"Circulation"},{"issue":"Suppl 1","key":"pmed.1003845.ref024","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.2337\/dc18-S002","article-title":"2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018","volume":"41","author":"A. American Diabetes","year":"2018","journal-title":"Diabetes Care"},{"key":"pmed.1003845.ref025","unstructured":"World Health Organisation. International Statistical Classification of Diseases and Related Health Problems 10th Revision. Geneva: 2010."},{"issue":"5","key":"pmed.1003845.ref026","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1002\/sim.4780080504","article-title":"Flexible regression models with cubic splines","volume":"8","author":"S Durrleman","year":"1989","journal-title":"Stat Med"},{"issue":"3","key":"pmed.1003845.ref027","first-page":"1","article-title":"MICE: Multivariate Imputation by Chained Equations in R","volume":"45","author":"SG-O, K. van Buuren","year":"2011","journal-title":"Journal of Statistical Software"},{"key":"pmed.1003845.ref028","unstructured":"Therneau T.A Package for Survival Analysis in S. version 2.38 2015 [1\u20137\u20132020]. Available from: https:\/\/CRAN.R-project.org\/package=survival."},{"key":"pmed.1003845.ref029","article-title":"Survival Curves using \u2019ggplot2\u2019.","author":"AK Kassambara","year":"2019"},{"key":"pmed.1003845.ref030","unstructured":"Harrell FE. Package \u2018rms\u2019. Version: 5.1\u20134 2019 [1\u20137\u20132020]. Available from: https:\/\/cran.r-project.org\/web\/packages\/rms\/rms.pdf."},{"issue":"2","key":"pmed.1003845.ref031","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1152\/physrev.00014.2016","article-title":"Vascular Adaptation to Exercise in Humans: Role of Hemodynamic Stimuli","volume":"97","author":"DJ Green","year":"2017","journal-title":"Physiol Rev"},{"issue":"8","key":"pmed.1003845.ref032","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.jacc.2013.02.074","article-title":"Simvastatin impairs exercise training adaptations","volume":"62","author":"CR Mikus","year":"2013","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"pmed.1003845.ref033","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s40279-013-0110-5","article-title":"Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendations","volume":"44","author":"S Mann","year":"2014","journal-title":"Sports Med."},{"issue":"7","key":"pmed.1003845.ref034","doi-asserted-by":"crossref","first-page":"493","DOI":"10.7326\/0003-4819-136-7-200204020-00006","article-title":"Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials","volume":"136","author":"SP Whelton","year":"2002","journal-title":"Ann Intern Med"},{"issue":"3","key":"pmed.1003845.ref035","first-page":"CD002968","article-title":"Exercise for type 2 diabetes mellitus","author":"DE Thomas","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"pmed.1003845.ref036","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1042\/CS20100520","article-title":"The forgotten face of regular physical exercise: a \u2019natural\u2019 anti-atherogenic activity","volume":"121","author":"J Szostak","year":"2011","journal-title":"Clin Sci (Lond)"},{"issue":"10","key":"pmed.1003845.ref037","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s11936-018-0674-3","article-title":"The \"Extreme Exercise Hypothesis\": Recent Findings and Cardiovascular Health Implications","volume":"20","author":"TMH Eijsvogels","year":"2018","journal-title":"Curr Treat Options Cardiovasc Med."},{"issue":"18","key":"pmed.1003845.ref038","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1001\/jama.2015.10858","article-title":"Exercise Is Medicine At Any Dose?","volume":"314","author":"TMH Eijsvogels","year":"2015","journal-title":"Jama-Journal of the American Medical Association"},{"issue":"8","key":"pmed.1003845.ref039","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1161\/CIRCULATIONAHA.114.010296","article-title":"Frequent physical activity may not reduce vascular disease risk as much as moderate activity: large prospective study of women in the United Kingdom","volume":"131","author":"ME Armstrong","year":"2015","journal-title":"Circulation"},{"issue":"13","key":"pmed.1003845.ref040","doi-asserted-by":"crossref","first-page":"e705","DOI":"10.1161\/CIR.0000000000000749","article-title":"Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association","volume":"141","author":"BA Franklin","year":"2020","journal-title":"Circulation"},{"issue":"3","key":"pmed.1003845.ref041","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s10654-020-00707-3","article-title":"Physical activity and all-cause and cause-specific mortality: assessing the impact of reverse causation and measurement error in two large prospective cohorts","volume":"36","author":"DH Lee","year":"2021","journal-title":"Eur J Epidemiol"},{"issue":"10113","key":"pmed.1003845.ref042","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.1016\/S0140-6736(17)31634-3","article-title":"The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study","volume":"390","author":"SA Lear","year":"2017","journal-title":"Lancet"},{"issue":"3","key":"pmed.1003845.ref043","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1136\/bjsports-2017-097965","article-title":"The physical activity paradox: six reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does","volume":"52","author":"A Holtermann","year":"2018","journal-title":"Br J Sports Med"},{"issue":"24","key":"pmed.1003845.ref044","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1136\/bjsports-2018-100344","article-title":"Is there a \u2019recent occupational paradox\u2019 where highly active physically active workers die early? Or are there failures in some study methods?","volume":"53","author":"RJ Shephard","year":"2019","journal-title":"Br J Sports Med"},{"issue":"5","key":"pmed.1003845.ref045","doi-asserted-by":"crossref","first-page":"e36345","DOI":"10.1371\/journal.pone.0036345","article-title":"Objective vs. self-reported physical activity and sedentary time: effects of measurement method on relationships with risk biomarkers","volume":"7","author":"CA Celis-Morales","year":"2012","journal-title":"PLoS ONE."},{"key":"pmed.1003845.ref046","doi-asserted-by":"crossref","first-page":"l4570","DOI":"10.1136\/bmj.l4570","article-title":"Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis","volume":"366","author":"U Ekelund","year":"2019","journal-title":"BMJ"}],"container-title":["PLOS Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmed.1003845","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T13:40:39Z","timestamp":1638452439000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmed.1003845"}},"subtitle":[],"editor":[{"given":"Christelle","family":"Nguyen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,12,2]]},"references-count":46,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pmed.1003845","relation":{},"ISSN":["1549-1676"],"issn-type":[{"value":"1549-1676","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,2]]}}}