Leisure-Time Physical Activity Is Associated With Reduced Risks of Mortality in Adults With General or Abdominal Obesity in Mexico
*Prospective cohort study; Level 2b (OCEBM).
Citation
O’Donovan G, Petermann-Rocha F, Ferrari G, et al. Leisure-Time Physical Activity Is Associated With Reduced Risks of Mortality in Adults With General or Abdominal Obesity in Mexico. American Journal of Preventive Medicine. 2026;70(6):108302. doi:10.1016/j.amepre.2026.108302
Background
Obesity is highly common in Mexico, and long-term weight loss is difficult. This study tested whether leisure-time sport and exercise are linked to lower death risk among adults with overall or abdominal obesity.
Patients
153,060 adults aged ≥35 years (mean 52) from the Mexico City Prospective Study (1998–2004 baseline). Underweight participants were excluded from some combined analyses.
Intervention
Medium/high leisure-time sport and exercise (self-reported frequency and minutes per session).
Control
None/low leisure-time sport and exercise.
Outcome
Deaths from any cause (primary), plus deaths from heart and blood vessel disease and from cancer.
Follow-up Period
Mean 17.6 years (tracked through 2020).
Results
There were 25,317 deaths total. After adjustment for age, sex, education, income, marital status, smoking, alcohol, fruit/vegetable intake, and sleep, higher activity was linked to lower death risk and appeared to lessen (but not remove) the added risk linked to higher body weight and waist size.
| Finding (fully adjusted) | Adjusted relative risk over time (95% CI) |
|---|---|
| Medium/high activity vs none/low activity (any-cause death) | 0.86 (0.84 to 0.90) |
| Obesity class II (body mass index ≥35) vs normal weight (any-cause death) | 1.41 (1.35 to 1.48) |
| High waist size vs low waist size (any-cause death) | 1.25 (1.21 to 1.28) |
| Obesity class II + none/low activity vs normal weight + none/low activity (any-cause death) | 1.40 (1.33 to 1.47) |
| Obesity class II + medium/high activity vs normal weight + none/low activity (any-cause death) | 1.18 (1.06 to 1.32) |
Limitations
This was an observational study, so it cannot prove that activity causes lower death risk. Activity was self-reported and measured only once, and unmeasured factors (such as overall health or diet details) may partly explain results. The cohort was from Mexico City and may not represent all of Mexico.
Funding
No direct funding; cohort supported by Mexican and UK public/charity funders.
Clinical Application
For adults with obesity, counsel and support regular leisure-time exercise; it may reduce long-term death risk even without major weight loss.
Discussion
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In this prospective cohort study, leisure-time physical activity (medium/high vs none/low) appeared to attenuate obesity-related all-cause mortality (e.g., Obesity Class II HR 1.40 inactive vs 1.18 active vs normal-BMI inactive). Given self-reported activity and residual confounding, is this enough to change counseling or policy in your setting, and for whom? In this prospective cohort study, medium/high leisure-time physical activity was associated with all-cause mortality HR 0.86 (95% CI 0.84–0.90) versus none/low activity after full adjustment. Which statement best interprets this hazard ratio?