Daily steps and diet, but not sleep, are related to mortality in older Australians

Stina Oftedal*, Elizabeth G. Holliday, John Attia, Wendy J. Brown, Clare E. Collins, Benjamin Ewald, Nicholas Glozier, Mark McEvoy, Philip J. Morgan, Ronald C. Plotnikoff, Emmanuel Stamatakis, Corneel Vandelanotte, Mitch J. Duncan

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

22 Citations (Scopus)


Objectives: Supporting healthy ageing is a key priority worldwide. Physical activity, diet quality and sleep are all associated with health outcomes, but few studies have explored their independent associations with all-cause mortality in an older population in the same model. The study aim was to examine associations between step-count, self-reported diet quality, restless sleep, and all-cause mortality in adults aged 55–85 years. 

Design: A prospective cohort study of adults in Newcastle, New South Wales, Australia. 

Method: Data were from 1697 participants (49.3% women; baseline mean age 65.4 ± 7.1 years). Daily steps (measured by pedometer), diet quality (from a modified Australian Recommended Food Score), and frequency of restless sleep (by self-report) were assessed in relation to all-cause mortality using Cox proportional hazard regression with adjustment for sex, age, household income and smoking. Baseline data were collected between January 2005 and April 2008, and last follow-up was in March 2017 (median follow-up 9.6 years). 

Results: Higher step count (HR: 0.93, 95%CI: 0.88–0.98 per 1000-step increment) and higher diet quality (HR: 0.86, 95%CI: 0.74–0.99 per 8-point increment in diet quality score) were associated with reduced mortality risk. Restless sleep for ≥3 nights/week was not associated with mortality risk (HR: 1.03, 95%CI: 0.78–1.39). Sensitivity analyses, adjusting for chronic disease and excluding deaths <1 year after baseline, did not change these estimates. 

Conclusions: Increased daily steps and consumption of a greater variety of nutrient-dense foods every week would result in substantial health benefits for older people. Future research should include a greater variety of sleep measures.

Original languageEnglish
Pages (from-to)276-282
Number of pages7
JournalJournal of Science and Medicine in Sport
Issue number3
Publication statusPublished - Mar 2020
Externally publishedYes


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