ORIGINAL RESEARCH article
Front. Nutr.
Sec. Sport and Exercise Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1616561
Association between joint physical activity and alcohol intake and all-cause mortality in patients with cardiovascular disease: findings from NHANES 2007-2018
Provisionally accepted
Shiyang ZhangYeji zhuoCunyan ZhuTong Zhou
Zongtao WangJianyi ZhengRong ChenTudi LiDong Lin
Zhixin Xie
Zhenyang Fu
Zhihuan Zeng*
Kaitong Chen*- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
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Background: Physical activity and alcohol consumption are both highly prevalent in many countries, while the evidence related to joint effect on physical activity and alcohol consumption on patients with cardiovascular disease (CVD) was still deficient. This study was aimed to investigate the association between joint moderate-to-vigorous physical activity (MVPA) and alcohol intake and all-cause mortality in patients with CVD. Methods: A total of 4047 participants from the National Health and Nutrition Examination Survey (NHANES) with self-reported CVD history, exercise and alcohol consumption amounts were included this study. Participants were stratified into 12 groups by MVPA level (none/insufficient/sufficient) and alcohol intake (abstainer/light/moderate/heavy). Restricted cubic spline and Cox regression models assessed mortality associations. Results: MVPA showed an L-shaped association with mortality, while alcohol exhibited a U-shaped pattern. The lowest observed mortality risk occurred in patients with MVPA ≥150 min/week and alcohol consumption 8.4-15.4 drinks/week (HR=0.348, 95% CI: 0.169-0.667). Comparably lower risk was seen with MVPA <150 min/week plus light alcohol intake (<8.4 drinks/week) (HR=0.400, 95% CI: 0.267-0.588). Conclusion: Among patients with established CVD, any level of MVPA was associated with survival benefits. The greatest mortality reduction occurred with >150 minutes/week of MVPA alongside light to moderate alcohol consumption (<15.4 drinks/week). However, comparable survival benefits were observed with <150 minutes/week of MVPA when coupled with light alcohol intake. MVPA remains the cornerstone for mortality risk reduction in this population.
Keywords: cardiovascular disease, physical activity, alcohol, light drinking, NHANES
Received: 23 Apr 2025; Accepted: 19 Aug 2025.
Copyright: © 2025 Zhang, zhuo, Zhu, Zhou, Wang, Zheng, Chen, Li, Lin, Xie, Fu, Zeng and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhihuan Zeng, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
Kaitong Chen, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
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