HOW SAFE IS EXERCISE? ASSOCIATIONS BETWEEN MID-LIFE PHYSICAL ACTIVITY AND FRACTURE IN UK BIOBANK: A CROSS-SECTIONAL STUDY
- 1University of Bristol
Abstract
ObjectiveTo examine associations between volume and intensity of leisure time physical activity (LTPA) and fracture risk during mid-life and determine whether adherence to World Health Organization (WHO) physical activity recommendations was associated with fracture risk.
MethodsCross-sectional analysis of UK Biobank participants aged 40-65 years using self-reported physical activity and fracture data. LTPA volume (LTPAV) was derived from walking, moderate and vigorous activity. Participants were categorised into LTPAV quintiles and by adherence to WHO physical activity recommendations. Multivariable logistic regression examined associations with self-reported fracture within the previous five years, with sex stratified analyses.
ResultsAmong 322,749 participants, 53% were female with a mean age of 47 years. Fracture risk increased with higher LTPAV, although the association was non-linear and varied by age and sex. The strongest associations were in the highest quintile among men and women aged 40-49 years (OR 1.81, 95% CI 1.64-1.99 and OR 1.42, 95% CI 1.28-1.58 respectively). In mutually adjusted models, vigorous activity demonstrated the strongest independent association with fracture risk. Meeting WHO physical activity recommendations, without exceeding them, was not associated with increased fracture risk.
ConclusionsHigher fracture risk was observed in individuals undertaking higher volumes of leisure-time physical activity, with the association largely driven by vigorous-intensity activity. The association was strongest in adults aged 40-49 years and in men. Physical activity consistent with current WHO recommendations was not associated with increased fracture risk, supporting continued promotion of physical activity during mid-life.
Summary BoxO_ST_ABSWhat is already known on this topicC_ST_ABSO_LILeisure-time physical activity (LTPA) has established health benefits but may also increase fracture risk, particularly at higher activity levels. C_LIO_LIWhether fracture risk differs according to age, sex, activity volume and intensity remains unclear. C_LI
What this study addsO_LIHigher volumes of LTPA were associated with increased fracture risk, but this was confined to individuals undertaking the highest activity volumes and was strongest in men. C_LIO_LIVigorous activity showed the strongest independent association with fracture risk, whereas activity levels consistent with current WHO recommendations were not associated with increased fracture risk in either sex. C_LI
How this study might affect research, practice or policyO_LIThese findings support continued promotion of WHO-recommended physical activity during mid-life, including around the menopause. C_LIO_LIFor highly active individuals, future guidance may need to consider not only activity volume but also how vigorous activity is accumulated to reduce injury and fracture risk. C_LI
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BibTeX
@misc{rolls2026safe,
title = {{HOW SAFE IS EXERCISE? ASSOCIATIONS BETWEEN MID-LIFE PHYSICAL ACTIVITY AND FRACTURE IN UK BIOBANK: A CROSS-SECTIONAL STUDY}},
author = {C. Rolls and J. Tobias and h. dawes and E. Clark and B. G. Faber},
howpublished = {medRxiv},
year = {2026},
month = jul,
doi = {10.64898/2026.07.27.26358989},
url = {https://www.medrxiv.org/content/10.64898/2026.07.27.26358989v2},
note = {CC BY},
}
RIS
TY - UNPB
TI - HOW SAFE IS EXERCISE? ASSOCIATIONS BETWEEN MID-LIFE PHYSICAL ACTIVITY AND FRACTURE IN UK BIOBANK: A CROSS-SECTIONAL STUDY
AU - C. Rolls
AU - J. Tobias
AU - h. dawes
AU - E. Clark
AU - B. G. Faber
PY - 2026
DA - 2026/07/27
PB - medRxiv
DO - 10.64898/2026.07.27.26358989
UR - https://www.medrxiv.org/content/10.64898/2026.07.27.26358989v2
AB - ObjectiveTo examine associations between volume and intensity of leisure time physical activity (LTPA) and fracture risk during mid-life and determine whether adherence to World Health Organization (WHO) physical activity recommendations was associated with fracture risk. MethodsCross-sectional analysis of UK Biobank participants aged 40-65 years using self-reported physical activity and fracture data. LTPA volume (LTPAV) was derived from walking, moderate and vigorous activity. Participants were categorised into LTPAV quintiles and by adherence to WHO physical activity recommendations. Multivariable logistic regression examined associations with self-reported fracture within the previous five years, with sex stratified analyses. ResultsAmong 322,749 participants, 53% were female with a mean age of 47 years. Fracture risk increased with higher LTPAV, although the association was non-linear and varied by age and sex. The strongest associations were in the highest quintile among men and women aged 40-49 years (OR 1.81, 95% CI 1.64-1.99 and OR 1.42, 95% CI 1.28-1.58 respectively). In mutually adjusted models, vigorous activity demonstrated the strongest independent association with fracture risk. Meeting WHO physical activity recommendations, without exceeding them, was not associated with increased fracture risk. ConclusionsHigher fracture risk was observed in individuals undertaking higher volumes of leisure-time physical activity, with the association largely driven by vigorous-intensity activity. The association was strongest in adults aged 40-49 years and in men. Physical activity consistent with current WHO recommendations was not associated with increased fracture risk, supporting continued promotion of physical activity during mid-life. Summary BoxO_ST_ABSWhat is already known on this topicC_ST_ABSO_LILeisure-time physical activity (LTPA) has established health benefits but may also increase fracture risk, particularly at higher activity levels. C_LIO_LIWhether fracture risk differs according to age, sex, activity volume and intensity remains unclear. C_LI What this study addsO_LIHigher volumes of LTPA were associated with increased fracture risk, but this was confined to individuals undertaking the highest activity volumes and was strongest in men. C_LIO_LIVigorous activity showed the strongest independent association with fracture risk, whereas activity levels consistent with current WHO recommendations were not associated with increased fracture risk in either sex. C_LI How this study might affect research, practice or policyO_LIThese findings support continued promotion of WHO-recommended physical activity during mid-life, including around the menopause. C_LIO_LIFor highly active individuals, future guidance may need to consider not only activity volume but also how vigorous activity is accumulated to reduce injury and fracture risk. C_LI
ER -