Vigorous physical activity, incident heart disease, and cancer: how little is enough?

Abstract

Aims Vigorous physical activity (VPA) is a time-efficient way to achieve recommended physical activity levels. There is a very limited understanding of the minimal and optimal amounts of vigorous physical activity in relation to mortality and disease incidence. Methods and results A prospective study in 71 893 adults [median age (IQR): 62.5 years (55.3, 67.7); 55.9% female] from the UK Biobank cohort with wrist-worn accelerometry. VPA volume (min/week) and frequency of short VPA bouts (≤2 min) were measured. The dose–response associations of VPA volume and frequency with mortality [all-cause, cardiovascular disease (CVD) and cancer], and CVD and cancer incidence were examined after excluding events occurring in the first year. During a mean post-landmark point follow-up of 5.9 years (SD ± 0.8), the adjusted 5-year absolute mortality risk was 4.17% (95% confidence interval: 3.19%, 5.13%) for no VPA, 2.12% (1.81%, 2.44%) for >0 to <10 min, 1.78% (1.53%, 2.03%) for 10 to <30 min, 1.47% (1.21%, 1.73%) for 30 to <60 min, and 1.10% (0.84%, 1.36%) for ≥60 min. The ‘optimal dose’ (nadir of the curve) was 53.6 (50.5, 56.7) min/week [hazard ratio (HR): 0.64 (0.54, 0.77)] relative to the 5th percentile reference (2.2 min/week). There was an inverse linear dose-response association of VPA with CVD mortality. The ‘minimal’ volume dose (50% of the optimal dose) was ∼15 (14.3, 16.3) min/week for all-cause [HR: 0.82 (0.75, 0.89)] and cancer [HR: 0.84 (0.74, 0.95)] mortality, and 19.2 (16.5, 21.9) min/week [HR: 0.60 (0.50, 0.72)] for CVD mortality. These associations were consistent for CVD and cancer incidence. There was an inverse linear association between VPA frequency and CVD mortality. 27 (24, 30) bouts/week was associated with the lowest all-cause mortality [HR: 0.73 (0.62, 0.87)]. Conclusion VPA of 15–20 min/week were associated with a 16–40% lower mortality HR, with further decreases up to 50–57 min/week. These findings suggest reduced health risks may be attainable through relatively modest amounts of VPA accrued in short bouts across the week.

Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality

“…In contrast to questionnaires, wearable devices such as wrist 24,25 or thigh 26,27 accelerometers continuously record movement at a high resolution allowing them to capture fine-grain patterns of brief physical activity bouts, such as VILPA 19 . The rapidly growing use of wearable devices in research 25,[27][28][29][30] and among consumers 31 offers opportunities to better understand the health-enhancing potential of VILPA and analogous unexplored movement 'micro-patterns'. Such potential is greatly enhanced by the recent application of machine learning [32][33][34] in studies using wearable devices to understand the health effects of movement.…”

“…As the length of raw bouts within these two VILPA frequency exposures was highly variable, we length-standardized analytic bouts to one minute (for raw bouts lasting up to 1 minute) or two minutes (for raw bouts lasting up to 2 minutes) using a rolling sum on the time-series data until 1 or 2 minutes, respectively, was reached or exceeded. For example, a participant with five consecutive raw bouts lasting up to 1 minute each (20,30,20,40, and 10 seconds long), would be assigned 1.83 analytic bouts: the first three raw bouts would count as one and the rolling sum would be reset; then the last two raw counts would count as 0.83 length-standardised bouts (50 seconds divided by 60). This bout handling has analytic and interpretational advantages: a) it mitigates against the problem of multicollinearity between raw VILPA frequency and daily VILPA duration, and b) permits a more concrete behavioural interpretation of the VILPA frequency findings than raw bouts, as each length-standardised bout can be specifically interpreted as lasting 1 minute or 2 minutes.…”

“…We also present point estimates (HRs and 95% CI) associated with the median and maximum volume/frequency VILPA values. We calculated E-values to estimate the plausibility of bias from unmeasured confounding 30,55 .…”

Physical Inactivity, Sedentary Behavior and Quality of Life in the Chilean Population: ENCAVI Results, 2015–2016

“…This could indicate that PA is always beneficial, even if done for a few minutes but on a regular basis [ 53 ]. Together with this point, recent reports state that at least 20 min per day of moderate to intense PA for 5 days per week can lead to a 16 to 40% reduction in the risk of suffering cardiovascular diseases among adults [ 54 ]. This amount of time is similar to the figure studied in this investigation.…”

Prevalence, spatial pattern, and predictors of cardiovascular and chronic diseases: A cross-sectional study

“…In spite of the fact that vigorous and moderate PA have been extensively studied for their social and health bene ts (Thompson 1996;Wannamethee and Shaper 2001;Rennie et al 2003b, a;Richardson et al 2013;Valero-Elizondo et al 2016;Liu et al 2020;Ahmadi et al 2022), the evidence regarding their effects is mixed. Additionally, while research in developed countries has suggested a link between occupation-related PA trends and chronic health issues like obesity, the impact of levels of PA on health in developing countries is not clear.…”