Exercise is well-known to benefit health and well-being, but how much moderate or vigorous physical activity is needed to reduce mortality risk? A study in the journal *Circulation* explores this question, detailing the necessary amount and intensity of exercise to lower mortality rates.
The 2018 physical activity guidelines suggest adults engage in 150 to 300 minutes of moderate exercise or 75 to 150 minutes of vigorous exercise weekly, or a combination of both. Moderate activities include walking, weightlifting, and lower-intensity exercises, while vigorous activities encompass running, bicycling, and swimming. Exceeding these recommendations can further decrease mortality risk.
In two large U.S. cohorts, 116,221 adults self-reported their leisure-time physical activity (non-work exercise) through a validated questionnaire, repeated up to 15 times over 30 years. The study revealed that engaging in two to four times the minimum vigorous physical activity recommendations significantly lowered the risk of death from cardiovascular disease. Specifically, those who exercised two to four times above the moderate recommendations (300 to 599 minutes weekly) reaped the most benefits.
Participants exceeding the recommended moderate physical activity had a 26% to 31% lower all-cause mortality and a 28% to 38% lower risk of cardiovascular disease mortality. Additionally, they experienced a 25% to 27% lower risk of non-cardiovascular disease mortality. Adults who performed two to four times the recommended vigorous physical activity (150 to 299 minutes weekly) had a 21% to 23% lower all-cause mortality, a 27% to 33% lower cardiovascular disease mortality, and a 19% lower non-cardiovascular disease mortality.
The study highlighted that combining moderate and vigorous physical activity yields the best results. “A substantially lower risk of mortality was observed among individuals who had adequate levels of both long-term leisure time moderate and vigorous physical activity,” the study states, adding that higher levels of vigorous activity were linked to lower mortality among those with insufficient moderate exercise. However, this was not true for those already engaging in high levels of moderate activity (over 300 minutes weekly). The study concludes that “any combination of medium to high levels” of vigorous (75 to 300 minutes weekly) and moderate physical activity (150 to 600 minutes weekly) “can provide nearly the maximum mortality reduction,” around 35% to 42%.
People who are insufficiently active (less than 75 minutes of vigorous or 150 minutes of moderate exercise weekly) could achieve significant mortality reduction by incorporating modest levels of exercise. Engaging in 75 to 150 minutes of vigorous exercise or 150 to 300 minutes of moderate exercise weekly can reduce cardiovascular disease mortality by 22% to 31%.
A separate study in JAMA Oncology found that brief bouts of vigorous intermittent lifestyle physical activity, like fast walking or stair climbing for one to two minutes, were linked to a lower cancer risk.
Age doesn’t alter the impact of exercise. While younger people often choose vigorous activities, older adults tend to prefer moderate exercise. The study found no evidence that one type of exercise was superior for older adults. Instead, “long-term vigorous physical activity in generally healthy older adults can be an effective means of improving health.”
Despite concerns that long-term high-intensity endurance exercise could cause adverse events such as myocardial fibrosis, coronary artery calcification, atrial fibrillation, and sudden cardiac death, this study found no harmful effects of long-term vigorous activity on cardiovascular health. However, further research is necessary to confirm these findings.
To sum up, the study in Circulation underscores the significant health benefits of exceeding current physical activity recommendations, particularly through a mix of moderate and vigorous exercises. This approach maximizes the reduction in mortality risk from all causes, cardiovascular disease, and non-cardiovascular diseases.