8 However, Powell et al 14 noted that several of these studies did not control for the overall amount of activity. 24 Systematic reviews and meta-analyses have concluded that self-reported activity intensity is a better predictor of mortality than total amount of activity 26 and that vigorous activity provides more benefit in reducing mortality risk than moderate activity. 3, 13, 24 - 28 However, in doing this, it is important to account for the potential confounding of the total amount of activity because lower risk attributed to vigorous activities may simply reflect higher total energy expenditure. There have been calls for more research to examine the role of activity intensity for health benefits. 3, 9, 22, 23 Therefore, it could be hypothesized that there might be greater health benefits from vigorous activity than from moderate activities alone, even when the overall amount of activity is held constant. Independent of energy expenditure, vigorous physical activity is more efficient than moderate activity in inducing cardiorespiratory and metabolic fitness, 16 - 21 which is a stronger predictor of morbidity and mortality than activity. On the basis of epidemiologic and clinical studies, 3 current US, 4 UK, 5 Australian, 6 and World Health Organization 7 guidelines suggest that significant health benefits can accrue through accumulation of at least 150 minutes of moderate activity (3-5.9 metabolic equivalent tasks ) or 75 minutes of vigorous activity (≥6 METs) or an equivalent combination of moderate and vigorous activities where “2 minutes of moderate-intensity activity counts the same as 1 minute of vigorous-intensity activity.” 4 Implicit in these guidelines is that these amounts of moderate and vigorous activity confer similar benefits, but this remains unclear. Numerous studies 1, 2 have found that physical activity decreases the risk of many chronic diseases and increases longevity. Our findings suggest that vigorous activities should be endorsed in clinical and public health activity guidelines to maximize the population benefits of physical activity. These associations were consistent in men and women, across categories of body mass index and volume of MVPA, and in those with and without existing cardiovascular disease or diabetes mellitus.Ĭonclusions and Relevance Among people reporting any activity, there was an inverse dose-response relationship between proportion of vigorous activity and mortality. Among those who reported any MVPA, the proportion of vigorous activity revealed an inverse dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity (crude death rate, 3.84%) the fully adjusted hazard ratio was 0.91 (95% CI, 0.84-0.98 crude death rate, 2.35%) in those who reported some vigorous activity (but <30% of total activity) and 0.87 (95% CI, 0.81-0.93 crude death rate, 2.08%) among those who reported 30% or more of activity as vigorous. Compared with those who reported no MVPA (crude death rate, 8.34%), the adjusted hazard ratios for all-cause mortality were 0.66 (95% CI, 0.61-0.71 crude death rate, 4.81%), 0.53 (95% CI, 0.48-0.57 crude death rate, 3.17%), and 0.46 (95% CI, 0.43-0.49 crude death rate, 2.64%) for reporting 10 through 149, 150 through 299, and 300 min/wk or more of activity, respectively. Results During 1 444 927 person-years of follow-up, 7435 deaths were registered. Main Outcomes and Measures All-cause mortality during the follow-up period. Physical activity was measured with the Active Australia Survey. Associations between different contributions of vigorous activity to total MVPA and mortality were examined using Cox proportional hazards models, adjusted for total MVPA and sociodemographic and health covariates.Įxposures Different proportions of total MVPA as vigorous activity. ![]() Objective To examine whether the proportion of total moderate to vigorous activity (MVPA) that is achieved through vigorous activity is associated with all-cause mortality independently of the total amount of MVPA.ĭesign, Setting, and Participants We performed a prospective cohort study with activity data linked to all-cause mortality data from February 1, 2006, through June 15, 2014, in 204 542 adults aged 45 through 75 years from the 45 and Up population-based cohort study from New South Wales, Australia (mean follow-up, 6.52 years). ![]() Importance Few studies have examined how different proportions of moderate and vigorous physical activity affect health outcomes. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine. ![]()
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