Regular vigorous or moderate exercise linked to lower risk of death

Regular exercise is associated with a reduced risk of cardiovascular disease and premature death. However, there was limited evidence looking at the impact of exercise intensity on these risks.
A new analysis of over 100,000 participants, reviewed over a 30-year follow-up period, has shown that vigorous or moderate exercise is linked to the lowest risk of death.
Experts say taking small steps to move more can help one improve their health, and it’s important for individuals to consider their own unique circumstances and physical ability.

It is well known that being physically active can help you lead a healthier and happier life. People who exercise regularly have a lower risk of developing several long-term (chronic) conditions, such as heart disease, type 2 diabetes, and some cancers. Studies show that physical activity also boosts self-esteem and mood, and can also help people to have better quality sleep. However, while getting enough exercise is important, the intensity of the exercise should also be considered.

A recent analysis published in Circulation investigated the link between long-term physical activity intensity and the risk of death.

The study found that adults who perform two to four times the currently recommended amount of moderate or vigorous physical activity per week had a significantly reduced risk of death.

The 2018 physical activity guidelines recommend that adults engage in at least 150 to 300 minutes of moderate physical activity per week, and 75 to 150 minutes of vigorous physical activity per week. However, a growing number of people are performing higher levels of more vigorous exercise to maintain health and improve fitness. For example, high intensity interval training (HIIT) has become increasingly popular.

However, there have concerns about the potentially harmful effects on the cardiovascular health of an excessive amount of vigorous physical activity. Although, there is limited and sometimes conflicting evidence to support this.

This new research, conducted by Lee et al., involved analyzing data from 2 large cohorts of participants: the Nurses’ Health Study and the Health Professionals Follow-up Study, collected from 1988-2018.

In these cohorts, participants completed questionnaires about their physical activity up to 15 times during the follow-up period. They were asked to report the average hours they spent on various activities, including walking, jogging, running, swimming, bicycling, aerobic exercise, playing squash/racketball or tennis, while also logging low intensity exercise and weightlifting.

Study author Dr. Dong Hoon Lee explained to Medical News Today the implications of this research for people who want to increase their own activity levels.

“Our study showed that many people can get significant health benefits by performing the recommended physical activity (150 minutes per week of moderate activity or 75 minutes per week of vigorous activity) so it is important to stay active. For those who are looking for the optimal health benefits from exercise, they can aim for higher levels of activity (2+ times the recommended level).”

– Dr. Dong Hoon Lee

Benefits of moderate and vigorous exercise

The analysis showed that the greatest benefit for reducing the risk of death was observed among people who reported around 150 to 300 minutes per week of vigorous physical activity, 300 to 600 minutes per week of moderate physical activity, or an equivalent combination of both.

Prof. Becca Krukowski of the University of Virginia, who was not involved in the study, explained to Medical News Today how this research has real-world implications for people looking to improve their own health.

“These results indicate that either moderate and vigorous physical activity can have positive benefits for longevity and health. These results are consistent with previous research indicating that 300 minutes or more of moderate-to-vigorous physical activity may be necessary for those who wish to maintain a weight loss,” said Prof. Krukowski.

Study implications and limitations

The large study population, long follow-up time, and the regularity of the data collection (from the self-reported questionnaires) were considered to be strengths of the study.

“The authors did a nice job conducting sensitivity analyses that addressed many potential limitations. However, the type of physical activity—moderate or vigorous—was based on self-reported categories of activities,” said Krukowski. “For example, cycling was assumed to always be vigorous, but cycling could also be of moderate intensity.”

Prof. Catherine A. Sarkisian, Director of the UCLA Value-Based Care Research Consortium, who was also not involved in this research, explained to Medical News Today that for those who already meet the recommended guidelines of 150 to 300 minutes of moderate physical activity or 75 to 150 minutes of vigorous physical activity, there appears to be an added benefit of doing higher levels of vigorous physical activity (up to 600 minutes of moderate or 300 minutes of vigorous physical activity).

“We now have even stronger evidence than previously that exercising in mid-life will probably help you live longer,” Prof. Sarkisian noted.

In addition, for people who only do moderate but never vigorous physical activity, there appears to be an added benefit to adding 25% of the time doing a vigorous physical activity rather than only doing moderate physical activity.

“If you are a walker who never breaks a sweat, you might try adding some speed intervals or walking briskly up hills,” Prof. Sarkisian said.

However, on reviewing the study participants recruited for the study, Prof. Sarkisian noted that the studies included mostly non-Latino white people, a major limitation.

“It is very important to keep in mind that because this was not a clinical trial, we cannot be sure that it was the exercise itself that caused longer life rather than other factors associated with exercise. People who exercise are likely to be healthier in other ways that were not measured in this study, so the large effect sizes should be interpreted with caution.”

– Prof. Catherine A. Sarkisian

Small steps to increase physical activity levels

The study’s findings support the current physical activity guidelines and also suggest that higher levels of long-term vigorous and moderate exercise provide the most benefit in reducing the risk of death.

However, it’s important for individuals to consider their own unique circumstances and physical ability.

Not everyone is able to undertake vigorous exercise, but taking small steps to move more can help most people work toward improving their health.

Consider walking whenever possible instead of driving. Take the stairs instead of using the elevator. Go for an extra walk in the evening after dinner.

You can also do more inside your home, like gardening, yard work, or washing the car. Try to live as actively as possible, perhaps by doing sit-ups in front of the television or joining a local walking club. These small steps will make a positive impact on your health.

Prof. Krukowski had the following advice for people who want to increase their physical activity levels, but are unsure where to start:

Find a type of physical activity that you enjoy. That way, you’re more likely to continue with it.
Some people love being active in a group (like a cycling group or an exercise class), while others prefer to be active alone. Do what works for you.
Try pairing physical activity with something you enjoy, like listening to music or podcasts, talking with a friend, or watching your favorite show.

Although increasing exercise levels may sometimes feel overwhelming, it’s important to remember that any additional activity will help.

By doing activities a person enjoys, they’re much more likely to continue with it.

Ultimately, it’s important to figure out what works for the individual.

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