Higher proportion of vigorous physical activity may lower death risk: JAMA

The study is published in the Jama Internal Medicine Network.

It is unclear whether, for the sampe amount of total physical activity, higher the proportion of vigorous physical activity (VPA) to total physical activity is associated with a greater reduction in mortality.

Hence, to examine the association of the proportion of VPA to total physical activity (defined as moderate to vigorous physical activity [MVPA]) with all-cause mortality, cardiovascular disease mortality, and cancer mortality, Yafeng Wang and associates from the Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China conducted the present study.

The authors conducted a cohort study including 403 681 adults from the National Health Interview Survey who provided data on self-reported physical activity and were linked to the National Death Index records. All-cause mortality, cardiovascular disease mortality, and cancer mortality were the main outcomes to be assessed. Among the 403 681 individuals (225 569 women [51.7%]; mean [SD] age, 42.8 [16.3] years) in the study, during a median of 10.1 years (interquartile range, 5.4-14.6 years) of follow-up (407.3 million person-years), 36 861 deaths occurred.

The following results were noted-

1. Mutually adjusted models considering the recommendations of moderate physical activity (MPA; 150-299 vs 0 minutes per week) and VPA (≥75-149 vs 0 minutes per week) showed similar associations for all-cause mortality and cardiovascular disease mortality.
2. For the same contrasts, VPA showed a stronger inverse association with cancer mortality compared with MPA.
3. Among participants performing any MVPA, a higher proportion of VPA to total physical activity was associated with lower all-cause mortality but not with cardiovascular disease and cancer mortality. For instance, compared with participants with 0% of VPA (no vigorous activity), participants performing greater than 50% to 75% of VPA to total physical activity had a 17% lower all-cause mortality, independent of total MVPA.
4. The inverse association between the proportion of VPA to total physical activity and all-cause mortality was consistent across sociodemographic characteristics, lifestyle risk factors, and chronic conditions at baseline.

Therefore, this study suggested that for the same volume of MVPA, a higher proportion of VPA to total physical activity was associated with lower all-cause mortality.

The authors concluded that "Clinicians and public health interventions should recommend 150 minutes or more per week of MVPA but also advise on the potential benefits associated with VPA to maximize population health."