Study: Lowest Mortality Risk Found Among Adults Who Exceed Current Physical Activity Guidelines

Adults who exercise 150-600 minutes a week have a significantly reduced risk of overall mortality and cardiovascular disease (CVD) mortality, according to research published in Circulation. This frequency of exercise represents 2 to 4 times the currently recommended amount of moderate or vigorous physical activity per week.

As of 2018, the US Department of Health and Human Services’ Physical Activity Guidelines for Americans recommended that adults engage in at least 150-300 minutes per week of moderate physical activity or 75-150 minutes per week of vigorous physical activity. The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic exercise, 75 minutes per week of vigorous aerobic exercise, or a combination of these.

“The potential impact of physical activity on health is great, yet it remains unclear whether engaging in high levels of prolonged, vigorous or moderate intensity physical activity above the recommended levels provides any additional benefits or harmful effects on cardiovascular health,” Dong Hoon Lee, ScD, MS, a research associate in the department of nutrition at the Harvard TH Chan School of Public Health in Boston, said in a statement. “Our study leveraged repeated measures of self-reported physical activity over decades to examine the association between long-term physical activity during middle and late adulthood and mortality.”

Researchers conducted an analysis of mortality data and medical records for more than 100,000 participants over a 30-year follow-up period. Data were collected from 2 large prospective studies, the all-female Nurses’ Health Study and the all-male Health Professionals Follow-Up Study from 1988-2018.

Participants had an average age of 66 years, 63% were female, and more than 96% were white adults.

Participants self-reported data on their leisure time physical activity by completing a validated questionnaire for either the Nurses’ Health Study or Health Professionals Follow-Up Study every 2 years. Questionnaires included questions about health information, physician-diagnosed illnesses, family medical histories, and personal habits such as cigarette and alcohol consumption and frequency of exercise.

Exercise data included the average time spent per week on various physical activities over the past year. Moderate activity was defined as walking, lower-intensity exercise, weightlifting, and calisthenics, whereas vigorous activity was defined as jogging, running, swimming, bicycling, and other aerobic exercises.

The findings of the analysis showed that adults who performed double the currently recommended range of either moderate or vigorous physical activity each week had the lowest long-term risk of mortality.

Participants who met the guidelines for vigorous physical activity had an observed 31% lower risk of cardiovascular disease mortality and a 15% lower risk of non-CVD mortality. An overall 19% lower risk of death from all causes was found for these participants.

Participants who met the guidelines for moderate physical activity had an observed 22%-25% lower risk of CVD mortality, as well as a 19%-20% lower risk for non-CVD mortality. This represented an overall 20%-21% lower risk of death from all causes.

Participants who performed 2 to 4 times above the recommended amount of long-term vigorous activity had an overall 21%-23% lower risk of death from all causes, including an observed 27%-33% lower risk of CVD mortality and 19% non-CVD mortality.

Participants who performed 2 to 4 times above the recommended amount of moderate physical activity had an observed 28%-38% lower risk of CVD mortality and 25%-27% non-CVD mortality. These participants saw an overall 26%-31% lower risk of mortality from all causes, the greatest among the participant groups.

Researchers also found no harmful cardiovascular health effects among the adults who reported engaging in more than 4 times the recommended minimum activity levels. However, engaging in long-term, high intensity physical activity (300 minutes/week) or moderate intensity physical activity (600 minutes/week) at levels more than 4 times the recommended weekly minimum provided no additional reduction in risk of death.

Previous studies have found evidence that long-term, high-intensity, endurance exercise may increase the risk of adverse cardiovascular events.

“This finding may reduce the concerns around the potential harmful effect of engaging in high levels of physical activity observed in several previous studies,” Lee said.

He also suggested that people who perform < 75 minutes of vigorous activity or < 150 minutes of moderate activity per week may have greater benefits on mortality reduction by consistently performing approximately 75-150 minutes of vigorous activity or 150-300 minutes of moderate exercise per week, or a combination of both, over the long term.

“Our study provides evidence to guide individuals to choose the right amount and intensity of physical activity over their lifetime to maintain their overall health,” Lee added. “Our findings support the current national physical activity guidelines and further suggest that the maximum benefits may be achieved by performing medium to high levels of either moderate or vigorous activity or a combination.”

Regular physical activity is known to be associated with reduced risk of CVD and premature death, but this study helps provide further information on the reduction of mortality and exercise intensity and frequency.

“We have known for a long time that moderate and intense levels of physical exercise can reduce a person’s risk of both atherosclerotic cardiovascular disease and mortality,” Donna K Arnett, MSPH, PhD, BSN, a past president of the American Heart Association (2012-2013) and the dean and a professor in the department of epidemiology at the University of Kentucky College of Public Health in Lexington, Kentucky, said in a statement.

Arnett served as co-chair of the writing committee for the American Heart Association’s 2019 Guideline on the Primary Prevention of Cardiovascular Disease.

“We have also seen that getting more than 300 minutes of moderate-intensity aerobic physical activity or more than 150 minutes of vigorous-intensity aerobic physical exercise each week may reduce a person’s risk of atherosclerotic cardiovascular disease even further, so it makes sense that getting those extra minutes of exercise may also decrease mortality,” she commented, though she was not involved with the study.

Reference

New study finds lowest risk of death was among adults who exercised 150-600 minutes/week [press release]. Dallas, TX: EurekAlert; July 25, 2022. https://www.eurekalert.org/news-releases/959314. Accessed July 25, 2022.