TOPLINE:

People who engaged in more vigorous physical activity during the week had lower risks for many chronic diseases and death, regardless of the total volume of activity. Intensity mattered more than volume of activity for most conditions, although metabolic conditions benefited from both.

METHODOLOGY:

• Researchers used data from a prospective cohort study (UK Biobank) to assess whether the volume or intensity of physical activity was more strongly associated with the risk for chronic diseases and death.
• They included 96,408 adults who wore wrist accelerometers continuously for 7 days (mean age, 61.9 years; 56.3% female) between 2013 and 2015 and 375,730 adults who completed self-reported questionnaires (mean age, 56.2 years; 52.2% female) from 2006 to 2010.
• The total volume of activity was measured in terms of metabolic equivalent minutes per week (MET minutes per week) on the basis of accelerometer data or questionnaire responses, and the intensity of activity was classified as light, moderate, or vigorous using relevant estimates.
• The percentage of vigorous physical activity was calculated as the volume of vigorous physical activity divided by the total volume of physical activity × 100; on the basis of device-measured data, the percentage of vigorous physical activity performed by participants was categorized as 0%, > 0% to ≤ 2%, > 2% to ≤ 4%, and > 4%.
• Over a follow-up period of 8.8-14.6 years, researchers tracked new cases of eight major chronic diseases — major adverse cardiovascular events, atrial fibrillation, type 2 diabetes, immune-mediated inflammatory diseases (IMIDs), chronic respiratory disease, metabolic dysfunction-associated steatotic liver disease, chronic kidney disease, and dementia — along with all-cause mortality.

TAKEAWAY:

• Participants with > 4% of their physical activity at vigorous intensity had 29%-63% lower risks for all eight categories of chronic diseases and a 46% lower risk for mortality than those who did not engage in any vigorous physical activity, regardless of the total volume of the activity (P < .01 for all).
• Although the risks for most disease categories decreased as the percentage of vigorous activity increased, additional benefits plateaued for some outcomes once vigorous activity reached about 4%-5% of total activity, according to device-measured data.
• The intensity consistently showed greater preventive potential than the volume of activity. For example, performing vigorous activity vs increasing total volume could theoretically prevent 20.3% vs 1.0% of IMIDs.
• Both the intensity and total volume of physical activity were associated with reduced risks for metabolic conditions and mortality.

IN PRACTICE:

“[The study] suggests that comprehensive activity programs incorporating both sufficient volume and intensity remain optimal for metabolic health, unlike the intensity-focused strategies that may be most effective for immune-mediated and other strongly intensity-dependent conditions,” the researchers of the study wrote.

SOURCE:

The study was led by Jiehua Wei, Xiangya School of Public Health, Central South University, Changsha, China. It was published online on March 29 in the European Heart Journal.

LIMITATIONS:

Residual confounding and errors in self-reporting could not be ruled out. Activity was recorded for a single 7-day period, which may not have reflected long-term behavior. The cohort was mainly White with a low response rate.

DISCLOSURES:

Several authors reported receiving support from multiple research organizations and foundations, including the National Natural Science Foundation of China and the Fundamental and Interdisciplinary Disciplines Breakthrough Plan of the Ministry of Education of China. One author reported serving as a paid consultant and holding equity in Compliment 1, a US-based commercial entity developing products related to physical activity and chronic disease prevention.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.