Associations of the volume and proportion of vigorous-intensity physical activity with all-cause, cardiovascular, and cancer mortality: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 40487062 · doi:10.7717/peerj.19538
What was done
A systematic review and dose-response meta-analysis (registered in PROSPERO: CRD42024525067) searched PubMed, Embase, and Web of Science up to March 22, 2024. The authors included empirical studies examining the associations of vigorous-intensity physical activity (VPA) volume (compared with light-to-moderate activity) and the proportion of VPA relative to moderate-to-vigorous physical activity (MVPA) with all-cause, cardiovascular disease (CVD), and cancer mortality.
What was found
Across 20 included studies, an inverse curvilinear dose-response relationship was observed between VPA volume and mortality. Compared with light-to-moderate activity, 180 minutes per week of VPA was associated with a 22% reduction in all-cause mortality, a 23% reduction in CVD mortality, and a 14% reduction in cancer mortality, with modest additional benefit beyond that volume. For VPA proportion relative to MVPA, a U-shaped inverse relationship occurred: compared to 0% VPA, a 37.5% VPA proportion showed the greatest risk reductions for all-cause mortality (HR = 0.90, 95% CI [0.88–0.93]) and CVD mortality (HR = 0.88, 95% CI [0.83–0.94]), with risk reductions plateauing between 30% and 60% VPA.
Why it matters
These findings provide specific quantitative targets for exercise recommendations, indicating that optimal longevity and cardiovascular benefits occur around 180 minutes of vigorous activity per week or when vigorous activity comprises 30% to 60% of total moderate-to-vigorous activity.
Limits
The abstract does not report total participant count, follow-up durations, or specific study populations. The underlying studies are observational and susceptible to confounding, reverse causation, and measurement error in physical activity reporting. Dose-response results for the proportion of VPA on cancer mortality were not reported.
Cited by
- contradicts Spending about 30 to 40 minutes per day performing vigorous physical activity is associated with a 50% or greater reduction in cardiovascular mortality, all-cause mortality, and type 2 diabetes incidence.