Wearable device-based health equivalence of different physical activity intensities against mortality, cardiometabolic disease, and cancer.
Level 3 - non-randomized controlled study
Prospective observational cohort study
PubMed 41057301 · doi:10.1038/s41467-025-63475-2
What was done
Using accelerometer data from 73,485 UK Biobank participants followed for a mean of 8.0 (1.0) years, researchers assessed the equivalence of light physical activity (LPA) and moderate physical activity (MPA) to 1 minute of vigorous physical activity (VPA). Outcomes evaluated included all-cause mortality (ACM), cardiovascular disease (CVD) mortality, major adverse cardiovascular events (MACE), type 2 diabetes, and cancer outcomes across a standardised 5% to 35% risk reduction.
What was found
For a standardised 5%-35% risk reduction, the median MPA equivalent per 1 minute of VPA was 4.1 minutes (95% CI: 4.1-4.2) for ACM, 7.8 minutes (95% CI: 7.7-8.0) for CVD mortality, 5.4 minutes (95% CI: 5.3-5.5) for MACE, 9.4 minutes (95% CI: 9.3-9.6) for type 2 diabetes, and 3.5 minutes (95% CI: 3.4-3.5) for cancer mortality. For non-cancer outcomes, the median LPA equivalent per 1 minute of VPA ranged from 53 minutes (ACM) to 94 minutes (type 2 diabetes).
Why it matters
Public health guidelines and consumer wearables frequently assume 1 minute of vigorous activity equals 2 minutes of moderate activity based on self-report. These device-based measurements show that vigorous activity yields substantially greater efficiency per minute for cardiometabolic and mortality risk reduction.
Limits
The study is an observational cohort and cannot establish causality. Exposure was derived from accelerometer wear at a single baseline period without accounting for longitudinal changes in physical activity. The UK Biobank cohort exhibits volunteer bias and lacks broad demographic diversity.