Beyond the basics: How extra exercise delivers maximum health benefits

Did you know that getting two to four times the minimum amount of weekly physical activity recommended for U.S. adults might significantly lower your risk of dying from cardiovascular disease and other causes?

The American Heart Association recommends that adults get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous activity, or a combination of both, preferably spread throughout the week.

One study from 2022 found that people who stuck to the minimum guidelines for moderate or vigorous long-term leisure physical activity significantly reduced their risk of mortality from any cause by up to 21%. However, adults who exercised two to four times the minimum might lower their mortality risk by as much as 31%. These findings supported the current physical activity guidelines while also suggesting that people who do medium to high levels of moderate or vigorous activity — or a combination of both- — can achieve the maximum benefits.

The research team analyzed 30 years of data for over 100,000 adults, with an average age of 66. The data the team assessed included self-reported physical activity intensity and time spent being active. The study defined moderate physical activity as walking, lower-intensity exercise, weightlifting and calisthenics. Meanwhile, jogging, running, swimming, bicycling and other aerobic exercises were classified as vigorous activity.

The study found that:

• Engaging in 300 to 600 minutes of moderate-intensity exercise each week was associated with a 26% to 31% decrease in the risk of death from any cause.
• People meeting only the minimum requirements for 150 minutes of moderate physical activity each week still experienced a 20% to 21% reduction in risk.
• Those who met the minimum requirement of 75 minutes of vigorous activity each week had a 19% lower mortality risk.
• Committing 150 to 300 minutes per week of physical activity correlated with a 21% to 23% lower risk of death from any cause.

Study author Dong Hoon Lee said, "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 is a research associate in the Department of Nutrition at the Harvard T.H. Chan School of Public Health in Boston.

Previously, research has indicated that long-term, high-intensity endurance activities, like marathons, triathlons and long-distance bicycle races, could increase the risk for cardiovascular problems, including sudden cardiac death. However, this 2022 study found that doing more than 300 minutes of vigorous or 600 minutes of moderate physical activity each week did not further reduce death risk, but it also did not harm cardiovascular health.

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

Donna K. Arnett, executive vice president for academic affairs and provost at the University of South Carolina, said the findings support what researchers already know about the heart health benefits associated with regular physical activity. Arnett helped write guidelines for cardiovascular disease prevention from the American Heart Association and American College of Cardiology, but she was not involved in the 2022 study.

"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," she said. "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.”