Getting more exercise than guidelines suggest may further lower death risk

Doubling to quadrupling the minimum amount of weekly physical activity recommended for U.S. adults may substantially lower the risk of dying from cardiovascular disease and other causes, new research finds.

The study, published Monday in the American Heart Association journal Circulation, found people who followed the minimum guidelines for moderate or vigorous long-term, leisure physical activity lowered their risk of dying from any cause by as much as 21%. But adults who exercised two to four times the minimum might lower their mortality risk by as much as 31%.

"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," study author Dong Hoon Lee said in a news release. Lee is a research associate in the department of nutrition at the Harvard T.H. Chan School of Public Health in Boston.

"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."

The American Heart Association recommends adults get at least 150 minutes per week of moderate-intensity aerobic exercise, 75 minutes per week of vigorous aerobic exercise, or a combination of both. That advice is based on federal guidelines for physical activity.

For the new research, a team analyzed 30 years of medical records and mortality data for over 100,000 adults enrolled in two large studies: the all-female Nurses' Health Study and all-male Health Professionals Follow-Up Study. The data included self-reported measures of leisure time physical activity intensity and duration. Participants were an average 66 years old.

In the study, moderate physical activity was defined as walking, lower-intensity exercise, weightlifting and calisthenics. Vigorous activity included jogging, running, swimming, bicycling and other aerobic exercises.

Going above and beyond the recommended minimums reaped greater longevity rewards, especially for moderate physical activity. Extra moderate-intensity exercise – 300 to 600 minutes per week – was associated with a 26%-31% lower risk of death from any cause compared with almost no long-term moderate-intensity exercise. By comparison, people who hit just the minimum goals for moderate physical activity had a lower risk of 20%-21%.

For vigorous physical activity, getting 150 to 300 minutes a week was linked to a 21%-23% lower risk of death from any cause compared to getting none. That compared to a 19% lower risk for people who just met the minimum exercise target.

People who reported meeting the recommendation for moderate physical activity had a 22%-25% lower risk of dying from cardiovascular disease, while those who exercised two to four times the recommendation had a 28%-38% lower risk, the analysis found. Those reporting the recommended amount of vigorous physical activity were 31% less likely to die from cardiovascular disease, while those who doubled to quadrupled the recommended target had a 27%-33% lower risk.

Engaging in more than 300 weekly minutes of vigorous or 600 weekly minutes of moderate physical activity did not provide any further reduction in death risk, the study found. But it also did not harm cardiovascular health. Prior research has suggested long-term, high-intensity endurance activities – such as marathons, triathlons and long-distance bicycle races – may increase the risk for cardiovascular problems, including sudden cardiac death.

"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.

Donna K. Arnett, incoming executive vice president for academic affairs and provost at the University of South Carolina, said in the release that the findings fit with what is already known about the heart health benefits of regular physical activity.

"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," said Arnett, who helped write guidelines for cardiovascular disease prevention from the AHA and American College of Cardiology. She was not involved in the new research.

"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 said.

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