Does Exercise Intensity Affect Mortality Risk?

While moderate-to-vigorous physical activity (MVPA) is adequate for achieving recommended weekly exercise goals, higher amounts of vigorous physical activity (VPA) are associated with increased benefits to all-cause mortality risk, according to the results of a recent study.

In order to examine how the level of physical activity could affect outcomes, the researchers conducted a study of 403,681 adults from the National health Interview Survey 1997-2013. All participants self-reported physical activity, and National Death Index records were utilized to chart mortality.

Among the 403,681 participants, 36,861 deaths occurred over a median of 10.1 years of follow-up. Overall, hazard ratios (HRs) for both levels of exercise were similar when compared with no exercise for both all-cause mortality (MPA: HR 0.83; 95% CI, 0.80-0.87; and VPA: HR 0.80; 95% CI, 0.76-0.84) and cardiovascular disease mortality (MPA: HR 0.75; 95% CI, 0.68-0.83; and VPA: HR 0.79; 95% CI, 0.70-0.91). VPA, however, had a greater inverse association with cancer-related mortality compared with MPA (HR 0.94; 95% CI, 0.86-1.02).

Among individuals performing any level of MVPA, higher proportions of VPA were associated with lower all-cause mortality, but not with cardiovascular- or cancer-related mortality.

“This study suggests that, for the same volume of MVPA, a higher proportion of VPA to total physical activity was associated with lower all-cause mortality. Clinicians and public health interventions should recommend 150 minutes or more per week of MVPA but also advise on the potential benefits associated with VPA to maximize population health,” the authors concluded.

—Michael Potts


Wang Y, Nie J, Ferrari G, et al. Association of physical activity intensity with mortality—a national cohort study of 403 681 US adults. JAMA Intern Med. 2021;181(2):203-211. doi:10.1001/jamainternmed.2020.6331