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Exceeding exercise guidelines will improve survival to some extent

Exceeding exercise guidelines will improve survival to some extent

 


New research suggests that beyond current guidance on moderate and active physical activity levels, it can add years to life.

According to the US Department of Health and Human Services, Americans are advised to do at least 150-300 minutes of moderate exercise, 75-150 minutes of strenuous exercise, or an equivalent combination of both. Physical activity guidelines..

Results from more than 100,000 U.S. adults tracked for 30 years show that individuals who perform twice the currently recommended range of moderate or intense physical activity each week have the lowest long-term mortality risk. Shown.

Studies show that adults who reported completing four times the recommended minimum activity level did not see any significant benefit of increased mortality, but no harm. Published in the journal on July 25 circulation.

“I think we’re more worried about the low end and those who don’t even do the bare minimum, but this should be reassuring for those who want a lot of exercise,” said senior author Edward Giovannucci, MD. , ScD said at Harvard TH Chan Public Health School in Boston, Massachusetts: theheart.org | Medscape Cardiology..

Some studies suggest that long-term, high-intensity exercise (eg, marathon, triathlon, and long-distance cycling) may be associated with increased risk. Atrial fibrillation, Coronary artery calcificationWhen Sudden cardiac death..

A Recent analysis The Copenhagen City Cardiac Study also reported a U-shaped association between long-term all-cause mortality and 0-2.5 hours and 10 hours or more of weekly leisure sports activity.

However, most studies suggesting harm use only one measure of physical activity that captures a mixture of people who exercise chronically at high levels and those who do it sporadically, which is probably the case. It can be harmful. “We could better see the consistent long-term activity and found it harmless.”

The survey included 116,221 participants in the Nurses’ Health Study and Health Professionals Follow-up Study from 1988 to 2018, with a median of up to 15 health and leisure physical activity updated biennially. , 11) I answered the questionnaire.

Most were Caucasian (96%) and 63% female, with mean age and obesity index of 66 years and 26 kg / m during follow-up.2.. During the 30-year follow-up period, 47,596 people died.

“Any effort is worth it”

Analysis shows that individuals who meet the guidelines for long-term intense physical activity (75-150 minutes / week) reduce their adjusted risk of death from cardiovascular disease (CVD) by a whopping 31% and risk of death from causes other than CVD. Was reduced by 15%. , And all causes-19% compared to those without long-term active activity.

Patients who completed 2-4 times the recommended minimum (150-299 minutes / week) had a 27% -33% lower risk of CVD mortality, a 19% lower risk of non-CVD mortality, and all The risk has been reduced by 21% to 23%. -Causes death.

Higher levels did not appear to further reduce the risk of death. For example, intense physical activity of 300-374 minutes / week is associated with a 32% lower risk of CVD death, an 18% lower risk of non-CVD death, and a 22% lower risk of death from any cause. I did.

The analysis also showed that individuals who met the guidelines for moderate physical activity were active for 150-244 minutes / week (22%, 19%, and 20%, respectively), CVD, non-CVD, and We found a low risk of death from all causes) or 225-299 minutes / week (21%, 25%, and 20%, respectively), compared to those with little long-term moderate activity.

Patients who meet 2-4 times the recommended minimum (300-599 minutes / week) have a 28% -38% lower risk of CVD mortality and a 25% -27% lower risk of non-CVD mortality. , 26% -31% lower. Mortality from all causes.

Mortality benefits peaked, with moderate physical activity at 600 minutes / week showing a similar association with 300-599 minutes / week.

“Sweet spots seem to be two to four times the recommended level, but for those who tend to sit down, one of the important messages I give to patients is that it’s worth the effort. Physical activity is the recommended level. That’s even less, said Dr. Erin Mikos, Deputy Director of Preventive Cardiology at Johns Hopkins University School of Medicine in Baltimore, Maryland, in an interview.

Indeed, individuals who reported 20-74 minutes of moderate exercise per week had a 19% lower risk of dying from any cause and a 13% lower risk of dying from CVD than those who reported less. became.

Current American Heart Association (AHA) Recommendations Moderate aerobic exercise for at least 150 minutes per week, intense aerobic exercise for 75 minutes per week, or a combination of both.

“This suggests that it’s probably even better, in the range of two to four times that, so we may need to raise our goals a bit. This is already done by the Department of Health and Welfare. It’s a kind of thing. ” Mikos who was not involved in the research.

Former AHA President Dr. Donna Arnett, MSPH, who was not involved in the study, said in a statement: Atherosclerosis And mortality. “

“Also, moderate intensity aerobic exercise for 300 minutes or more per week or intense aerobic exercise for 150 minutes or more may further reduce the risk of atherosclerotic cardiovascular disease. We also know that these extra exercise hours can also reduce mortality, “she added.

Mix and match

Giovannucci said that the joint effects of the two types of exercise on mortality have not been studied in previous studies: “For example, is it enough to do a lot of moderate activity, or more by doing it actively? I have some questions about whether I can benefit from it. Activities too. “

A joint analysis of both exercise intensities shows that additional strenuous physical activity is associated with reduced mortality in participants with inadequate levels of moderate exercise (<300 minutes / week), but at least 300 minutes. / It turns out that it is not related among the participants of the moderate exercise of the week.

“The main message is that you can get essentially all the benefits with just the right amount of exercise,” Giovannucci said. “There is no magical benefit of acting vigorously [exercise].. But if someone wants to do it vigorously, they can profit in about half the time. So if you can only exercise 2-3 hours a week, for example 2-3 hours of running, you’ll get almost the greatest benefit. “

Sensitivity analysis also showed a consistent association between long-term leisure physical activity and mortality without adjusting for BMI / caloric intake.

“Some people think that the effect of exercise is to lose or control weight. This may be one of the benefits, but regardless, it can be beneficial even if it doesn’t affect your weight. “He said. “So definitely it’s important.”

Michos says that intense physical activity may seem daunting to many, but moderate exercise can include activities such as active walking, ballroom dancing, active yoga, and recreational swimming. I pointed out that there is.

“Many patients may not want to be active, so it’s great to be able to actually combine or replace both to get a similar reduction in mortality with moderate physical activity. “She said. “They don’t want to ride on a treadmill. It’s too intimidating or stressful.”

This study was supported by the National Institutes of Health. The author and Michos report that there is no relevant financial relationship.

circulation. Published July 25, 2022. Overview

Follow Patrice Wendling on Twitter. @pwendl For more information theheart.org | Medscape Cardiology, follow us twitter When Facebook ..

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