Combinations of aerobic, muscle-strengthening activities reduce risk for mortality

Key takeaways:

• Varying levels of aerobic and muscle-strengthening activity halved the rates of all-cause and cancer mortality.
• These activities also resulted in a threefold lower rate for CVD mortality.

Adults who completed at least some levels of moderate and vigorous aerobic physical activity and the recommended levels of muscle-strengthening activity reduced their risks for all-cause, CVD and cancer mortality, a recent study found.

Researchers also found that higher than recommended levels could further lower CVD and cancer risk.

According to Rubén López-Bueno, PhD, from the department of physical medicine and nursing at the University of Zaragoza in Spain, and colleagues, both the 2018 Physical Activity Guidelines for Americans and the 2020 WHO guidelines on physical activity recommend a weekly total of:

• 150 to 300 minutes of moderate aerobic physical activity (MPA);
• 75 to 150 minutes of vigorous aerobic physical activity (VPA); or
• an equivalent combination of both MPA and VPA plus muscle-strengthening activity (MSA) for at least 2 days.

Despite these guidelines, the optimal combination of these activities needed to lower mortality risk remains unknown, with prior research suggesting “the existence of unique associations among different combinations of MPA, VPA, and MSA with all-cause mortality,” the researchers wrote in JAMA Internal Medicine.

“However, the associations of MPA, VPA, and MSA with CVD or cancer mortality have been much less explored,” they wrote. “To our knowledge, the only existing study on the topic found both independent and joint associations of [moderate to vigorous aerobic physical activity (MVPA)] and MSA with a lower risk for all-cause and CVD mortality but failed to find statistically significant associations with cancer mortality.”

López-Bueno and colleagues conducted a nationwide prospective cohort study to determine potential associations between the three physical activity categories and risk for causes of death among 500,705 adults who participated in the National Health Interview Survey from 1997 to 2018. The participants had a mean age of 46 years and 58% were women. They were followed for a median of 10 years.

Compared with a reference group of participants who did not perform VPA or MPA and had less than the recommended MSA, López-Bueno and colleagues found that the levels of activity that were linked to the lowest risk for all-cause mortality were more than 0 to 75 minutes of MPA plus more than 150 minutes of VPA and two or more MSA sessions per week (HR = 0.5; 95% CI, 0.42-0.59).

The optimal combination to lower the risk for CVD mortality was more than 150 to 225 minutes of MPA, more than 0 to 75 minutes of VPA and at least two MSA sessions per week (HR = 0.3; 95% CI, 0.15-0.57).

For cancer mortality risk, the optimal combination was more than 300 minutes of MPA, more than 0 to 75 minutes of VPA and at least two MSA sessions per week (HR = 0.44; 95% CI, 0.23-0.82),

The researchers noted that the optimal combinations were associated with a 50% lower rate for all-cause and cancer mortality and a threefold lower rate for CVD mortality.

In contrast to prior research, López-Bueno and colleagues pointed out that adults did not need to exceed guideline-recommended levels of MVPA to achieve a mortality benefit.

“This might be due to the fact that CVD mortality derives from multifactorial causes, each of which may reduce the risk through different pathways such as reduced incidence of

major cardiovascular events among older adults when doing regular MVPA and/or MSA,” they wrote.

The researchers concluded that “to lower the risk of all-cause, CVD, and cancer mortality, at least some amount of both MPA and VPA as well as the recommended levels MSA were necessary.”

“Increasing VPA while maintaining any amount of MPA and recommended levels of MSA may result in greater reduction of all-cause mortality risk, while more MPA than currently recommended, combined with any VPA and recommended MSA, may lead to lower risk of cancer mortality,” they wrote.