Massive study uncovers how much exercise is needed to live longer

Sara Berg, MS , Senior News Writer

Consistent exercise is good for a person’s health and well-being—that is well known. But how many minutes of moderate or vigorous physical activity are needed to lower the risk of premature mortality? A study published in the journal Circulation defines that number and shares guidance on what level of physical activity is needed to maintain health and improve fitness.

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While the 2018 physical activity guidelines recommend that adults engage in at least 150 to 300 minutes per week of moderate exercise, 75 to 150 minutes each week of vigorous movement or an equivalent combination of both intensities, it turns out that if adults do more than the recommended amount, it can help them live longer. Moderate physical activity is defined as walking, weightlifting and lower-intensity exercise. Meanwhile, vigorous exercise is categorized as running, bicycling and swimming. 

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From two large prospective U.S. cohorts, 116,221 adults self-reported leisure-time physical activity—defined as exercise that is not done at work—through a validated questionnaire. The questionnaire was repeated up to 15 times over the course of 30 years.

The study found that those who worked out two to four times beyond the minimum physical activity recommendations had a lower risk of death from cardiovascular disease. Those who worked out two to four times above the moderate physical activity recommendations—about 300 to 599 minutes each week—saw the most benefit. Participants had a 26% to 31% lower all-cause mortality while 28% to 38% had lower cardiovascular mortality. On top of that, 25% to 27% experienced lower non-cardiovascular mortality.

Additionally, adults who worked out two to four times more than the vigorous physical activity recommendations—about 150 to 299 minutes per week—were found to have 21% to 23% lower all-cause mortality, according to the study. They were also reported to have 27% to 33% lower cardiovascular mortality and 19% lower non-cardiovascular mortality.

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“A substantially lower risk of mortality was observed among individuals who had adequate levels of both long-term leisure time moderate and vigorous physical activity”, the study says, noting that higher levels of vigorous physical activity were associated with lower mortality among those with insufficient levels of moderate physical activity each week.

But this was not the case for those who already had high levels of moderate physical activity—more than 300 minutes each week.

With that, the study notes that “any combination of medium to high levels” of vigorous (75 to 300 minutes per week) and moderate physical activity (150 to 600 minutes per week) “can provide nearly the maximum mortality reduction,” which is about 35% to 42%.

Additionally, people who are insufficiently active—meaning less than 75 minutes per week of vigorous or less than 150 minutes of moderate physical activity—could get greater benefits in mortality reduction by adding in modest levels of either exercise. This means 75 to 150 minutes per week of vigorous exercise or 150 to 300 minutes each week of moderate physical activity. Doing so can reduce mortality by 22% to 31%.

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There was an inverse association between long-term vigorous and moderate physical activity and mortality regardless of age. While younger people tend to choose vigorous activities more often, older adults choose moderate levels of exercise. Yet there was no evidence to show that one was better than the other in older people compared with younger folks.

Instead, in addition to long-term moderate physical activity, “long-term vigorous physical activity in generally healthy older adults can be an effective means of improving health,” says the study.

“It is well documented that light to moderate regular physical activity prevents” cardiovascular disease, says the study. “But previous studies also showed evidence that long-term high-intensity endurance exercise (e.g., marathons, triathlons, long-distance bicycle races) may cause adverse events such as myocardial fibrosis, coronary artery calcification and atrial fibrillation as well as sudden cardiac death.”

Yet this study suggests there is no harmful effect of high, long-term vigorous physical activity on cardiovascular health. More studies are needed to better understand the effects of high amounts of vigorous physical activity on cardiovascular outcomes and to identify the optimal amount and intensity of long-term exercise for health benefits.