Higher proportions of vigorous physical activity (%VPA) were associated with lower incidence of multiple chronic diseases and all-cause mortality in a large prospective cohort analysis. This prospective population-based cohort study, published in the European Heart Journal, assessed the association between the proportion of vigorous physical activity (%VPA) and the incidence of multiple chronic conditions and all-cause mortality.
Data were derived from the UK Biobank, including 96,408 participants with device-measured PA using wrist-worn accelerometers and 375,730 participants with self-reported PA via the International Physical Activity Questionnaire (IPAQ). Mean ages were 61.9 and 56.2 years, respectively, with women comprising 56.3% and 52.2% of cohorts.
Outcomes included major adverse cardiovascular events (MACE), atrial fibrillation (AFib), type 2 diabetes (T2D), immune-mediated inflammatory diseases, metabolic dysfunction-associated steatotic liver disease (MASLD), chronic respiratory diseases (CRD), chronic kidney disease (CKD), dementia, and all-cause mortality. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).
Non-linear inverse dose-response relationships were observed between %VPA and all outcomes (P<.001), consistent across PA volume strata. After adjustment for total PA volume, individuals with >4% VPA demonstrated 29%-61% lower incidence of outcomes compared with 0% VPA. Population attributable fraction analyses showed stronger contributions from intensity than volume for several outcomes, including immune-mediated inflammatory diseases (20.3% vs 1.0%), MACE (17.8% vs 6.0%), AFib (16.2% vs 5.0%), CRD (21.4% vs 5.6%), and dementia (32.3% vs 8.1%), while T2D, MASLD, CKD, and all-cause mortality showed more balanced contributions.
Higher %VPA was consistently associated with lower disease incidence independent of total PA volume. These findings indicate that higher %VPA is inversely associated with multiple chronic disease outcomes and all-cause mortality.
