A Systematic Review Comparing Dose Response of Exercise on Cardiovascular and All-Cause Mortality

Abstract

It is well established that exercise improves cardiovascular and all-cause mortality, although an ideal dose of exercise is not known. The physical activity guidelines currently recommend 150 minutes per week of moderate-intensity exercise or 75 minutes of vigorous-intensity activity. Most individuals do not engage in adequate exercise, although a safe upper limit does not exist and a too much exercise hypothesis has recently emerged. This review of the literature analyzes studies that have evaluated exercise dose response on all-cause and cardiovascular mortality for the purpose of determining safe and effective exercise prescriptions. Searches were performed in PubMed and CINAHL between 2010 and 2018 to identify six studies that met inclusion criteria. Moderate-intensity exercise reduced all-cause mortality in five of six studies, whereas low-dose exercise most effectively improved all-cause mortality in three studies, and cardiovascular mortality in one study. Vigorous-intensity exercise or extreme doses demonstrated variable outcomes and remain controversial; two studies found vigorous-intensity exercise beneficial to improve health, two studies discouraged vigorous exercise, and two studies had less conclusive outcomes. It is not surprising that any amount of exercise improves health compared with none at all, with the greatest benefits observed when sedentary individuals began exercising. Low-dose exercise should be recommended to everyone with a goal of meeting the minimal requirements according to guidelines for decreased all-cause and cardiovascular mortality. Additional research to more thoroughly understand exercise dose response and motivate individuals to improve exercise engagement is currently warranted.

Effectiveness of an 8-Week Physical Activity Intervention Involving Wearable Activity Trackers and an eHealth App: Mixed Methods Study (Preprint)

“…Specifically, during the 8-week intervention, participants, on average, increased their walking time by approximately 73 minutes/week and reduced their sitting time by approximately 67 minutes/day. An increase in walking of this magnitude has the potential to protect against all-cause and cardiovascular-related mortality and chronic disease [48][49][50]. Given that a 60-minute increase in sitting time has been found to be associated with an increased risk of cardiovascular disease (4%), cancer (1%), and all-cause mortality (1%) [51], this reduction in sitting time also has clinical relevance.…”

Physical Activity Tracker Application in Promoting Physical Activity Behavior among Older Adults: A 24-month Follow-Up Study

“…Table 2 and Figure 2). Especially the increases in the 25 th percentile should be noted, as the greatest relative health benefits are observed in physically inactive individuals who become more physically active (Moxley & Habtzghi, 2019; Warburton & Bredin, 2016). Moreover, an increase of this magnitude in walking (e.g., Kelly et al, 2014) and total PA (e.g., Warburton & Bredin, 2016) has the potential to protect against cardiovascular and all-cause mortality as well as against chronic diseases (e.g., Arem et al, 2015; Kelly et al, 2014; Warburton & Bredin, 2016).…”

Health behavior, life-years loss and the educational gradient

“…A narrative review of approximate median estimates that t the categories in the Tromsø Study are provided in Table 3. Smoking was found to be associated with the largest loss of life expectancy (24-31), followed by low physical activity and obesity (32)(33)(34)(35). Depending on study and sample characteristics, high alcohol consumption, moderate physical activity, under-and overweight were found to be associated between one and two years of life lost (34-36) .…”