Untapping the Health Enhancing Potential of Vigorous Intermittent Lifestyle Physical Activity (VILPA): Rationale, Scoping Review, and a 4-Pillar Research Framework

Abstract

Recently revised public health guidelines acknowledge the health benefits of regular intermittent bouts of vigorous intensity incidental physical activity done as part of daily living, such as carrying shopping bags, walking uphill, and stair climbing. Despite this recognition and the advantages such lifestyle physical activity has over continuous vigorous intensity structured exercise, a scoping review we conducted revealed that current research in this area is, at best, rudimentary. Key gaps include the absence of an empirically-derived dose specification (e.g., minimum duration of lifestyle physical activity required to achieve absolute or relative vigorous intensity), lack of acceptable measurement standards, limited understanding of acute and chronic (adaptive) effects of intermittent vigorous bouts on health, and paucity of essential information necessary to develop feasible and scalable interventions (e.g., acceptability of this kind of physical activity by the public). To encourage collaboration and research agenda alignment among groups interested in this field, we propose a research framework to further understanding of vigorous intermittent lifestyle physical activity (VILPA). This framework comprises four pillars aimed at the development of: (a) an empirical definition of VILPA, (b) methods to reliably and accurately measure VILPA, (c) approaches to examine the short and long-term dose-response effects of VILPA, and (d) scalable and acceptable behavioural VILPA-promoting interventions.

Fig. 1

An example of a day characterized by a 10 min/bout pattern of vigorous intermittent lifestyle physical activity (VILPA). MET values reflect relative intensity as described in Martenstyn et al. 2019 [55]. Figure reproduced under CC BY-NC 4.0 license from Stamatakis E et al. Br J Sports Med 2019;53:1137–1139 [56]

Fig. 2

Hypothetical comparison of the different physical activity components in terms of time efficiency and theoretical feasibility. The illustration is based on the authors’ rough appraisal of the evidence base to date and is not meant to represent a general consensus on the feasibility or research gaps surrounding each physical activity class. Yellow: inherent part of daily living; grey: requires planning; black: requires planning, high levels of motivation, and sometimes direct supervision/skills/costs. The size of the bubbles illustrates gaps in knowledge (larger: we know less)