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Review
. 2020 Oct 5;6(1):e000775.
doi: 10.1136/bmjsem-2020-000775. eCollection 2020.

Do vigorous-intensity and moderate-intensity physical activities reduce mortality to the same extent? A systematic review and meta-analysis

Juan Pablo Rey Lopez  1   2 , Angelo Sabag  3 , Maria Martinez Juan  4 , Leandro F M Rezende  5 , Maria Pastor-Valero  4   6
Affiliations
Review

Do vigorous-intensity and moderate-intensity physical activities reduce mortality to the same extent? A systematic review and meta-analysis

Juan Pablo Rey Lopez et al. BMJ Open Sport Exerc Med. .

Abstract

Objective: To examine whether vigorous-intensity physical activity confers additional reductions on all-cause and cause-specific mortality compared with moderate-intensity physical activity.

Design: A systematic review (registered in PROSPERO CRD42019138995) and meta-analysis.

Data sources: Three electronic databases up to April 14 2020.

Eligibility criteria: Inclusion criteria were prospective studies that contained information about (1) moderate-intensity (3-5.9 metabolic equivalent tasks (METs)) and vigorous-intensity (≥6 METs) physical activities and (2) all-cause and/or cause-specific mortality. Exclusion criteria were prospective studies that (1) exclusively recruited diseased patients (eg, hypertensive patients and diabetics) or (2) did not account for total physical activity in their multivariable models (3) or did not adjust or exclude individuals with comorbidities at baseline or (4) used physically inactive participants as reference group.

Results: Five studies (seven cohorts using sex-specific results) were pooled into a meta-analysis. For all-cause mortality and controlling by total physical activity, vigorous-intensity physical activity (vs moderate) was not associated with a larger reduction in mortality (HR 0.95, 95% CI 0.83 to 1.09). After the exclusion of one study judged with critical risk of bias (Risk Of Bias in Non randomized Studies, ROBINS tool) from meta-analysis, results remained similar (HR 0.98, 95% CI 0.85 to 1.12). Due to the limited number of studies, meta-analyses for cancer and cardiovascular mortality were not performed.

Conclusions: Prospective studies suggest that, for the same total physical activity, both vigorous-intensity and moderate-intensity physical activities reduce all-cause mortality to the same extent. However, absence of evidence must not be interpreted as evidence of absence due to the existing methodological flaws in the literature.

Keywords: Epidemiology; physical activity; prevention.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-analysis flow diagram for search strategy. Prospective studies.
Figure 2
Figure 2
Risk of bias judgement using ROBINS-I.
Figure 3
Figure 3
Forest plot summary of association between vigorous-intensity and moderate-intensity physical activities and all-cause mortality.
Figure 4
Figure 4
Contour-enhanced funnel plot in all cohort studies.
Figure 5
Figure 5
Funnel plot with pseudo 95% CI for identifying publication bias in all cohort studies.
See this image and copyright information in PMC

References

    1. Pontzer H, Wood BM, Raichlen DA. Hunter-gatherers as models in public health. Obes Rev 2018;19:24–35. 10.1111/obr.12785 - DOI - PubMed
    1. World Health Organization . Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, 2009. Available https://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_r... (accessed 20 Nov 2018)
    1. Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012;380:219–29. 10.1016/S0140-6736(12)61031-9 - DOI - PMC - PubMed
    1. Department of Health and Human Services . Physical activity guidelines advisory committee scientific report. Washington, DC, USA: Physical Activity Guidelines Advisory Committee, 2018. Available https://health.gov/paguidelines/second-edition/report/? (accessed 4 Feb 2019)
    1. Department of Health and Social Care . UK chief medical officers’ physical activity guidelines. 2019. Available https://assets.publishing.service.gov.uk/government/uploads/system/uploa... (accessed 3 Oct 2019)

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