Best exercise and combo to lower death risk?
Best exercise and combo to lower death risk?
Image Source: Hernandez & Sorokina/Stocksy
According to a study recently published in JAMA Internal Medicine, incorporating a balanced mix of exercise types can significantly reduce the risk of mortality in various forms. The study also suggests that exceeding the current physical activity guidelines can lead to even greater reductions in mortality risk. Clinicians should consider easing their physically inactive patients into a healthy combination of exercises.
This study aimed to determine the ideal combination of exercise types for longevity. It analyzed different combinations of moderate aerobic physical activity (MPA), vigorous aerobic physical activity (VPA), and muscle-strengthening activity (MSA). The findings revealed that a balanced amount of MPA, VPA, and MSA was most closely associated with a lower risk of dying, although the specific mix of activities depended on the type of mortality.
To minimize the risk of all-cause mortality, a combination of more than 0-75 minutes of MPA each week, over 150 minutes of VPA, and two or more MSA sessions per week was found to be optimal. For cardiovascular disease (CVD) and cancer mortality, the optimal combination was more than 150-225 minutes of MPA, more than 0-75 minutes of VPA, and two or more MSA sessions.
These recommendations align with the 2020 World Health Organization exercise guidelines, which suggest 150 to 300 minutes of MPA, 75 to 150 minutes of VPA, or a similar combination of both, along with two MSA sessions each week. However, the study also found that exceeding these guidelines further reduced the risk of mortality.
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Participants who engaged in more than 300 minutes of MPA, greater than 0 to 75 minutes of VPA, and two or more MSA sessions per week experienced approximately 50% lower all-cause and cancer mortality rates. Additionally, their CVD mortality rate was roughly three times lower than those who did not exceed the guidelines.
The study analyzed data from the U.S. National Health Interview Survey conducted between 1997 and 2018. With a sample size of 500,705 adults, the participants were followed for a median of 10 years, resulting in 5.6 million person-years of data. The participants self-reported their exercise habits.
The research team identified some intriguing differences between the effects of different exercise types on mortality risk. While twice the amount of VPA was associated with a reduction in all-cause mortality risk, twice the amount of MPA reduced the risk of cardiovascular and cancer mortality. Professor Emmanuel Stamatakis, co-author of the study, explained that sustained MPA can contribute to weight maintenance or loss, while MSA helps maintain muscle mass as we age.
Maintaining muscle mass is crucial for preventing various chronic conditions such as type 2 diabetes, cardiovascular disease, and age-related mobility issues. Professor Stamatakis emphasized that these conditions are often wrongly considered as “age-related” diseases. In reality, the chronic inactivity and lack of muscle mass among the population contribute significantly to their development.
While MPA helps with weight management and MSA supports muscle mass maintenance, VPA offers unique benefits such as improving cardiorespiratory fitness. The study’s corresponding author, Dr. Rubén López-Bueno, noted that prior research has observed an inverse association between MSA and cancer incidence, although the mechanisms involved require further investigation.
Professor Stamatakis suggested a possible mechanism behind MSA’s effect on reducing cancer risk, stating that strength training can lower circulating levels of sex hormones associated with breast, endometrial, and prostate cancer. However, Dr. Melody Ding, an associate professor at the Sydney School of Public Health, cautioned against concluding that MSA definitively reduces cancer risk, as the overall patterns involving MSA and those without MSA show similar trends.
Given the complex interaction of MPA, VPA, and MSA, it is unclear whether there is a synergistic effect among these exercise types. Dr. López-Bueno stressed the importance of each type of physical activity in optimizing mortality risk reduction. However, he acknowledged that raising the activity bar may further discourage people, considering the struggle to meet current recommended levels. Dr. Ding echoed this concern, emphasizing that focusing on a range of activities within one’s capacity is essential.
In conclusion, a balanced combination of different exercise types is key to maximizing the benefits and reducing the risk of mortality. No single exercise type or even the addition of two types alone surpasses the combined effect of all three. Physicians should provide holistic and tailored physical activity advice, taking into account baseline activity levels and individual abilities. For physically inactive individuals, starting with moderate-intensity walking and gradually incorporating bursts of VPA and muscle-strengthening exercises is a wise approach.
