Does Vigorous Activity Provide Extra Benefits Over Moderate?
Does Vigorous Activity Provide Extra Benefits Over Moderate?
Background: Although guidelines suggest that vigorous physical activity (PA) confers "extra" benefits compared with those from moderate-intensity activity alone, the magnitude of this additional benefit is unclear. The aim was to compare the reduction in risk of hypertension (HT) and depressive symptoms (DS) for 12 yr in middle-age women who reported (a) only moderate-intensity PA (MOPA) and (b) a combination of moderate and vigorous PA (MVPA), after controlling for overall volume of activity.
Methods: The study involved 11,285 participants in the Australian Longitudinal Study on Women's Health, who completed surveys in 1998 (age = 46–52 yr), 2001, 2004, 2007, and 2010. Generalized estimating equation models (with 3-yr time lag) were used to examine the relationship between PA in seven categories from 0 to >2000 MET·min·wk and occurrence of HT and DS for women who reported MOPA or MVPA.
Results: For HT, risk was slightly lower for MVPA than for MOPA across the entire range of PA levels, but this difference was only significant at the highest PA level (>2000; odds ratio [OR] = 0.80 MOPA and 0.56 MVPA). For DS, OR values were similar in both groups up to 500 MET·min·wk, then slightly lower for MVPA than for MOPA at higher PA levels. Again, this difference was only significant at the highest PA level (>2000; OR = 0.57 MOPA and 0.42 MVPA). OR values were slightly attenuated in adjusted models.
Conclusions: Doing both vigorous and moderate activity does not have significant additional benefits in terms of HT and DS, above those from moderate-intensity activity alone, except at very high levels of PA.
The benefits of regular physical activity (PA) for health and mortality are irrefutable. PA has an inverse relationship with many health outcomes, including coronary heart disease, diabetes, cancers, and depression, and further with all-cause mortality. These relationships are based on epidemiological data, where PA is generally a self-reported measure of moderate and vigorous PA (MVPA). Given this evidence, many current PA guidelines recommend 30 min of at least moderate-intensity PA (MOPA) on most days of the week (150 min·wk) for general population health benefits. More recent guidelines from the USA and the UK recognize that because vigorous PA expends approximately twice the energy of MOPA, equivalent health benefits can also be attained from 75 min of vigorous activity. However, in several countries, including Australia and New Zealand, there is an additional recommendation to "If you can, also enjoy some regular, vigorous activity for extra health and fitness".
There is some evidence to suggest that vigorous PA may provide additional physical and mental health benefits over those that result from moderate-intensity activity. However, it is unclear whether these additional benefits simply reflect the greater amount of activity that is usually accrued by those who do vigorous activity, as few studies have controlled for overall volume of activity.
Although women typically report less leisure time PA than men, in Australia, we have recently seen an increase in activity levels in middle-age women (45–55 yr), commensurate with more "free" time as children leave home and hours in paid work tend to decrease. Most of this increase in PA is attributable to walking, which is known to have demonstrable health benefits. Few women, however, seem to be taking up the recommendation of doing vigorous activity for extra health benefits; this could be important because metabolic changes around the time of menopause initiate an increase in the incidence of chronic disease.
The aim of this study was to assess whether vigorous PA has additional health benefits above those that accrue from MOPA (including walking) in middle-age women. We chose to use hypertension (HT) and depression as outcomes because these conditions are the most common physical and mental health outcomes, respectively, for primary care management in Australia. The approach was to compare the reduction in risk of developing HT and depressive symptoms (DS) for 12 yr in middle-age women who reported (a) only MOPA and (b) a combination of MVPA, after controlling for overall volume of activity.
Abstract and Introduction
Abstract
Background: Although guidelines suggest that vigorous physical activity (PA) confers "extra" benefits compared with those from moderate-intensity activity alone, the magnitude of this additional benefit is unclear. The aim was to compare the reduction in risk of hypertension (HT) and depressive symptoms (DS) for 12 yr in middle-age women who reported (a) only moderate-intensity PA (MOPA) and (b) a combination of moderate and vigorous PA (MVPA), after controlling for overall volume of activity.
Methods: The study involved 11,285 participants in the Australian Longitudinal Study on Women's Health, who completed surveys in 1998 (age = 46–52 yr), 2001, 2004, 2007, and 2010. Generalized estimating equation models (with 3-yr time lag) were used to examine the relationship between PA in seven categories from 0 to >2000 MET·min·wk and occurrence of HT and DS for women who reported MOPA or MVPA.
Results: For HT, risk was slightly lower for MVPA than for MOPA across the entire range of PA levels, but this difference was only significant at the highest PA level (>2000; odds ratio [OR] = 0.80 MOPA and 0.56 MVPA). For DS, OR values were similar in both groups up to 500 MET·min·wk, then slightly lower for MVPA than for MOPA at higher PA levels. Again, this difference was only significant at the highest PA level (>2000; OR = 0.57 MOPA and 0.42 MVPA). OR values were slightly attenuated in adjusted models.
Conclusions: Doing both vigorous and moderate activity does not have significant additional benefits in terms of HT and DS, above those from moderate-intensity activity alone, except at very high levels of PA.
Introduction
The benefits of regular physical activity (PA) for health and mortality are irrefutable. PA has an inverse relationship with many health outcomes, including coronary heart disease, diabetes, cancers, and depression, and further with all-cause mortality. These relationships are based on epidemiological data, where PA is generally a self-reported measure of moderate and vigorous PA (MVPA). Given this evidence, many current PA guidelines recommend 30 min of at least moderate-intensity PA (MOPA) on most days of the week (150 min·wk) for general population health benefits. More recent guidelines from the USA and the UK recognize that because vigorous PA expends approximately twice the energy of MOPA, equivalent health benefits can also be attained from 75 min of vigorous activity. However, in several countries, including Australia and New Zealand, there is an additional recommendation to "If you can, also enjoy some regular, vigorous activity for extra health and fitness".
There is some evidence to suggest that vigorous PA may provide additional physical and mental health benefits over those that result from moderate-intensity activity. However, it is unclear whether these additional benefits simply reflect the greater amount of activity that is usually accrued by those who do vigorous activity, as few studies have controlled for overall volume of activity.
Although women typically report less leisure time PA than men, in Australia, we have recently seen an increase in activity levels in middle-age women (45–55 yr), commensurate with more "free" time as children leave home and hours in paid work tend to decrease. Most of this increase in PA is attributable to walking, which is known to have demonstrable health benefits. Few women, however, seem to be taking up the recommendation of doing vigorous activity for extra health benefits; this could be important because metabolic changes around the time of menopause initiate an increase in the incidence of chronic disease.
The aim of this study was to assess whether vigorous PA has additional health benefits above those that accrue from MOPA (including walking) in middle-age women. We chose to use hypertension (HT) and depression as outcomes because these conditions are the most common physical and mental health outcomes, respectively, for primary care management in Australia. The approach was to compare the reduction in risk of developing HT and depressive symptoms (DS) for 12 yr in middle-age women who reported (a) only MOPA and (b) a combination of MVPA, after controlling for overall volume of activity.
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