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Moderate, vigorous exercise can reduce mortality risk

It’s no secret that physical inactivity (PI) is an inherent risk factor to mortality — the state of being subject to death — while physical activity (PA) provides a protective effect to cardiovascular disease, hypertension (high blood pressure), and type 2 diabetes. PI is the fourth leading risk factor to global mortality — 6% of deaths — followed by hypertension, smoking, and high blood sugar.

The 2018 Physical Activity Guidelines for American says, “adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity.

To quantify the volume and intensity of exercise relative to mortality risk, Korean researchers — writing in the December issue of Medicine & Science in Sports & Exercise – evaluated the records of 23,257,723 Koreans age twenty and older, who had undergone one biennial medical evaluation by the National Health Insurance Corporation.

The participants were stratified according to either 20 minutes of vigorous or 30 minutes of moderate PA – with walking stratified into four groups: inactive; 1 to 3 days per week; 4 to 5 days per week; and 6–7.

Participants were screened through structured questionnaires — lifestyle habits — exercise frequency, type, and intensity, medication usage, medical history, smoking history, alcohol usage, body mass (BMI), along with laboratory measurements — blood pressure, and fasting venous blood samples. Mortality status was certified from the Korean National Statistics Office between January 1, 2009 and December 31, 2015.

The researchers determined that those individuals, who performed 4 to 5 days of PA had the lowest mortality risk. Surprisingly, “daily PA did not show any additional benefit to mortality risk.” It was also determined that, “inactive individuals, or those performing PA daily showed an increased mortality risk compared with those engaging in each type of PA (moderate or vigorous) five times per week, after adjusting for potential confounding factors.”

Some expert recommendations on volume and intensity of exercise promote higher amounts of PA — 300 minutes of weekly moderate-intensity PA, or 150 minutes of weekly vigorous-intensity PA, or an equal blend of moderate and vigorous intensity exercise. As to the benefits of higher amounts — over 300 minutes — of weekly exercise, research is speculative at this point.

The Korean researchers point out the limitations of this study. “We did not consider the changes in exercise habits during the observation period and errors in recall, and a miscalculation bias could affect the associations found.”

The researchers note that they did not investigate any correlation of accelerometers (movement tracking) or heart rate monitoring (intensity of exercise relative to cardiovascular improvement), as an objective activity and intensity measurement.

Also, it was noted that, “participants with several chronic diseases and the uneven distribution of age may be a possible source of reverse causation bias, as healthy individuals tend to sustain healthier lifestyles, and individuals, who have disease, or are at the initial stage of disease, may not be able to be physically active.” And, it appears that the participants who performed regular exercise 6 to 7 days per week were older than those performing exercise 1 to 5 days per week.

“An appropriate amount of regular exercise,” concluded the researchers, “in each specific type of PA was associated with the lowest risk of mortality. The inactive participants showed an increased mortality risk, and daily PA did not show any additional benefit in the mortality risk.”

In my book, The Fat Burning Bible (John Wiley & Sons), I recommend that for an individual to lose weight effectively, it requires caloric restriction and 300 minutes of weekly exercise, which equates to 10,000 steps per day, broken into multiple movement sessions to increase resting metabolic rate for a 24-hour period.

With the new year upon us, it’s a great time to take back ownership of your health.

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