Participants sprint up a staircase in the November Project fitness workout at the Presidio in San Francisco on Friday, Aug. 31, 2018.
Paul Chinn/S.F. Chronicle
People who do more short bursts of vigorous activity — like running to catch the bus or running up stairs — are less likely to develop several chronic diseases including heart disease and dementia compared to people who do no vigorous activity, according to a recent study in the European Heart Journal.
The takeaway, the researchers said, is that people may want to prioritize intense activity over total volume of activity because it may prevent many chronic diseases more effectively. Even as little as 15 to 20 minutes a week of vigorous activity, or just two to three minutes a day, appear to have meaningful health benefits.
“The encouraging message is that how hard you move matters, not just how long you move,” said lead author Minxue Shen, a professor in the Xiangya School of Public Health at Central South University in Changsha, Hunan, China.
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“For people who feel they don’t have time for long workouts, even small amounts of vigorous activity — woven into a day that already includes some moderate movement — appear to meaningfully lower risk of major chronic diseases. You don’t have to overhaul your life or join a gym to benefit.”
The findings add to an ongoing debate among exercise researchers and fitness enthusiasts: whether short bouts of intense exercise have more health benefits than longer stretches of less intense exercise, like walking.
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Previous research had established that physical activity in general lowers the risk of many chronic diseases and that vigorous activity appears to have more health benefits per minute than moderate activity, but much of that research focused on cardiovascular benefits only.
Even a little bit helps
The new study, published March 29, found that people who spent the greatest proportion of their total physical activity doing vigorous activity (4% or more) had a 29% to 61% lower risk of eight chronic diseases, over the subsequent seven years.
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The steepest drop in risk occurred between the group that did no vigorous activity and the group one step above that (0% to 2%), which shows that doing even a little is significantly better than doing nothing.
“This hearkens to the, ‘Get up off the couch’ science done years ago — that if you can just get the lowest activity level people up to anything, you get the most public health bang for your buck,” said Dr. Jeffrey Christle, an exercise physiologist at Stanford Health Care who was not involved in the study.
What counts as ‘vigorous’
The researchers defined “vigorous activity” as movement that got people breathless enough to have a hard time holding a full conversation. Vigorous is not exactly the same thing as high-intensity exercise (like HIIT, or high-intensity interval training), but there is some overlap. Vigorous activity is a broader category that includes HIIT as well as less structured activities done during daily life, like walking uphill or carrying groceries up stairs, Shen said.
The study found that vigorous activity seemed to have more of an impact on lowering risk for inflammatory diseases in particular, like arthritis and psoriasis, than other diseases — potentially because vigorous exercise has anti-inflammatory effects.
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The eight chronic diseases studied were cardiovascular disease, irregular heartbeat (atrial fibrillation), Type 2 diabetes, immune-mediated inflammatory diseases (like rheumatoid arthritis, psoriasis and lupus), liver diseases, chronic respiratory diseases, chronic kidney disease and dementia. They were picked because they represent the major categories of non-infectious diseases that account for the leading causes of global health burdens.
The study included about 96,000 adults aged 40 to 69 from the UK Biobank, one of the largest data sources for public health research. Participants wore accelerometers on their wrists to measure their movements.
The researchers divided study participants into four groups based on how much time they spent doing vigorous activity: more than 4% of their total physical activity, 2% to 4%, 0% to 2% and none. All groups did some activity, like walking or moving around the house, even if they did not do any vigorous activity. The more vigorous activity they did as a proportion of overall activity, the lower their risk of the chronic diseases, the analysis found.
No perfect exercise formula
While the research adds new clues about the potential of vigorous exercise to lower disease risk, it leaves open the question of how much vigorous versus lower-intensity exercise people should strive for. For this, there is no magic ratio and depends on what your goals and baseline abilities are, experts said.
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“The question of what’s the best exercise has been around for years if not decades,” said Dr. David Ding, chief of orthopedic surgery at Kaiser Permanente San Francisco and a team physician for the Golden State Warriors and Golden State Valkyries. “In general, we tell patients there’s no one exercise, but everything in combination is probably the best exercise. A combination of aerobic and some strength training with vigorous exercise.”
Strength training, which can be with body weight, weights or resistance bands, is especially important as you age to maintain muscle mass and bone density, said Ding, who was not involved in the study.
“Your goals just have to be to get some exercise, get your heart rate up a little bit everyday,” he said. “That seems to be enough to prevent some of these diseases.”
For people who are already fit and trying to maximize their limited workout time, doing shorter periods of high-intensity exercise should reap slightly stronger benefits because of the anti-inflammatory effects, Christle said. Generally speaking, 10 minutes of high-intensity exercise can provide similar benefits as 25 to 30 minutes of moderate exercise, depending on the intensity, he said.
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“The recommendation for your average person who wants to exercise for their health and maybe a little for fitness and a little for aesthetics, is to exercise at the highest heart rate that’s tolerable for a relatively long period of time,” he said. “That’s the best way you get the most efficiency out of your workout.”