- This study related physical activity with components of cardiorespiratory fitness as measured by cycle ergometry in 2,070 participants in the Framingham Heart Study, mean age 54
- More steps/day, reduced sedentary time and greater moderate/vigorous physical activity (MVPA) were each associated with improved measures of cardiorespiratory fitness in a cross-sectional analysis; the associations were generally consistent across categories of age, sex, body mass index and cardiovascular disease status
- For each minute of increase in average MVPA, more than three minutes of intermediate-pace walking and more than 14 minutes less sedentary time would be required for equivalent changes in fitness
- 1,720 participants had data available on change in accelerometry measures over time (median, eight years); in the longitudinal analysis, increases in steps/day or MVPA, and reductions in sedentary time were again related to better fitness
- Above-average physical activity eight years prior to exercise testing and at the time of testing had similar influences on fitness, showing both antecedent physical activity and maintenance of physical activity over time preserve fitness throughout life
U.S. government guidelines encourage several types of physical activity, including moderate–vigorous dedicated exercise, lower-level activity (e.g., steps during routine daily activities) and minimized sedentary time, citing growing evidence that each form of activity has long-term health benefits.
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Using data from a large, prospective longitudinal cohort, Matthew Nayor, MD, MPH, Ravi V. Shah, MD, and Gregory D. Lewis, MD, cardiologists in the Heart Failure and Transplantation Program at the Corrigan Minehan Heart Center at Massachusetts General Hospital, and colleagues from the Framingham Heart Study in affiliation with Boston University, found the intensity and duration of each of these types of activity affect cardiovascular fitness across age, sex and cardiovascular risk status. Their report appears in the European Heart Journal.
The researchers identified 2,070 participants in exam cycle 3 of the Framingham Heart Study (2016–2019) who underwent cardiopulmonary exercise testing (CPET) on a cycle ergometer and provided eight days of accelerometry data. Half were female, the mean age was 54, and the mean body mass index (BMI) was 28.
- After adjustment for clinical risk factors, each of three accelerometer-measured activities—greater moderate/vigorous physical activity (MVPA), more steps/day and reduced sedentary activity—were significantly associated with clinically meaningful improvements in CPET measures of cardiorespiratory fitness
- The effect estimate was greatest for MVPA: for each minute of increase in average MVPA, more than three minutes of intermediate-pace walking and more than 14 minutes less sedentary time would be required for equivalent changes in fitness
- The relationship of steps and MVPA with peak oxygen uptake was additive, such that the highest peak oxygen uptake values were observed in individuals with higher values for both MVPA and steps/day
- Intriguingly, individuals with high steps/day or high MVPA demonstrated better than average fitness even with high sedentary time
These key findings were generally consistent across categories of age, sex, BMI and cardiovascular disease status.
Changes Over Time
1,720 participants also provided accelerometry data for eight days in exam cycle 2 (2008–2011). The research team was able to analyze the relationship of CPET measures to change in accelerometry measures over a median interval of eight years. They found:
- Increases in average steps/day or MVPA, and reductions in sedentary time between the two exam cycles, were related to favorable measures of fitness, with the largest effect size observed for MVPA
- Above-average physical activity eight years prior to CPET and at the time of CPET had similar influences on fitness
Regardless of age, sex, BMI or cardiovascular disease status, patients can be counseled that all three of these forms of physical activity help maintain cardiorespiratory fitness throughout life.
The linear relationship of MVPA to peak exercise suggests that while the guideline-recommended thresholds (>150 minutes/week) of MVPA are a reasonable benchmark, higher levels result in more improvement in fitness. Specifically, MVPA should have more than three-fold greater efficiency in achieving higher fitness levels than moderate walking and more than 14-fold greater efficiency than reducing sedentary time.
Learn more about the Heart Failure and Transplantation Program
Refer a patient to the Corrigan Minehan Heart Center