Wearable device study in 88,000 people shows the heart health benefits of more intense physical activity

Increasing physical activity of any intensity is beneficial for health, but new research published today in the European Heart Journal shows that there is a greater reduction in cardiovascular disease risk when more of that activity is of at least moderate intensity.  The study, led by researchers at the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre and University of Cambridge, analysed wrist-worn accelerometer-measured physical activity data from more than 88,000 UK Biobank participants.

Current physical activity guidelines from the UK Chief Medical Officers recommend that adults should aim to be active every day, and also that adults should undertake 150 minutes of moderate intensity activity (such as a brisk walk) or 75 minutes of vigorous intensity activity (such as running) every week. Physical activity volume is defined as the intensity of the activity multiplied by time, but until recently it has not been clear if overall physical activity volume is what is most important for health, or if more vigorous activity confers additional benefits.

Dr Paddy Dempsey, Research Fellow at the University of Leicester and Medical Research Council (MRC) Epidemiology Unit at the University of Cambridge, and first author on the paper, said:

“Most large-scale studies to date have used questionnaires to determine participants’ physical activity levels, but physical activity intensity and duration is hard to recall accurately, especially when it comes to low intensity every day activities like washing the car, or sorting laundry. Without accurate records of physical activity duration and intensity it hasn’t been possible to sort out the contribution of more vigorous physical activity from that of overall physical activity volume.

Wearable devices helped us to accurately detect and record the intensity and duration of movement for 90,000 individual UK Biobank participants, and we recently published an analysis of wearable device data demonstrating that moderate and vigorous intensity activity gives a greater reduction in the overall risk of early death. More vigorous physical activity may also reduce the risk of cardiovascular disease, over and above the benefit seen from the total amount of physical activity, as it stimulates the body to adapt to the higher effort required.  This is what we set out to investigate in the research published today.”

The authors investigated the association between physical activity volume and intensity and cardiovascular disease incidence in 88,412 middle-aged adults free from cardiovascular disease in Great Britain.  These individuals wore a research-grade activity tracker on their dominant wrist for a week while taking part in the UK Biobank study. The movement data they collected was used to calculate the total volume of activity, and the authors also worked out the percentage of that volume that was achieved through moderate and vigorous intensity activity. The number of cardiovascular events, including ischaemic heart disease or cerebrovascular disease, was then recorded among study participants over an average of follow-up period of 6.8 years.

The authors found that total physical activity volume was strongly associated with a decrease in cardiovascular disease risk, and they also demonstrated that getting more of the total physical activity volume from moderate-to-vigorous physical activity was associated with a further reduction in cardiovascular risk. Cardiovascular disease rates were 14% (95%CI: 5-23%) lower when moderate-to-vigorous physical activity accounted for 20% rather than 10% of overall physical activity energy expenditure, even in those that otherwise had low levels of activity. This is equivalent to converting a daily 14-min stroll into a brisk 7-min walk.

Overall, the lowest cardiovascular disease rates were observed among those UK Biobank participants who undertook higher overall levels of physical activity and a higher proportion of moderate-to-vigorous physical activity.  However, interestingly, when overall volume of physical activity increased but the proportion from moderate-to-vigorous activity remained the same, the authors observed little effect on cardiovascular disease rate. For example, when overall physical activity levels were doubled there was no significant effect on cardiovascular disease rates when the proportion from moderate-to-vigorous activity remained at 10%, but the cardiovascular disease rate fell by 23% and 40% when the proportion from moderate-to-vigorous physical activity rose by 20% and 40% respectively.

Professor Tom Yates, professor of physical activity, sedentary behaviour and health at the University of Leicester, and a senior author on the paper, said:

“Our analysis of data from UK Biobank confirms that increasing the total amount of physical activity can lower the risk of suffering a heart attack or stroke, but we also found that achieving the same overall amount of physical activity through higher intensity activity has a substantial additional benefit.

Our findings support simple behaviour-change messages that “every move counts” to encourage people to increase their overall physical activity, and if possible to do so by incorporating more moderately intense activities. This could be as simple as converting a leisurely stroll into a brisk walk, but a variety of approaches should encourage and help individuals to find whatever is most practical or enjoyable for them.”

This study was supported by the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, the MRC Epidemiology Unit, UK Biobank, and NIHR Applied Research Collaborations East Midlands. The NIHR Leicester Biomedical Research Centre is a partnership between the University Hospitals of Leicester NHS Trust, the University of Leicester and Loughborough University.

ENDS

Reference

Dempsey P.C., Rowlands A.V., Strain T., Zaccardi F., Dawkins N., Razieh C., Davies M.J., Khunti K.K., Edwardson C.L., Wijndaele K., Brage S., Yates T. Physical Activity Volume, Intensity and Incident Cardiovascular Disease. European Heart Journal: 28 October 2022. DOI:10.1093/eurheartj/ehac613

Copies of the manuscript can be obtained under embargo from Paul Browne, Communications Manager at the MRC Epidemiology Unit at Paul.Browne@mrc-epid.cam.ac.uk

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Notes to Editors

Contact details

Rachael Dowling, Communications Lead, NIHR Leicester Biomedical Research Centre
Mob: +44 (0)7950 891193
Email: rachael.dowling@uhl-tr.nhs.uk

The NIHR Leicester Biomedical Research Centre

The National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC) is a partnership between University Hospitals of Leicester NHS Trust, the University of Leicester and Loughborough University. It is funded by the National Institute for Health and Care Research (NIHR).

The NIHR Leicester BRC undertakes translational clinical research in priority areas of high disease burden and clinical need. These include cardiovascular disease, respiratory disease, and lifestyle, obesity and physical activity. There is also a cross-cutting theme for precision medicine. The BRC harnesses the power of experimental science to explore and develop ways to help prevent and treat chronic disease. It brings together 70 highly skilled researchers, 30 of which are at the forefront of clinical services delivery. By having scientists working closely with clinicians, the BRC can deliver research that is relevant to patients and the professionals who treat them. www.leicesterbrc.nihr.ac.uk

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NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

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The MRC Epidemiology Unit is a department at the University of Cambridge. It is working to improve the health of people in the UK and around the world.  Obesity, type 2 diabetes and related metabolic disorders present a major and growing global public health challenge. These disorders result from a complex interplay between genetic, developmental, behavioural and environmental factors that operate throughout life. The mission of the Unit is to investigate the individual and combined effects of these factors and to develop and evaluate strategies to prevent these diseases and their consequenceswww.mrc-epid.cam.ac.uk

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Cambridge research spans almost every discipline, from science, technology, engineering and medicine through to the arts, humanities and social sciences, with multi-disciplinary teams working to address major global challenges. Its researchers provide academic leadership, develop strategic partnerships and collaborate with colleagues worldwide.

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The Medical Research Council is at the forefront of scientific discovery to improve human health. Founded in 1913 to tackle tuberculosis, the MRC now invests taxpayers’ money in some of the best medical research in the world across every area of health. Thirty-three MRC-funded researchers have won Nobel prizes in a wide range of disciplines, and MRC scientists have been behind such diverse discoveries as vitamins, the structure of DNA and the link between smoking and cancer, as well as achievements such as pioneering the use of randomised controlled trials, the invention of MRI scanning, and the development of a group of antibodies used in the making of some of the most successful drugs ever developed. Today, MRC-funded scientists tackle some of the greatest health problems facing humanity in the 21st century, from the rising tide of chronic diseases associated with ageing to the threats posed by rapidly mutating micro-organisms. The Medical Research Council is part of UK Research and Innovation. https://mrc.ukri.org/