Dose-response association of moderate-to-vigorous physical activity with cardiovascular biomarkers and all-cause mortality: Considerations by individual sports, exercise and recreational physical activities

Prev Med. 2015 Dec;81:73-7. doi: 10.1016/j.ypmed.2015.08.014. Epub 2015 Aug 22.


Background: Previous research demonstrates that moderate-to-vigorous physical activity (MVPA) is associated with reduced all-cause mortality risk. Our understanding of whether individual physical activities are associated with all-cause mortality is less understood.

Methods: Data from the 1999-2006 NHANES were employed, with follow-up through 2011. 48 different individual physical activities (e.g., swimming, running, bicycling) were assessed, and total MVPA MET-min-month was calculated based on their responses to these 48 individual physical activities.

Results: Greater engagement in MVPA was associated with more favorable cardiovascular biomarkers, particularly for men. Even after adjustment for total MVPA, different individual physical activities were associated with cardiovascular biomarkers across gender. When compared to those not meeting guidelines (0-1999 MVPA MET-min-month), a dose-response association between MVPA and mortality was observed, with those engaging in 5 times the guideline level having the lowest risk of all-cause mortality (45% reduced risk). There was no evidence of a harmful effect of very high MVPA (e.g., 20,000+ MVPA MET-min-month).

Conclusions: Engaging in MVPA even below the minimum recommendation was associated with survival benefits, and the greatest survival effects occurred at a dose of approximately 5 times the minimum recommendation. Although very high levels (e.g., 10 times the minimum recommendation) of self-reported MVPA did not demonstrate the greatest survival effects, high levels of physical activity did not appear to have harmful effects.

Keywords: Cardiovascular biomarkers; Epidemiology; Mortality; Survival.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood*
  • Blood Pressure
  • C-Reactive Protein / analysis
  • Cardiovascular Physiological Phenomena*
  • Cholesterol / blood
  • Exercise / physiology*
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Mortality*
  • Self Report
  • Sports / physiology*
  • Time Factors
  • Young Adult


  • Biomarkers
  • C-Reactive Protein
  • Cholesterol