Background:The 2018 physical activity guidelines for Americans recommend a minimum of 150 to 300 min/wk of moderate physical activity (MPA), 75 to 150 min/wk of vigorous physical activity (VPA), or an equivalent combination of both. However, it remains unclear whether higher levels of long-term VPA and MPA are, independently and jointly, associated with lower mortality.Methods:A total of 116 221 adults from 2 large prospective US cohorts (Nurses’ Health Study and Health Professionals Follow-up Study, 1988–2018) were analyzed. Detailed self-reported leisure-time physical activity was assessed with a validated questionnaire, repeated up to 15 times during the follow-up. Cox regression was used to estimate the hazard ratio and 95% CI of the association between long-term leisure-time physical activity intensity and all-cause and cause-specific mortality.Results:During 30 years of follow-up, we identified 47 596 deaths. In analyses mutually adjusted for MPA and VPA, hazard ratios comparing individuals meeting the long-term leisure-time VPA guideline (75–149 min/wk) versus no VPA were 0.81 (95% CI, 0.76–0.87) for all-cause mortality, 0.69 (95% CI, 0.60–0.78) for cardiovascular disease (CVD) mortality, and 0.85 (95% CI, 0.79–0.92) for non-CVD mortality. Meeting the long-term leisure-time MPA guideline (150–299 min/wk) was similarly associated with lower mortality: 19% to 25% lower risk of all-cause, CVD, and non-CVD mortality. Compared with those meeting the long-term leisure-time physical activity guidelines, participants who reported 2 to 4 times above the recommended minimum of long-term leisure-time VPA (150–299 min/wk) or MPA (300–599 min/wk) showed 2% to 4% and 3% to 13% lower mortality, respectively. Higher levels of either long-term leisure-time VPA (≥300 min/wk) or MPA (≥600 min/wk) did not clearly show further lower all-cause, CVD, and non-CVD mortality or harm. In joint analyses, for individuals who reported <300 min/wk of long-term leisure-time MPA, additional leisure-time VPA was associated with lower mortality; however, among those who reported ≥300 min/wk of long-term leisure-time MPA, additional leisure-time VPA did not appear to be associated with lower mortality beyond MPA.Conclusions:The nearly maximum association with lower mortality was achieved by performing ≈150 to 300 min/wk of long-term leisure-time VPA, 300 to 600 min/wk of long-term leisure-time MPA, or an equivalent combination of both.

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长期休闲时间体力活动强度以及全因和特定原因死亡率：美国成年人的前瞻性队列

背景：2018 年美国人体力活动指南建议每周至少进行 150 至 300 分钟的中等体力活动 (MPA)、每周 75 至 150 分钟的剧烈体力活动 (VPA)，或两者的等效组合。然而，目前尚不清楚较高水平的长期 VPA 和 MPA 是否单独或共同与较低的死亡率相关。 方法：来自 2 个大型前瞻性美国队列的总共 116 221 名成年人（护士健康研究和健康专业人员跟踪研究） up 研究，1988-2018）进行了分析。详细的自我报告的休闲时间体力活动通过经过验证的问卷进行评估，并在随访期间重复最多 15 次。Cox 回归用于估计长期休闲时间体力活动强度与全因和特定原因死亡率之间关联的风险比和 95% CI。 结果：在 30 年的随访期间，我们确定了 47 596死亡人数。在对 MPA 和 VPA 进行相互调整的分析中，满足长期休闲时间 VPA 指南（75-149 分钟/周）的个体与没有 VPA 的个体相比，全因死亡率的风险比为 0.81（95% CI，0.76-0.87）心血管疾病 (CVD) 死亡率为 0.69 (95% CI, 0.60–0.78)，非 CVD 死亡率为 0.85 (95% CI, 0.79–0.92)。满足长期休闲 MPA 指南（每周 150-299 分钟）同样与较低的死亡率相关：全因死亡率、CVD 和非 CVD 死亡率降低 19% 至 25%。与那些符合长期休闲时间身体活动指南的参与者相比，报告的长期休闲时间 VPA（150-299 分钟/周）或 MPA（300-599 分钟/周）建议最低值高出 2 至 4 倍的参与者周）显示死亡率分别降低了 2% 至 4% 和 3% 至 13%。较高水平的长期休闲时间 VPA（≥300 分钟/周）或 MPA（≥600 分钟/周）并没有明确表明全因、CVD 和非 CVD 死亡率或伤害进一步降低。在联合分析中，对于报告长期休闲时间 MPA 少于 300 分钟/周的个体，额外的休闲时间 VPA 与较低的死亡率相关；然而，在那些报告长期休闲时间 MPA ≥300 分钟/周的人中，额外的休闲时间 VPA 似乎与 MPA 之外的较低死亡率没有相关性。结论：通过执行以下操作实现了与较低死亡率的几乎最大关联：约 150 至 300 分钟/周的长期休闲时间 VPA，300 至 600 分钟/周的长期休闲时间 MPA，或两者的等效组合。