Maintaining optimal heart health may necessitate significantly more exercise than what is currently recommended. Presently, health experts suggest engaging in 150 minutes of moderate-to-vigorous physical activity (MVPA) each week. However, what are the implications of exceeding this amount?
Research involving health data from the United Kingdom indicates that increased physical activity could further benefit cardiovascular health. This extensive analysis, carried out by researchers in China, examined data from 17,088 individuals in the UK Biobank over approximately eight years.
Those adhering to the current exercise guidelines experienced an 8 to 9 percent reduced risk of major cardiovascular incidents such as heart attacks or strokes. In contrast, participants who exercised three to four times more saw a risk reduction exceeding 30 percent.
This equates to about 9 to 10 hours of weekly exercise, a daunting figure for many with busy schedules. Yet, the health benefits are notably higher, particularly for individuals starting with lower fitness levels.
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A press release from the British Medical Journal argues that existing exercise guidelines are inadequate, suggesting that individuals with lower fitness need more exercise to achieve comparable benefits. However, Aiden Doherty, a biomedical informatician at the University of Oxford not involved in the study, considers this view “misleading.”
Doherty emphasizes that every bit of exercise counts, especially for those with low fitness levels. He states in a perspective for Science Media Centre, “We can’t give much weight to the figure of 560 to 610 minutes of exercise a week.” He acknowledges the cardiovascular benefits of engaging in over 1 hour and 20 minutes of moderate-to-vigorous physical activity daily but doubts the practicality of this as a public health guideline.
Despite the press release’s claims, the study’s lead author, Zhide Liang from Macao Polytechnic University in China, concurs with Doherty that current guidelines should be maintained. The study’s authors conclude that many still do not meet these guidelines, affirming, “The primary public health message remains straightforward: achieving 150 min/week of MVPA delivers meaningful cardiovascular protection regardless of fitness level.”
This means individuals can be assured that even minimal exercise can benefit heart health, without the need for excessive gym time.
During the study, 1,233 serious cardiovascular incidents were recorded within the UK Biobank cohort over nearly eight years, including instances of atrial fibrillation, heart attacks, heart failure, and strokes.
Steffen Petersen, a cardiologist from Queen Mary University of London, describes the study as a “large, well‑conducted observational study” in an independent review. Although the research only identifies associations between exercise and cardiovascular outcomes, the authors used Mendelian Randomization to approach causal inferences.
Petersen adds that a significant strength of the study is its use of device-measured activity and fitness, which boosts confidence in the observed dose–response relationships.
The study identified a sharp increase in cardiovascular benefits based on weekly exercise “doses.” A 20 percent risk reduction required participants to engage in approximately 340 to 370 minutes of exercise weekly, well above current recommendations.
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However, individuals with the lowest fitness levels needed to exercise more to gain similar benefits. For a 20 percent risk reduction, they needed an additional 30 to 50 minutes of MVPA each week compared to those with higher fitness levels.
The authors reinforce the public health importance of the 150 min/week guideline, noting, “This threshold functions as a robust universal minimum…”
For even greater heart protection, more exercise may be necessary, but it is crucial to keep expectations realistic.
Only 12 percent of Biobank participants achieved at least 560 minutes of exercise weekly, showing that while possible, this volume represents a significant behavioral challenge for most.
Public health messages must consider this, which is why they typically offer a minimum recommendation. However, determining the precise exercise amount needed for optimal health benefits is also important.
Randomized controlled trials are necessary to confirm if higher exercise levels truly lead to better heart health. The study was published in the British Journal of Sports Medicine.
