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Published on: 11-Jan-2023

For many years, The American Heart Association and organizations such as the US Department of Health and Human Services have published physical activity guidelines outlining the recommended amount of exercise required for adults. However, recently, the results of a 30-year longitudinal study were released, suggesting that while those physical activity guidelines are useful, increasing your weekly physical activity beyond the recommendations may provide extra, life-extending benefits.

In fact, doubling to quadrupling your minimum amount of weekly physical activity may substantially lower the risk of dying from cardiovascular disease and other causes. While those who followed the minimum guidelines lowered their risk of dying from any cause by as much as 21 percent, adults who exercised two to four times the minimum could potentially lower their mortality risk by as much as 31 percent.

Here’s the History

In 2008, the HHS published their first activity guidelines for Americans after examining science-based evidence available at the time. Ten years later, in 2018, they released updated guidelines for recommended daily/weekly exercise. The 2018 guidelines recommended 150 to 300 minutes/week of moderate physical activity (MPA) or 75 to150 minutes per week of vigorous physical activity (VPA), along with twice weekly full body strength training workouts to lower all-cause mortality. However, last month, the results of a 30-year study indicated that exercise beyond these minimum recommendations may be beneficial.

About the Study

The study, Long-Term Leisure-Time Physical Activity Intensity and All-Cause and Cause-Specific Mortality: A Prospective Cohort of US Adults, was published in the American Heart Association’s peer-reviewed journal Circulation. Donghoon Lee of Harvard’s T.H. Chan School of Public Health and his colleagues analyzed medical records and mortality data from more than 116,000 adults (average age 66 years old) who were enrolled in either the all-female Nurses’ Health Study or the all-male Health Professionals Follow-Up Study. The longitudinal study was conducted over 30 years from 1988 through 2018, and the data included self-reported measures of leisure time physical activity intensity and duration.

The research showed that participants who performed double—or up to four times—the minimum recommended dose of moderate or vigorous physical activity lived longer. Their analysis suggests that 300-600 min/week of moderate physical activity or 150-300 min/week of vigorous exercise significantly reduces all-cause mortality risk. Results also showed that performing up to 4 times the recommended weekly exercise does not cause harm, but that the benefits actually stop after 600 minutes per week.

Participants who followed current guidelines and did 150-300 min/week of moderate physical activity (MPA) had a 20 to 21 percent lower risk of death from all causes, while participants who performed 300-600 min/week of MPA (two to four times above current guidelines) had a 26 to 31 percent lower risk of mortality from all causes. Doing two to four times more than the recommended weekly exercise guidelines, or participating in high intensity endurance training or competition, did not increase the risk of atrial fibrillation, coronary artery calcification, myocardial fibrosis, or sudden cardiac death.

What is Moderate vs. Vigorous Exercise?

In its simplest form, exercise intensity refers to the rate of metabolic energy demand during exercise. For this study, vigorous exercise was defined as any activity that uses more than six METs of energy. A Metabolic Equivalent Task (MET) unit gauges the amount of energy required to perform different tasks or physical activities at varying intensities. For example, sitting in a chair uses one MET, walking at three miles per hour (mph) uses about four METs, and slow jogging uses about six METs.

Moderate-intensity activities are those that get you moving fast enough or strenuously enough to burn off three to six times as much energy per minute as you do when you are sitting quietly, or exercises that clock in at 3 to 6 METs. This includes walking, lower-intensity exercise, weightlifting and calisthenics. Vigorous activity burns more than 6 METs and includes jogging, running, swimming, bicycling and other aerobic exercises. One limitation to this way of measuring exercise intensity is that it does not consider the fact that some people have a higher level of fitness than others.

Examples of Light, Moderate and Vigorous Exercise

So, if you’re thinking about increasing your daily exercise, what exactly do you need to do?Here are a few examples of light, moderate, and vigorous activities for a healthy adult:

Light exercise (less than 3.0 METs) requires the least amount of effort

  • Uses 55 to 64% of your maximum heart rate
  • Walking slowly
  • Sitting using computer
  • Standing light work (cooking, washing dishes)
  • Fishing sitting
  • Playing most instruments

Moderate exercise (between 3.0 and 6.0 METs) means you’re working hard enough to raise your heart rate and break a sweat.

  • Uses 65 to 74 % of your maximum heart rate
  • Brisk walking (4 mph)
  • Heavy cleaning (mopping, vacuuming, washing windows)
  • Bicycling (10-12 mph)
  • Doubles tennis
  • Water aerobics

Vigorous exercise (more than 6.0 METs) requires the highest amount of oxygen consumption to complete the activity.

  • Uses 75 to 90% of your maximum heart rate
  • Running/Jogging (6 mph)
  • Hiking
  • Swimming
  • Shoveling
  • Bicycling fast (14-16 mph)
  • Basketball or soccer game
  • Singles tennis

Final Thoughts

The findings of the study support the current national physical activity guidelines; however, they also indicate that increasing your weekly physical activity may provide extra, life-extending benefits. The data can be used as a general guide to choose the right amount and intensity of physical activity to maintain your overall health.

Authored by Zach Meeker, Research Assistant for Midwest Orthopaedics at Rush University Medical Center


Dong Hoon Lee, Leandro F.M. Rezende, Hee-Kyung Joh, NaNa Keum, Gerson Ferrari, Juan Pablo Rey-Lopez, Eric B. Rimm, Fred K. Tabung and Edward L. Giovannucci. “Long-Term Leisure-Time Physical Activity Intensity and All-Cause and Cause-Specific Mortality: A Prospective Cohort of US Adults.” Circulation (First published: July 25, 2022)

MacIntosh, B.R., Murias, J.M., Keir, D.A., and Weir, J.M. “What is Moderate to Vigorous Exercise Intensity?” Frontiers in Physiology, Perspectives, 22 Sept, 2021.