Appropriate Amount of Regular Exercise is Associated with a Reduced Mortality Risk

Purpose This study aimed at investigating whether there is a continuous dose-response relationship between the amount of physical activity (PA) and longevity benefit. Methods We evaluated the records of 23,257,723 Koreans aged ≥20 years who had undergone one biennial medical evaluation by the National Health Insurance Corporation. Participants with ≥20 minutes of vigorous or ≥30 minutes of moderate PA or walking were stratified into four groups: 0 days/week; 1-3 days/week; 4-5 days/week; and 6-7 days/week. After calculating total metabolic equivalent task-hours per week (MET-h/wk), we created eight categories of MET-h/wk (0, 0.1-4.9, 5.0-9.9, 10.0-14.9, 15.0-19.9, 20.0-24.9, 25.0-29.9, and ≥30.0). Multivariate Cox proportional hazard analyses were performed. Results A reverse J-shaped risk curve was observed, with the lowest mortality risk in the participants exercising 4-5 days/week (reference). Participants who did not exercise at all and those who exercised with a PA frequency of 1-3 days/week or 6-7 days/week showed a significantly increased mortality risk compared with the reference group. When we repeated the Cox analysis among the eight MET-h/wk categories with the participants reporting 20.0-24.9 MET-h/wk of PA as the reference group, we found that those with physical inactivity and 25.0-29.9 or ≥30.0 MET-h/wk of PA showed a higher mortality risk than the reference group. These relationships were persistently observed after adjustment for confounders. Conclusions An appropriate amount of regular exercise in each specific type of PA was associated with the lowest risk of mortality. The inactive participants showed an increased mortality risk, and daily PA did not show any additional benefit in the mortality risk. *These authors contributed equally to this work. Address for correspondence: Won-Young Lee, Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea, Tel: +82-2-2001-2579; Fax: +82-2-757-0436; E-mail: wonyoung2.lee@samsung.com This study was supported by grant HC16C2285 from the Korean Health Technology and Research and Development project, Ministry of Health and Welfare, Republic of Korea. The results of the study do not constitute endorsement by the American College of Sports Medicine. Funding: None. Conflict of Interest: The authors declare that they have no competing interests. Accepted for Publication: 11 June 2018 © 2018 American College of Sports Medicine

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