title: Effect of Moderate to Vigorous Physical Activity on All-Cause Mortality in Middle-aged and Older Australians.
abstract: OBJECTIVE
  Few studies have examined how different proportions of moderate and vigorous physical activity affect health outcomes.
  
  
  OBJECTIVE
  To examine whether the proportion of total moderate to vigorous activity (MVPA) that is achieved through vigorous activity is associated with all-cause mortality independently of the total amount of MVPA.
  
  
  METHODS
  We performed a prospective cohort study with activity data linked to all-cause mortality data from February 1, 2006, through June 15, 2014, in 204,542 adults aged 45 through 75 years from the 45 and Up population-based cohort study from New South Wales, Australia (mean [SD] follow-up, 6.52 [1.23] years). Associations between different contributions of vigorous activity to total MVPA and mortality were examined using Cox proportional hazards models, adjusted for total MVPA and sociodemographic and health covariates.
  
  
  METHODS
  Different proportions of total MVPA as vigorous activity. Physical activity was measured with the Active Australia Survey.
  
  
  METHODS
  All-cause mortality during the follow-up period.
  
  
  RESULTS
  During 1,444,927 person-years of follow-up, 7435 deaths were registered. Compared with those who reported no MVPA (crude death rate, 8.34%), the adjusted hazard ratios for all-cause mortality were 0.66 (95% CI, 0.61-0.71; crude death rate, 4.81%), 0.53 (95% CI, 0.48-0.57; crude death rate, 3.17%), and 0.46 (95% CI, 0.43-0.49; crude death rate, 2.64%) for reporting 10 through 149, 150 through 299, and 300 min/wk or more of activity, respectively. Among those who reported any MVPA, the proportion of vigorous activity revealed an inverse dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity (crude death rate, 3.84%) the fully adjusted hazard ratio was 0.91 (95% CI, 0.84-0.98; crude death rate, 2.35%) in those who reported some vigorous activity (but <30% of total activity) and 0.87 (95% CI, 0.81-0.93; crude death rate, 2.08%) among those who reported 30% or more of activity as vigorous. These associations were consistent in men and women, across categories of body mass index and volume of MVPA, and in those with and without existing cardiovascular disease or diabetes mellitus.
  
  
  CONCLUSIONS
  Among people reporting any activity, there was an inverse dose-response relationship between proportion of vigorous activity and mortality. Our findings suggest that vigorous activities should be endorsed in clinical and public health activity guidelines to maximize the population benefits of physical activity.
authors.affiliation: Centre for Chronic Disease Prevention, College of Public Health, Medical, and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia2Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, New So.
authors.forename: Klaus
authors.initials: K
authors.lastname: Gebel
authors.affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Ding
authors.initials: D
authors.lastname: Ding
authors.affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Tien
authors.initials: T
authors.lastname: Chey
authors.affiliation: Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia4Exercise and Sport Sciences, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Stamatakis
authors.affiliation: Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Brown
authors.affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Adrian E
authors.initials: AE
authors.lastname: Bauman
mesh_terms: D000368:Aged; D001315:Australia; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011446:Prospective Studies