A claim you hear on longevity podcasts
The claim checked: More than 10 hours of exercise a week raises the risk of death Hear it at 27:55
Eight studies found no extra risk of death at very high amounts of exercise. A pooled study of 661,137 adults found no excess risk at 10 or more times the minimum. A Copenhagen study of joggers found higher risk in strenuous joggers than light ones. A review noted risk may rise slightly at the very top.
Computed from 10 studies that test this point, each judged by two readers, in full. 3 more studies are waiting for a full read and do not count yet.
“more than 10 hours a week, also had higher risk of death compared to people who exercised moderately. The lowest risk of dying from both cardio and all causes was seen in people who exercised about 2 and 1/2 to 4 and 1/2 hours per week.”
On tape: Copenhagen, nearly 9,000 healthy adults, over 25 years, U-shaped, lowest risk at 2.5 to 4.5 hours, higher risk above 10 hours. This study matches every detail; the over-10-hour group's hazard ratio was 1.18 with a confidence interval that touches 1.00. U-Shaped Association Between Duration of Sports Activities and Mortality: Copenhagen City Heart Study. Mayo Clin Proc, 2021. Prospective cohort (Copenhagen City Heart Study), self-reported weekly hours of leisure sports, 8,697 healthy adults in Copenhagen, median follow-up 25.6 years.
What it found
“Compared with the reference group of 2.6 to 4.5 hours of weekly leisure-time sports activities, we found an increased risk for all-cause mortality for those with 0 hours (hazard ratio [HR], 1.51; 95% CI, 1.29 to 1.76), for those with 0.1 to 2.5 hours (HR, 1.24; 95% CI, 1.05 to 1.46), and for those with more than 10 hours (HR, 1.18; 95% CI, 1.00 to 1.39) of weekly leisure-time sports activities.”
How the authors extend it
“Participation in sport activities should be promoted, but the potential risk of very high weekly hours of sport participation should be considered for inclusion in guidelines and recommendations.”
Not stated in the abstract we read. Two readers agreed on the label.
None.
trial or observed group · 2015 · landmark
“Compared with light joggers, the moderate and strenuous joggers had significantly higher adjusted HRs (3.06 [95% CI: 1.11 to 8.45] and 9.08 [95% CI: 1.87 to 44.01], respectively).”
Dose of jogging and long-term mortality: the Copenhagen City Heart Study. J Am Coll Cardiol
Who: Healthy white men and women aged 20-86 (joggers) and 21-92 (nonjoggers) from the Copenhagen City Heart Study, free of CHD, stroke and cancer
PMID 25660917
other primary study · 2012
“Mortality risk tended to increase slightly in those expending more than 3,500 Kcal per week exercising [21].”
Physical activity, health benefits, and mortality risk. ISRN Cardiol
Who: Narrative review of epidemiologic studies in apparently healthy adults and in patients with hypertension, type 2 diabetes and cardiovascular disease
PMID 23198160
other primary study · 2015 · landmark
“We observed a benefit threshold around 3–5 times the recommended leisure-time physical activity minimum, and no excess risk at 10+ times the minimum.”
Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern Med
Who: 661,137 men and women (median age 62, range 21-98) from six US and European prospective cohorts in the NCI Cohort Consortium
PMID 25844730
other primary study · 2017 · landmark
“we did not observe any adverse efforts of PA on our outcomes even”
The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet
Who: 130 843 adults aged 35-70 without pre-existing CVD from 17 high-, middle- and low-income countries (PURE cohort)
PMID 28943267
systematic review · 2019 · landmark
“However, as in these previous reports, the apparent rise in risk at very high amounts of moderate-to-vigorous physical activity did not reach the level of statistical significance.”
Physical Activity, All-Cause and Cardiovascular Mortality, and Cardiovascular Disease. Med Sci Sports Exerc
Who: Adults in systematic reviews, meta-analyses and pooled analyses of prospective cohorts (2006-March 2018) on physical activity and all-cause mortality, CVD mortality and incident CVD
PMID 31095084
other primary study · 2020 · landmark
“The association was non-linear, being steeper between 15-30 kJ/kg/day, then stabilising around 80% lower hazard.”
Wearable-device-measured physical activity and future health risk. Nat Med
Who: UK Biobank accelerometer sub-study participants, mean age 62 years, 56% female, healthier and more affluent than the general population
PMID 32807930
other primary study · 2021 · landmark
“For all-cause mortality, corresponding hazard ratios for higher leisure time physical activity were 0.74 (0.68–0.81), 0.59 (0.54–0.64), and 0.60 (0.52–0.69), and for higher occupational physical activity 1.06 (0.96–1.16), 1.13 (1.01–1.27), and 1.27 (1.05–1.54), respectively.”
The physical activity paradox in cardiovascular disease and all-cause mortality: the contemporary Copenhagen General Population Study with 104 046 adults. Eur Heart J
Who: White women and men of Danish descent aged 20-100 years from the Copenhagen General Population Study, free of MACE at baseline
PMID 33831954
other primary study · 2022 · landmark
“There was no greater risk of mortality even at very high level of VPA though no additionally lower mortality was observed beyond 300 min/week of VPA.”
Long-Term Leisure-Time Physical Activity Intensity and All-Cause and Cause-Specific Mortality: A Prospective Cohort of US Adults. Circulation
Who: 116,221 US adults (63% women, mostly white health professionals, mean age 66 over follow-up) from the Nurses' Health Study and Health Professionals Follow-up Study, free of CVD and cancer at baseline
PMID 35876019
pooled analysis · 2020 · landmark
“Our analyses suggest that 10–12 hours of weekly vigorous physical activity cannot be considered harmful to longevity.”
Association of high amounts of physical activity with mortality risk: a systematic review and meta-analysis. Br J Sports Med
Who: General-population adults in prospective cohort studies (most self-reported leisure or MVPA; 5 accelerometer studies), excluding work-only activity and specific risk groups
PMID 31406017
other primary study · 2019
“Of note, there was still benefit rather than excess risk associated with very high levels of leisure time physical activity.”
Beneficial associations of low and large doses of leisure time physical activity with all-cause, cardiovascular disease and cancer mortality: a national cohort study of 88,140 US adults. Br J Sports Med
Who: US adults aged 40-85 years from 12 waves of the National Health Interview Survey (1997-2008), free of chronic disease at baseline
PMID 30890520
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