Intensity-specific physical activity and mortality in 147,414 adults: a pooled accelerometer analysis

Abstract Background Insufficient physical activity is a leading global cause of premature mortality, yet how light-, moderate-, and vigorous-intensity activity differ in their associations with mortality and the implications of reallocating time across intensities remain unclear. Methods We prospectively analysed individually pooled baseline device-measured physical activity from 147,414 participants aged 40–74 years in the German National Cohort (NAKO) and UK Biobank, the largest pooled accelerometer dataset to date. Multivariable Cox models estimated hazard ratios (HR) and 95% confidence intervals (CI) for mortality across activity intensities and under time-reallocation models holding total active time constant. Results Over a mean follow-up of 7.9 years, 5,545 deaths occurred. Compared with no activity, 150 min per week of moderate-intensity activity was associated with lower mortality (HR: 0.70; 95% CI: 0.67, 0.72). Similar associations were observed for approximately 510 min per week of light-intensity activity or 12 min per week of vigorous-intensity activity. Additional activity beyond these levels was associated with further risk reduction. Replacing 15–60 min per week of light- or moderate-intensity activity with vigorous-intensity activity was associated with 18–30% lower mortality risk. Conclusions Physical activity at all intensities was associated with lower mortality, with vigorous-intensity activity showing strong inverse associations even at low volumes. Shifting modest amounts of active time toward higher intensities was associated with further risk reductions. These findings provide quantitative evidence to inform the interpretation of physical activity recommendations.

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Journal
International Journal of Behavioral Nutrition and Physical Activity
Published
2026-09-15
DOI
https://doi.org/10.1186/s12966-026-01980-3
Primary Topic
Physical Activity and Health
Type
article
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article

Intensity-specific physical activity and mortality in 147,414 adults: a pooled accelerometer analysis

Karin Halina Greiser, Julian Brummer, Michael J. Stein, Henry Völzke et al.
International Journal of Behavioral Nutrition and Physical Activity
Physical Activity and Health
article

Intensity-specific physical activity and mortality in 147,414 adults: a pooled accelerometer analysis

Karin Halina Greiser, Julian Brummer, Michael J. Stein, Henry Völzke, Claudia Meinke‐Franze, Wolfgang Lieb, Ronny Westermann, Hansjörg Baurecht, Patricia Bohmann, Steffen Ringhof, Kerstin Wirkner, Fabian Bamberg, Michael F. Leitzmann, Börge Schmidt, Florian Herbolsheimer, Claas Lendt, Tobias Pischon, Jana-Kristin Heise, Klaus Berger, Nadia Obi, Janett Barbaresko, Thomas Keil, Markus Scholz, Daniela Georges, Paula Stürmer, Heinz Freisling, Cara Övermöhle, Peggy Sekula, Marie‐Theres Huemer, Beate Fischer, Lilian Krist, Katharina Nimptsch, Karen Steindorf, Annette Peters, Christoph Buck, Rafael Mikolajczyk, André Karch, Johanna Wirler
article en

Abstract

Abstract Background Insufficient physical activity is a leading global cause of premature mortality, yet how light-, moderate-, and vigorous-intensity activity differ in their associations with mortality and the implications of reallocating time across intensities remain unclear. Methods We prospectively analysed individually pooled baseline device-measured physical activity from 147,414 participants aged 40–74 years in the German National Cohort (NAKO) and UK Biobank, the largest pooled accelerometer dataset to date. Multivariable Cox models estimated hazard ratios (HR) and 95% confidence intervals (CI) for mortality across activity intensities and under time-reallocation models holding total active time constant. Results Over a mean follow-up of 7.9 years, 5,545 deaths occurred. Compared with no activity, 150 min per week of moderate-intensity activity was associated with lower mortality (HR: 0.70; 95% CI: 0.67, 0.72). Similar associations were observed for approximately 510 min per week of light-intensity activity or 12 min per week of vigorous-intensity activity. Additional activity beyond these levels was associated with further risk reduction. Replacing 15–60 min per week of light- or moderate-intensity activity with vigorous-intensity activity was associated with 18–30% lower mortality risk. Conclusions Physical activity at all intensities was associated with lower mortality, with vigorous-intensity activity showing strong inverse associations even at low volumes. Shifting modest amounts of active time toward higher intensities was associated with further risk reductions. These findings provide quantitative evidence to inform the interpretation of physical activity recommendations.

International Journal of Behavioral Nutrition and Physical Activity
Universität Hamburg (DE), Zimmer Biomet (Netherlands) (NL), German Cancer Research Center (DE), Max Delbrück Center (DE), Heidelberg University (DE), University of Münster (DE), University of Würzburg (DE), Universitätsmedizin Greifswald (DE), Luther University (KR), University Medical Center Freiburg (DE), University Hospital Heidelberg (DE), Helmholtz Zentrum München (DE), University Hospital Regensburg (DE), Micromun (DE), Health and Safety Authority (IE), University Medical Center Hamburg-Eppendorf (DE), University Hospital Schleswig-Holstein (DE), Leibniz Institute for Prevention Research and Epidemiology - BIPS (DE), Essen University Hospital (DE), Helmholtz Centre for Infection Research (DE), German Centre for Cardiovascular Research (DE), Berlin Institute of Health at Charité - Universitätsmedizin Berlin (DE), Federal Institute for Population Research (DE), Deutsches Diabetes-Zentrum e.V. (DE), Centre international de recherche sur le cancer (FR), Heinrich Heine University Düsseldorf (DE), University of Rostock (DE), University of Regensburg (DE), University of Duisburg-Essen (DE), Martin Luther University Halle-Wittenberg (DE), Ludwig-Maximilians-Universität München (DE), Leipzig University (DE), University of Lübeck (DE)
Good health and well-being
Openalex Percentile: Top 11%
Physical Activity and Health
DOIOpen Access PDFOpenAlex
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