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Is Vigorous Physical Activity Better than Moderate Physical Activity for Women?

It has not been demonstrated that in overweight or obese people high-intensity interval training is better than moderate-intensity exercise in inducing weight loss except for….

Many current physical activity (PA) guidelines recommend 30 min of at least moderate-intensity physical activity on most days of the week (150 min·wk−1) for general population health benefits. In several countries, there is an additional recommendation that, "If you can, also enjoy some regular, vigorous activity for extra health and fitness. However, the magnitude of the additional health benefits is unclear. In a study conducted in Australia, researchers aimed to compare the reduction in risk of hypertension (HTN) and depressive symptoms (DS) for 12 years in middle-age women who reported only moderate-intensity PA (MOPA) and a combination of moderate and vigorous PA (MVPA). According to the authors, depression and hypertension were chosen as outcomes because they were the most common physical and mental health outcomes, respectively, for primary care management in Australia.

The study involved 11,285 participants in the Australian Longitudinal Study on Women’s Health, who completed surveys in 1998, 2001, 2004, 2007, and 2010. At baseline, the women were largely representative of women age 45–50 yr in the Australian population. The occurrence of hypertension was assessed by the question, "In the past three years, have you been diagnosed with or treated for HTN?" Depressive symptoms were assessed by the 10-item Center for Epidemiological Studies Depression Scale, with participants who scored 10 points or higher classified as having DS. To assess for physical activity, women were asked to report time spent walking briskly and time spent in moderate leisure activities (e.g., golf, recreational swimming, and gardening) in the last week. Women were also asked to report time spent in vigorous leisure activities (e.g., competitive sport, running, and aerobics) in the last week. A vigorous only category was not created because <2% of women reported doing vigorous activity, without any walking or moderate-intensity activity. Generalized estimating equation models (with 3-yr lag time) were used to examine the data.

In the results of this study, Pavey et al found that the odds for HTN declined with increasing physical activity for the physically active women compared to the inactive women. This decline was slightly lower for MVPA than for MOPA across the entire range of PA levels, but this difference was only significant at the highest PA level (>2000; odds ratio [OR] = 0.80 MOPA and 0.56 MVPA). For depressive symptoms, OR values were similar in both groups up to 500 MET·min·wk−1, then slightly lower for MVPA than for MOPA at higher PA levels. Again, this difference was only significant at the highest PA level (>2000; OR = 0.57 MOPA and 0.42 MVPA).

Thus the authors conclude that doing both vigorous and moderate activity does not have significant additional benefits in terms of HT and DS, above those from moderate-intensity activity alone, except at very high levels of PA.

Practice Pearls:

  • The odds for hypertension declined with increasing physical activity for the physically active women compared to the inactive women.
  • For depressive symptoms, the OR values were slightly lower for moderate and vigorous physical activity than for moderate-intensity physical activity at higher PA levels.
  • Doing both vigorous and moderate activity does not have significant additional benefits in terms of improving the odds for hypertension and depressive symptoms.

Medicine and Science in Sports and Exercise, October 2013