{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:20:16Z","timestamp":1787721616613,"version":"build-2784847793"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Although both moderate\u2010intensity physical activity (MPA) and vigorous\u2010intensity physical activity (VPA) are recommended, the optimal combination of intensities for maximal health benefits remains uncertain. This study examined the associations of MPA, VPA, and combined moderate\u2010to\u2010vigorous physical activity (MVPA) with all\u2010cause, cardiovascular disease, and cancer mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed data from 586\u2009936 adults, aged \u226518\u2009years, in the US National Health Interview Survey (1997\u20132018), linked to mortality through 2019. Participants were categorized as inactive, MPA only, VPA only, or MVPA. Among those engaging in MVPA, we further classified participants by activity frequency and the proportion of VPA. Cox proportional hazards models estimated hazard ratios (HRs) and 95% CIs for all\u2010cause, cardiovascular disease, and cancer mortality, adjusting for sociodemographic, lifestyle, and clinical factors. Sensitivity analyses excluded individuals with baseline chronic diseases or deaths within the first 2\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Over a median 10.0\u2010year follow\u2010up, 82\u2009959 deaths occurred. Compared with inactivity, MPA only (HR, 0.74 [95% CI, 0.72\u20130.76]), VPA only (HR, 0.56 [95% CI, 0.54\u20130.59]), and MVPA (HR, 0.50 [95% CI, 0.48\u20130.52]) were associated with progressively lower all\u2010cause mortality. Similar patterns were observed for cardiovascular disease and cancer mortality. Across all MVPA volumes, individuals with &gt;25% of MVPA from VPA had the lowest mortality risks. Findings were consistent across subgroups and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">VPA was associated with greater mortality reduction than MPA, and combining both intensities conferred the strongest survival benefits. These results support current guidelines and highlight the importance of incorporating VPA, when feasible, into public health strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.051199","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:34:12Z","timestamp":1782210852000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Combined Moderate and Vigorous Physical Activity With All\u2010Cause, Cardiovascular, and Cancer Mortality: A Cohort Study of 586\u2009936 US Adults"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8245-4871","authenticated-orcid":false,"given":"Yongyu","family":"Huang","sequence":"first","affiliation":[{"name":"School of Physical Education and Sports Science, South China Normal University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1747-2392","authenticated-orcid":false,"given":"Qing","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College","place":["Beijing, China"]},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8511-9996","authenticated-orcid":false,"given":"Geng","family":"Li","sequence":"additional","affiliation":[{"name":"School of Psychology, Shanghai University of Sport","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhe","family":"Zhang","sequence":"additional","affiliation":[{"name":"First Medical Center of Chinese People\u2019s Liberation Army General Hospital, National Clinical Research Center for Kidney Diseases","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6105-8797","authenticated-orcid":false,"given":"Mingyue","family":"Yin","sequence":"additional","affiliation":[{"name":"The Mary MacKillop Institute for Health Research, Australian Catholic University","place":["Melbourne, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8367-4980","authenticated-orcid":false,"given":"Yanwei","family":"You","sequence":"additional","affiliation":[{"name":"Tsinghua University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruyi","family":"Huang","sequence":"additional","affiliation":[{"name":"Xiamen Health Inspection Institute","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2373-6494","authenticated-orcid":false,"given":"Ming","family":"Ding","sequence":"additional","affiliation":[{"name":"School of Public Health, Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0654-147X","authenticated-orcid":false,"given":"Zuosheng","family":"Lu","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sports Science, South China Normal University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00150-5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-103640"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00482-X"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3857"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.0533"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.3093"},{"key":"e_1_3_2_8_2","volume-title":"Physical activity guidelines for Americans","author":"U.S. Department of Health and Human Services","year":"2018","unstructured":"U.S. Department of Health and Human Services . Physical activity guidelines for Americans. 2nd ed. Washington, DC: U.S. Department of Health and Human Services; 2018.","edition":"2"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.000802"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys038"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031210-101151"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.6331"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1741826710393196"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300257"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-0114"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.9.669"},{"key":"e_1_3_2_18_2","volume-title":"Physical activity and health: a report of the surgeon general","author":"Manley AF","year":"1996","unstructured":"Manley AF. Physical activity and health: a report of the surgeon general. Atlanta, GA: U.S. Department of Health and Human Services; 1996."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2031"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2021-105315"},{"key":"e_1_3_2_21_2","unstructured":"Centers for Disease Control and Prevention . National Health Interview Survey (NHIS). Accessed January 10 2024. https:\/\/www.cdc.gov\/nchs\/nhis\/index.htm."},{"key":"e_1_3_2_22_2","volume-title":"Design and estimation for the national health interview survey, 2006\u20132015","author":"Parsons VL","year":"2014","unstructured":"Parsons VL. Design and estimation for the national health interview survey, 2006\u20132015. Hyattsville, MD: National Center for Health Statistics; 2014."},{"key":"e_1_3_2_23_2","volume-title":"Design and estimation for the national health interview survey, 1995\u20132004","author":"Botman S","year":"2000","unstructured":"Botman S, Moriarity CL. Design and estimation for the national health interview survey, 1995\u20132004. Hyattsville, MD: National Center for Health Statistics; 2000."},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-022-01393-y"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-018-0695-z"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcaa051"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0000000000000631"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003677-200410000-00007"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-016-9740-z"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.0541"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.07.130"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2017.03.006"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2009.04.015"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002173420702"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.126.051199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:36:05Z","timestamp":1787718965000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.126.051199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":33,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2026,7,7]]}},"alternative-id":["10.1161\/JAHA.126.051199"],"URL":"https:\/\/doi.org\/10.1161\/jaha.126.051199","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"assertion":[{"value":"2026-04-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e051199"}}