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However, no research to date has explored its association with mortality in a nationally representative population. This study aimed to examine the dose-response association between VILPA and mortality risk in a nationally representative sample of US adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included a nationally representative sample of 3293 US adults from the 2011-14 National Health and Nutrition Examination Survey (NHANES) who self-reported no participation in structured exercise (52.3% female; mean age: 50.7 [SD: 16.6 years]. The dose-response relationship between VILPA and all-cause mortality was estimated using multivariable-adjusted cubic splines. Average daily frequency (bouts\/day) and duration (minutes\/day) of VILPA bouts lasting up to one minute were measured using a wrist-worn accelerometer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over the mean (SD) 6.7 (1.4) year follow-up period, 290 all-cause mortality events occurred. Compared to the referent point (0 bouts per day), there was an L-shaped dose-response association where the median frequency (5.3 bouts per day) was associated with a 44% lower risk of all-cause mortality (HR: 0.56; 95% CI: 0.39, 0.82). The dose response curve was less steep beyond approximately 8 bouts per day (HR: 0.46; 95% CI: 0.28, 0.77). Findings for the median frequency of VILPA bouts (5.3 bouts per day) remained consistent after excluding participants with poor health (HR: 0.51: 95% CI: 0.29, 0.87) and those who completed no VILPA (HR: 0.57: 95% CI: 0.38, 0.86). When excluding adults with prevalent cardiovascular disease or cancer at baseline (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092,731, 152 events), the dose-response relationship was similar, although the 95% CIs crossed unity for most of the curve (e.g. median frequency of VILPA bouts HR: 0.68: 95% CI: 0.41, 1.11).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a nationally representative sample of US adults, short bursts of intermittent vigorous physical activity were associated with a lower risk of mortality. Excluding those with prevalent cardiovascular disease and cancer led to attenuated dose-response curves and wider confidence intervals, suggesting that the observed relationships may, at least partly, be driven by existing disease-induced reverse causation. While these results highlight some potential of VILPA as a time-efficient source of activity, additional observational studies with longer follow up and larger sample sizes are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12966-026-01876-2","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T03:03:39Z","timestamp":1769742219000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Vigorous intermittent lifestyle physical activity (VILPA) and mortality risk among US adults: a wearables-based national cohort study"],"prefix":"10.1186","volume":"23","author":[{"given":"Nicholas A.","family":"Koemel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew N.","family":"Ahmadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raaj Kishore","family":"Biswas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie","family":"Th\u00f8gersen-Ntoumani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Teixeira-Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara K.","family":"Chow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaroslaw","family":"Harezlak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Stamatakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"issue":"10113","key":"1876_CR1","doi-asserted-by":"publisher","first-page":"2643","DOI":"10.1016\/S0140-6736(17)31634-3","volume":"390","author":"SA Lear","year":"2017","unstructured":"Lear SA, Hu W, Rangarajan S, et al. 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