Wearable device-based health equivalence of different physical activity intensities against mortality, cardiometabolic disease, and cancer

Raaj Kishore Biswas, Matthew N. Ahmadi, Adrian Bauman, Karen Milton, Nicholas A. Koemel and Emmanuel Stamatakis ()
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Raaj Kishore Biswas: The University of Sydney
Matthew N. Ahmadi: The University of Sydney
Adrian Bauman: The University of Sydney
Karen Milton: University of East Anglia
Nicholas A. Koemel: The University of Sydney
Emmanuel Stamatakis: The University of Sydney

Nature Communications, 2025, vol. 16, issue 1, 1-8

Abstract: Abstract Current conventions, partly derived from self-reported data, typically equate 1 minute of vigorous physical activity (VPA) to 2 minutes of moderate physical activity (MPA). Using accelerometer-derived intensity classification in 73,485 UK Biobank participants (mean follow-up: 8.0 [1.0] years), we assess the equivalence of light activity (LPA) and MPA to 1 minute of VPA for all-cause (ACM) and cardiovascular (CVD) mortality, major adverse cardiovascular events (MACE), type 2 diabetes, and cancer outcomes. For a standardised 5%–35% risk reduction, the median MPA equivalent per minute of VPA is 4.1 (ACM, 95% CI: 4.1–4.2), 7.8 (CVD mortality, 7.7-8.0), 5.4 (MACE, 5.3–5.5), 9.4 (type 2 diabetes, 9.3-9.6), and 3.5 (cancer mortality, 3.4-3.5) minutes. For non-cancer outcomes, the median LPA equivalent per 1 minute of VPA ranges from 53 (ACM) to 94 minutes (type 2 diabetes), reflecting generally weaker dose-response curves of LPA with all outcomes. These findings indicate a substantial departure from self-reported estimates and support integrating device-based equivalence into guidelines and wearables.

Date: 2025
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DOI: 10.1038/s41467-025-63475-2

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