21/02/2024
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Summary: A new study suggests that regular aerobic exercise, even less than the recommended 150 minutes per week, can significantly reduce the risk of dying from the flu or pneumonia.

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However, the benefits appear to level off or even become detrimental beyond a certain level of activity, particularly in muscle-strengthening exercises. The study evaluated responses from more than 577,000 adults who participated in the US National Health Interview Survey (NHIS) from 1998 to 2018.

The research found that those who achieved both their aerobic activity and muscle-strengthening goals had nearly half the risk of dying from the flu or pneumonia than those who didn’t achieve either goal.

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Main aspects:

  1. According to research, meeting your weekly aerobic activity goal was associated with a 36 percent lower risk of dying from the flu or pneumonia.
  2. Regular aerobic exercise, even less than the recommended 150 minutes per week, is associated with a significantly lower risk of death from flu or pneumonia.
  3. While achieving the weekly goal of 2 muscle-strengthening sessions was associated with a 47% lower risk of death, seven or more sessions were associated with a 41% higher risk.

Source: BMJ extension

According to US research published online in theBritish Journal of Sports Medicine.

But there may be a level above which the effects level off or, in the case of muscle-strengthening activities, become potentially harmful, the findings suggest.

Adults are recommended to exercise for at least 150 minutes per week of moderate intensity or 75 minutes of vigorous intensity, aerobic physical activity or an equivalent combination, plus muscle-strengthening activity of moderate or higher intensity at least twice a week.

Aerobic exercise, which includes brisk/brisk walking, swimming, running, and stair climbing, is sustained, increases heart rate, and increases sweating. Muscle-strengthening activities involve the use of weights and resistance bands; exercises such as squats, lunges and push-ups (calisthenics); and heavy gardening.

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Credit: Neuroscience News

In addition to helping maintain good health and ward off serious illness, regular physical activity may also protect against death from the flu or pneumonia, evidence indicates.

The researchers then wanted to find out whether specific types and amounts of physical activity could be associated with this reduced risk.

They drew on responses from 577,909 adults who had taken part in the U.S. nationally representative National Health Interview Survey (NHIS) between 1998 and 2018.

Respondents were asked how often they spent 10 or more minutes in vigorous-intensity and light-to-moderate-intensity aerobic activity. And they were asked how often they did muscle-strengthening activities.

Each person was then ranked according to how well they met the recommended aerobic activity + weekly muscle-strengthening goals: neither; achievement of aerobic activity goal; achieve the goal of muscle strengthening; and achieve both goals.

Five levels of physical activity were defined: less than 10, 10149, 150300, 301600 and greater than 600 minutes/week of moderate to vigorous physical activity; and fewer than 2, 2, 3, 46, and 7 or more sessions/week of muscle-strengthening activity.

Half of the respondents (50.5%) did not achieve any of their weekly goals. How well they did differed significantly based on sociodemographic and lifestyle factors, underlying health conditions, and whether they had been vaccinated against influenza and/or pneumonia.

One-third (34%) were aerobically inactive, and more than three-quarters (78%) reported fewer than 2 weekly sessions of muscle-strengthening activity.

During an average 9-year follow-up period, 81,431 participants died; 1516 of these deaths were attributed to influenza and pneumonia.

This shows a man running over a speeding car.
In addition to helping maintain good health and ward off serious illness, regular physical activity may also protect against death from the flu or pneumonia, evidence indicates. Credit: Neuroscience News

Those who met both of the recommended weekly physical activity goals had nearly half (48%) the risk of dying from the flu or pneumonia compared with their peers who didn’t meet either, after accounting for potentially influential factors.

Achieving only your aerobic activity goal was associated with a 36% lower risk, after accounting for potentially influential factors, while achieving only your muscle-strengthening goal was not associated with any significant difference in risk.

In terms of quantity, increasing 10149, 150300 and 301600 minutes/week of aerobic physical activity was associated with 21%, 41% and 50% lower risks, respectively, compared with none. But no additional benefit beyond the 600 minutes per week was seen.

While [10-150 mins/week] is often labeled insufficient because it falls below the recommended duration, may confer health benefits over physical inactivity, the researchers suggest.

When it came to muscle-strengthening activities, compared with fewer than 2 sessions per week, achieving a 2-week goal was associated with a 47% lower risk, but 7 or more sessions were associated with a 41% higher risk.

While beyond the scope of this study, plausible explanations [for this dichotomy] range from imprecise responses (such as reporting occupational physical activity, which may not confer the same protective effect as leisure physical activity) to the hemodynamic ramifications of frequent, high-intensity [muscle strengthening activity]the researchers explain.

This is an observational study and, as such, cannot establish a cause, beyond which the researchers acknowledge various limitations.

For example, the study was based on personal and point-in-time recollection; the NHIS survey only found leisure-time physical activity in periods of 10 minutes or more, nor did it distinguish between light- and moderate-intensity activity.

However, the researchers conclude: Efforts to reduce influenza and pneumonia mortality among adults could focus on decreasing the prevalence of aerobic inactivity and increasing the prevalence of achieving 2 episodes/wk of muscle-strengthening activity.

Learn about this exercise and health research news

Author: Caroline White
Source: BMJ extension
Contact: Caroline White – BMJ
Image: The image is credited to Neuroscience News

Original research: Free access.
“Leisure physical activity and mortality from influenza and pneumonia: A cohort study of 577,909 US adults” by Bryant J Webber et al. British Journal of Sports Medicine


Abstract

Recreational Physical Activity and Influenza and Pneumonia Mortality: A Cohort Study of 577,909 US Adults

Goal

To examine the association of leisure-time physical activity with influenza and pneumonia mortality.

Methods

A nationally representative sample of U.S. adults (age 18 and older) who participated in the National Health Interview Survey from 1998 to 2018 were followed for mortality through 2019. Participants were classified as compliant with both physical activity guidelines if they reported 150 minutes/week of moderate-intensity aerobic equivalent physical activity and 2 episodes/week of strength-training activity. Participants were also classified into five categories based on the volume of self-reported aerobic and muscle-strengthening activity. Influenza and pneumonia mortality was defined as having an underlying cause of death with an International Classification of Diseases, 10th revision code of J09J18 recorded in the National Death Index. Mortality risk was assessed using Cox proportional hazards, adjusting for sociodemographic and lifestyle factors, health status, and influenza and pneumococcal vaccination status. The data was analyzed in 2022.

Results

Among 577,909 participants followed for a median of 9.23 years, 1516 deaths from influenza and pneumonia were recorded. Compared with participants who did not meet either guideline, those who met both guidelines had a 48% lower adjusted risk of flu and pneumonia mortality. Compared with no aerobic activity, 10149, 150300, 301600 and >600 min/week were associated with a lower risk (by 21%, 41%, 50% and 41%). Compared with <2 episodes/week of muscle-strengthening activity, 2 episodes/week was associated with a 47% lower risk and 7 episodes/week with a 41% higher risk.

Conclusions

Aerobic physical activity, even at amounts below the recommended level, may be associated with lower influenza and pneumonia mortality, while muscle-strengthening activity has demonstrated a J-shaped relationship.

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