Abstract
Background
Current physical activity guidelines recommend 150-300 min/week of moderate-to-vigorous physical activity (MVPA) to improve health. However, whether brief, sporadic MVPA can be included within this recommended dose remains unclear.
Methods
In a cohort study, we analyzed data from 96,054 UK Biobank participants whose MVPA was objectively measured by accelerometers at baseline between 2013 and 2016. The primary outcome was all-cause mortality, with follow-up through 2022. A machine learning algorithm, trained on ground-truth camera data, was employed to differentiate between sporadic and bouted MVPA.
Results
During a follow-up period of 8.0 years, 3586 deaths and 4948 incident cardiovascular disease events are identified. Compared to the least active individuals (65 min/week of sporadic MVPA at 10th percentile), those accumulating 150 and 300 min/week of sporadic MVPA have 48% (95% confidence interval [CI]: 44% to 52%) and 50% (95% confidence interval [CI]: 41% to 57%) lower all-cause mortality, respectively. For bouted MVPA, compared to the least active individuals (38 min/week of bouted at 10th percentile), those accumulating 150 and 300 min/week of bouted MVPA have 33% (95% CI: 29% to 37%) and 49% (95% CI: 44% to 53%) lower all-cause mortality, respectively. In joint analysis, optimal health benefits are observed in individuals who incorporated both bouted and sporadic MVPA, rather than merely accumulating additional sporadic MVPA beyond 150 min/week.
Conclusions
In conclusion, meeting the minimum physical activity recommendation through accumulating brief, sporadic MVPA is supported. Incorporating bouted MVPA, rather than accumulating additional sporadic MVPA beyond 150 min/week, may confer further health benefits.
Plain language summary
The health benefits of brief, sporadic physical activity are increasingly recognized. However, it is still unclear how many minutes of sporadic physical activity per week are needed for health benefits. In this study, we analyzed a large cohort of 96,054 participants from the United Kingdom. To align with current physical activity guidelines, we focused on activity at or above moderate intensity, known as moderate-to-vigorous physical activity (MVPA). We found that higher levels of sporadic MVPA were associated with lower risks of death from all causes and lower risk of cardiovascular diseases. Maximal benefits of sporadic MVPA are gained when MVPA is 150 min/week. Further increases in sporadic MVPA did not provide appreciable additional benefits.
Similar content being viewed by others
Data availability
UK Biobank data are available to eligible researchers via the formal application process described at https://www.ukbiobank.ac.uk/enable-your-research, and the datasets analyzed in this study can be requested through this route. The Capture-24 dataset can be freely accessed at https://ora.ox.ac.uk/objects/uuid:99d7c092-d865-4a19-b096-cc16440cd00149. The numerical source data underlying the main-figure graphs and charts are provided as Supplementary Data and are labeled sequentially. Specifically, the source data for Fig. 1 is in Supplementary Data 1; the source data for Fig. 2 is in Supplementary Data 2; the source data for Fig. 3 is in Supplementary Data 3; and the source data for Fig. 4 is in Supplementary Data 4.
Code availability
The R code implementing the algorithm to capture bouted moderate-to-vigorous physical activity, along with all project scripts for preprocessing, analysis, and figure generation, is available at: https://figshare.com/articles/online_resource/Sporadic_bout_CommMed_code/3085762750. The code is free to use for non‑commercial purposes; for other uses, please contact the corresponding authors.
References
Berra, K., Rippe, J. & Manson, J. E. Making physical activity counseling a priority in clinical practice: the time for action is now. JAMA 314, 2617–2618 (2015).
Piercy, K. L. et al. The physical activity guidelines for Americans. JAMA 320, 2020–2028 (2018).
Bull, F. C. et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br. J. Sports Med. 54, 1451–1462 (2020).
Arem, H. et al. Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern. Med. 175, 959–967 (2015).
Martinez-Gomez, D. et al. Long-term leisure-time physical activity and risk of all-cause and cardiovascular mortality: dose-response associations in a prospective cohort study of 210 327 Taiwanese adults. Br. J. Sports Med. 56, 919–926 (2022).
Moore, S. C. et al. Leisure time physical activity of moderate to vigorous intensity and mortality: a large pooled cohort analysis. PLoS Med. 9, e1001335 (2012).
Lear, S. A. et al. The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet 390, 2643–2654 (2017).
Derdeyn, C. P. et al. Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial. Lancet 383, 333–341 (2014).
O’Connor, C. M. et al. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA 301, 1439–1450 (2009).
Hambrecht, R. et al. Percutaneous coronary angioplasty compared with exercise training in patients with stable coronary artery disease: a randomized trial. Circulation 109, 1371–1378 (2004).
Knowler, W. C. et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 346, 393–403 (2002).
Loh, R., Stamatakis, E., Folkerts, D., Allgrove, J. E. & Moir, H. J. Effects of interrupting prolonged sitting with physical activity breaks on blood glucose, insulin and triacylglycerol measures: a systematic review and meta-analysis. Sports Med. 50, 295–330 (2020).
Saunders, T. J. et al. The acute metabolic and vascular impact of interrupting prolonged sitting: a systematic review and meta-analysis. Sports Med. 48, 2347–2366 (2018).
Jefferis, B. J. et al. Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: Does volume of activity matter more than pattern of accumulation?. Br. J. Sports Med. 53, 1013–1020 (2019).
Saint-Maurice, P. F., Troiano, R. P., Matthews, C. E. & Kraus, W. E. Moderate-to-vigorous physical activity and all-cause mortality: Do bouts matter? J. Am. Heart Assoc. 7, e007678 (2018).
Troiano, R. P. et al. Physical activity in the United States measured by accelerometer. Med. Sci. Sports Exerc. 40, 181–188 (2008).
Wang, X. & Ma, T. Flexible goals for daily step count: associations between sporadic and bouted steps and all-cause mortality. J. Phys. Act. Health 22, 1051–1058 (2025).
Rowlands, A. V. et al. Intensity modifies the association between continuous bouts of physical activity and risk of mortality: a prospective UK Biobank cohort analysis. J. Sport Health Sci. 15, 101078 (2025).
Schwendinger, F. et al. Intensity or volume: the role of physical activity in longevity. Eur. J. Prev. Cardiol. 32, 10–19 (2025).
Wanigatunga, A. A. et al. Association of total daily physical activity and fragmented physical activity with mortality in older adults. JAMA Netw. Open 2, e1912352 (2019).
Cai, Y., Ma, T., Sirard, J., Pang, M. Y. C. & Xie, Y. J. Move more beneficially: physical activity variability as a novel metric of physical activity pattern and an independent predictor of mortality and chronic disease incidence. Scand. J. Med. Sci. Sports 35, e70124 (2025).
Chan, S. et al. CAPTURE-24: a large dataset of wrist-worn activity tracker data collected in the wild for human activity recognition. Sci. Data 11, 1135 (2024).
Littlejohns, T. J., Sudlow, C., Allen, N. E. & Collins, R. UK Biobank: opportunities for cardiovascular research. Eur. Heart J. 40, 1158–1166 (2019).
Sabia, S. et al. Association between questionnaire- and accelerometer-assessed physical activity: the role of sociodemographic factors. Am. J. Epidemiol. 179, 781–790 (2014).
van Hees, V. T. et al. Estimation of daily energy expenditure in pregnant and non-pregnant women using a wrist-worn tri-axial accelerometer. PLoS ONE 6, e22922 (2011).
Doherty, A. et al. Large scale population assessment of physical activity using wrist worn accelerometers: the UK Biobank study. PLoS ONE 12, e0169649 (2017).
Strain, T. et al. Wearable-device-measured physical activity and future health risk. Nat. Med. 26, 1385–1391 (2020).
Fishman, E. I. et al. Association between objectively measured physical activity and mortality in NHANES. Med. Sci. Sports Exerc. 48, 1303–1311 (2016).
Ainsworth, B. E. et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med. Sci. Sports Exerc. 43, 1575–1581 (2011).
White, T. et al. Estimating energy expenditure from wrist and thigh accelerometry in free-living adults: a doubly labelled water study. Int. J. Obes. 43, 2333–2342 (2019).
Ellis, K. et al. A random forest classifier for the prediction of energy expenditure and type of physical activity from wrist and hip accelerometers. Physiol. Meas. 35, 2191–2203 (2014).
Kandola, A. A. et al. Impact of replacing sedentary behaviour with other movement behaviours on depression and anxiety symptoms: a prospective cohort study in the UK Biobank. BMC Med. 19, 133 (2021).
Clarke, J. & Janssen, I. Sporadic and bouted physical activity and the metabolic syndrome in adults. Med Sci. Sports Exerc. 46, 76–83 (2014).
White, D. K., Gabriel, K. P., Kim, Y., Lewis, C. E. & Sternfeld, B. Do short spurts of physical activity benefit cardiovascular health? The CARDIA study. Med. Sci. Sports Exerc. 47, 2353–2358 (2015).
Ekelund, U. et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ 366, l4570 (2019).
Ramakrishnan, R. et al. Objectively measured physical activity and all cause mortality: a systematic review and meta-analysis. Prev. Med. 143, 106356 (2021).
Wahid, A. et al. Quantifying the association between physical activity and cardiovascular disease and diabetes: a systematic review and meta-analysis. J. Am. Heart Assoc. 5, e002495 (2016).
Coffey, V. G. & Hawley, J. A. The molecular bases of training adaptation. Sports Med. 37, 737–763 (2007).
Stamatakis, E. et al. Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality. Nat. Med. 28, 2521–2529 (2022).
Stamatakis, E. et al. Device-measured vigorous intermittent lifestyle physical activity (VILPA) and major adverse cardiovascular events: evidence of sex differences. Br. J. Sports Med. 59, 316–324 (2025).
Stamatakis, E. et al. Untapping the health enhancing potential of vigorous intermittent lifestyle physical activity (VILPA): rationale, scoping review, and a 4-pillar research framework. Sports Med. 51, 1–10 (2021).
Garber, C. E. et al. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med. Sci. Sports Exerc. 43, 1334–1359 (2011).
Oja, P. et al. Associations of specific types of sports and exercise with all-cause and cardiovascular-disease mortality: a cohort study of 80306 British adults. Br. J. Sports Med. 51, 812–817 (2017).
O’Donovan, G., Lee, I. M., Hamer, M. & Stamatakis, E. Association of “weekend warrior” and other leisure time physical activity patterns with risks for all-cause, cardiovascular disease, and cancer mortality. JAMA Intern. Med. 177, 335–342 (2017).
Gao, Z., Liu, W., McDonough, D. J., Zeng, N. & Lee, J. E. The dilemma of analyzing physical activity and sedentary behavior with wrist accelerometer data: challenges and opportunities. J. Clin. Med. 10, 5951 (2021).
Pedišić, Ž & Bauman, A. Accelerometer-based measures in physical activity surveillance: current practices and issues. Br. J. Sports Med. 49, 219–223 (2015).
Gall, N., Sun, R. & Smuck, M. A comparison of wrist-versus hip-worn actigraph sensors for assessing physical activity in adults: a systematic review. J. Meas. Phys. Behav. 5, 252–262 (2022).
Stamatakis, E. et al. Is Cohort Representativeness Passé? Poststratified associations of lifestyle risk factors with mortality in the UK Biobank. Epidemiology 32, 179–188 (2021).
Chan Chang, S. et al. Capture-24: activity tracker dataset for human activity recognition. (University of Oxford, 2021).
Cai, Y. Sporadic_bout_CommMed_code. figshare https://doi.org/10.6084/m9.figshare.30857627 (2025).
Acknowledgements
The authors deeply appreciate the participants of the UK Biobank study and those who handled the data collection and management. This work was conducted under UK Biobank application number 85118. The study is funded by The Start-up Fund for RAPs under the Strategic Hiring Scheme, The Hong Kong Polytechnic University. Grant Number: P0048570.
Author information
Authors and Affiliations
Contributions
Y.C. and T.M. conceived the idea. Y.C. and T.M. wrote the first draft of the report with input from M.Y.C.P., J.S., Y.J.X., Q.Y., C.D.L., X.L., Y.L., and J.L. Y.C. and T.M. did the statistical analysis. X.W. contributed to the development of the machine learning algorithm. T.M. had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. All authors contributed to the critical revision and approved the final version.
Corresponding authors
Ethics declarations
Competing interests
The authors declare no competing interests.
Peer review
Peer review information
Communications Medicine Communications Medicine thanks Fabian Schwendinger and the other, anonymous, reviewers for their contribution to the peer review of this work. A peer review file is available.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Cai, Y., Ma, T., Sirard, J. et al. Data from the UK Biobank demonstrates that increased brief, sporadic moderate-to-vigorous physical activity reduces mortality. Commun Med (2026). https://doi.org/10.1038/s43856-026-01421-z
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s43856-026-01421-z
