Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality.
Wearable devices can capture unexplored movement patterns such as brief bursts of vigorous intermittent lifestyle physical activity (VILPA) that is embedded into everyday life, rather than being done as leisure time exercise. Here, we examined the association of VILPA with all-cause, cardiovascular disease (CVD) and cancer mortality in 25,241 nonexercisers (mean age 61.8 years, 14,178 women/11,063 men) in the UK Biobank. Over an average follow-up of 6.9 years, during which 852 deaths occurred, VILPA was inversely associated with all three of these outcomes in a near-linear fashion. Compared with participants who engaged in no VILPA, participants who engaged in VILPA at the sample median VILPA frequency of 3 length-standardized bouts per day (lasting 1 or 2 min each) showed a 38%-40% reduction in all-cause and cancer mortality risk and a 48%-49% reduction in CVD mortality risk. Moreover, the sample median VILPA duration of 4.4 min per day was associated with a 26%-30% reduction in all-cause and cancer mortality risk and a 32%-34% reduction in CVD mortality risk. We obtained similar results when repeating the above analyses for vigorous physical activity (VPA) in 62,344 UK Biobank participants who exercised (1,552 deaths, 35,290 women/27,054 men). These results indicate that small amounts of vigorous nonexercise physical activity are associated with substantially lower mortality. VILPA in nonexercisers appears to elicit similar effects to VPA in exercisers, suggesting that VILPA may be a suitable physical activity target, especially in people not able or willing to exercise.
Stamatakis 2022は「運動嫌いの人にこそ希望を与える」研究だ。25,241人の非運動者を加速度計で7年追跡し、たった1日3〜4分の高強度短時間活動（VILPA = Vigorous Intermittent Lifestyle Physical Activity）で全死因死亡が38〜40%、心血管死が48〜49%下がった。階段ダッシュ、坂を急ぐ、買い物袋を持って歩く——この程度が「ジムに行かない人の運動」として有効だと初めて示した。
外来でこのデータをどう使うか。私は「忙しくて運動の時間がない」という患者に、まず1週間「どこで早歩き・階段・荷物を持つ機会があるか」を観察してもらう。多くの場合、平日でも合計15〜30分は埋まっている。そこに「あと1分だけ強度を上げる」を足すだけで、研究の閾値に届く。
「30分の運動」を1セットでこなすより、「1〜2分のVILPAを1日に何度も入れる」方が現実的で、続く。エレベーター→階段の置き換えだけでも本当に効く、というのが結論。