Moderate-to-vigorous Intensity Physical Activity Research Articles

Ecological Network Analysis: Utilizing Machine Learning to Unravel the Effects of Multilevel Pathways of Moderate⁃to⁃Vigorous Physical Activity Facilitators Among School Children

ABSTRACT The objective of the present study was to ascertain whether the association between moderate-to-vigorous intensity physical activity (MVPA) levels and individual, interpersonal, organizational, and environmental factors among school children is influenced by their attitudes toward emerging sports participants (ESP). To this end, machine learning (ML) was employed to analyze the data. This cross-sectional study, involved 655 child-parent pairs in Changsha City to assess children’s MVPA. Data were collected via self-administered questionnaires, evaluating MVPA levels and attitudes from children and caregivers. Various statistical models, including random forest and LASSO regression, were utilized for analysis. The study revealed that boys engaged in more MVPA than girls. Most participants liked ESP, with significant teacher support noted. Random forest and LASSO regression models identified key factors influencing MVPA, with notable variability among non-achievers. The gradient boosting machine and K-nearest neighbors models demonstrated similar predictive performance. The final model, comprising 37 parameters, indicated significant relationships between variables, particularly highlighting the importance of school offerings ESP and living near sports field. This study concludes that offering ESP in schools, along with positive modeling and encouragement from caregivers and peers, effectively enhances children’s participation in MVPA. Living near sports field also positively impacts MVPA levels.

A randomized controlled trial adding behavioral counseling to supervised physical activity in people living with and beyond cancer (BOOST-UP-): a study protocol for a live remotely-delivered behavior change intervention

BackgroundFor many people living with and beyond cancer (LWBC), physical activity (PA) declines significantly after supervised PA interventions. The effect of short-term, supervised PA interventions on motivational outcomes and longer-term PA in people LWBC is limited, especially theoretically-based approaches to identify key motivational outcomes for behavior change. The purpose of this study is to compare the effects of a 6-month virtual supervised PA group plus standard exercise counseling (PA + EC) versus a virtual supervised PA plus motivationally-enhanced behavioral counseling (PA + BC) group on moderate-to-vigorous intensity PA (MVPA) in people LWBC.MethodsThis study is a two-armed, multi-site randomized controlled trial (RCT). People LWBC will be recruited and randomized to a 6-month virtual supervised PA intervention plus standard exercise counseling (PA + EC group; n = 118) or a 6-month virtual supervised PA plus behavioral counseling based on the Multi-Process Action Control (M-PAC) framework (PA + BC group; n = 118). Supervised PA will be delivered via synchronous Zoom classes that tapers to a home-based protocol at the end of the study. The goal of both groups is to gradually increase PA to the cancer PA guidelines (e.g., 90 min of MVPA/week). The PA + BC group will receive twelve behavioral counseling sessions with a qualified exercise professional (QEP), and the corresponding counseling session will be delivered bi-weekly. The behavioral counseling sessions will be based on the M-PAC’s reflective, regulatory, and reflexive processes. In addition to the supervised PA classes, the PA + EC (i.e., attention control group) will receive twelve standard PA counseling sessions based on PA training principles. People LWBC will complete measures at baseline, midpoint, post-intervention (6-months), at 6-months follow-up, and 1-year follow-up. Self-reported measures include quality of life (QoL), motivational outcomes, health economics, and patient satisfaction. Objective measures include PA via accelerometry. Multilevel modelling will examine change in the primary (i.e., PA) and secondary outcomes (i.e., motivational outcomes from the M-PAC, physical function, QoL) at the five time points.DiscussionThis study will create greater understanding on efficacious programming to support PA maintenance that can be used by clinical and community-based organizations as a low-cost, supportive care tool to improve health outcomes for people LWBC.Trial registrationClinicaltrials.gov ID NCT06624930.

Spillover effect of a dietary intervention on physical activity in a randomized controlled trial with colorectal cancer patients

BackgroundRandomized controlled studies (RCTs) targeting dietary changes may also lead to other, untargeted changes in lifestyle habits, as spillover effects. In particular, the isolated impact of the dietary intervention may be difficult to separate due to spillover effects from changes in physical activity and physical function. Therefore, the aim of this study was to investigate the spillover effect of a one-year dietary intervention in post-surgery colorectal cancer patients by comparing the changes in physical activity and physical function between the diet intervention group and the control group in a randomized controlled trial, called the CRC-NORDIET study.MethodsMen and women, aged 50–80 years were randomized into either the intervention group (n = 240) or the control group (n = 229). Both groups received similar incentives on physical activity. Activity sensors were used to collect data on physical activity at baseline, 6 months, and 12 months. Physical function was estimated by results from handgrip strength, 30 s sit-to-stand test and 6-min walking test. Anthropometric measurements and body composition were also measured.ResultsWe found a significantly higher increase in moderate-to-vigorous intensity physical activity (MVPA) of 0.18 h per day from baseline to 6 months in the diet intervention group compared to the control group, respectively. However, the spillover effect of the dietary intervention on physical activity diminished to 0.10 h per day at 12 months follow-up which was not statistically significantly different (p = 0.24) from the control group. All measures of physical function increased in both groups from baseline to 6 months with no further increase at the 12-month follow-up.ConclusionsThe dietary intervention did not induce a significant spillover effect on physical activity after 12 months of baseline, which was the main timepoint of the intervention. Providing identical physical activity guidance to both study groups during the 12-month intensive dietary intervention period, ensured comparable levels of physical activity across both study groups. This approach facilitated the isolation and analysis of the dietary intervention's effects on primary endpoints, as well as effects of behaviour interventions in secondary preventions, such as the CRC-NORDIET study.Trial registrationThe study is registered on the National Institutes of Health Clinical Trials website (www.ClinicalTrials.gov; Identifier: NCT01570010).

Interactions Between Sedentary Behaviour, Moderate-Vigorous Intensity Physical Activity and Acute Psychological Stress-Induced Inflammatory Responses.

Psychological stress, physical activity (PA) and sedentary behaviour (SB) are modifiable risk factors for cardiovascular disease (CVD), possibly through altering one's inflammatory profile. The links between inflammatory responses to acute psychological stress and habitual moderate-vigorous physical activity (MVPA) levels and SB volume is not clear. We explored the relationships in the magnitude of inflammatory responses to passive and active psychological stress with habitual MVPA and SB levels. Eighty-eight healthy participants completed this study. Habitual MVPA and SB volume were measured over 1week using wearable devices. The main trial consisted of a baseline period, a 6-min passive (International Affective Picture System: IAPS) and an 8-min active stress task (Paced Auditory Serial Addition Test: PASAT) with 45-min rest post-tasks. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured throughout the testing protocol. Blood samples were collected after each time point to measure circulating and lipopolysaccharide (LPS)-stimulated interleukin-6 (IL-6), systemic inflammation response index (SIRI) and the neutrophil:lymphocyte ratio (NLR). There was a significant positive relationship between changes in HR during the IAPS and habitual SB (B=1.061; p=0.008). There were no relationships between the change in SBP or DBP during the IAPS and habitual SB (all p>0.05). There were no relationships between acute psychological stress-induced circulating IL-6, LPS-stimulated IL-6, NLR or SIRI and habitual MVPA or SB levels. This is the first study to investigate passive psychological stress-induced responses in the context of SB and builds on previous work in relation to SB and inflammatory responses to active stress. We found no associations between the inflammatory response to a passive or active psychological stress task and SB or MVPA levels in healthy young adults, but since our participants were very lean (21.7% body fat), findings may differ in other populations.

Goal conflict and the physical activity intention-behavior relationship: Insights from a study of People's daily experiences.

Goal conflict and the physical activity intention-behavior relationship: Insights from a study of People's daily experiences.

A Telehealth Physical Therapy Intervention to Increase Physical Activity in Adults With Knee OA: The Delaware PEAK Randomized Controlled Trial.

OBJECTIVE: To evaluate whether a remotely delivered physical therapy exercise and education intervention with daily step goals increased moderate- to vigorous-intensity physical activity (MVPA) compared to a control. DESIGN: Assessor-blinded superiority randomized controlled trial with 2 parallel arms. METHODS: We included adults from the United States who met the National Institute for Health and Care Excellence osteoarthritis (OA) criteria. Participants were randomized to the intervention of five 45- to 60-minute video conferencing consultations with a physical therapist for strengthening exercises, step goals, and education over 12 weeks or a control of OA web-based resources. The primary outcome was change in MVPA over 12 weeks (measured with ActiGraph GT3X). The secondary and exploratory outcomes were changes in light-intensity physical activity, steps/day, treatment beliefs, pain, function in activities of daily living, function in sports and recreation, and quality of life over 12 and 24 weeks. RESULTS: Of 103 participants who were randomized, 88 had monitor data at baseline and 67 (76% of 88) had monitor data at 12 weeks. There were no between-group differences in MVPA change over 12 weeks (between-group difference, -1.8 min/day; 95% confidence interval: -7.0, 3.3), change in light-intensity physical activity, or steps/day. Pain and function improved more with the intervention group compared to the control. A greater number of intervention participants (n= 44) reported nonserious adverse events than the control group (n =10). CONCLUSION: Incorporating daily step goals into a telehealth strength exercise and education program for people with knee OA did not increase MVPA. J Orthop Sports Phys Ther 2025;55(5):1-9. Epub 20 March 2025. doi:10.2519/jospt.2025.13132.

The Associations Between Parental-Reported and Device-Based Measured Outdoor Play and Health Indicators of Physical, Cognitive, and Social-Emotional Development in Preschool-Aged Children.

Examine in preschool-aged children: (1)the associations between parental-reported and device-measured outdoor play (OP) and health indicators of physical, cognitive, and social-emotional development and (2)whether associations were independent of outdoor moderate- to vigorous-intensity physical activity (MVPA). This cross-sectional study included 107 participants. Children's OP was measured via a parental questionnaire and the lux feature of accelerometers. Children's growth, adiposity, and motor skills were assessed as physical development indicators. Visual-spatial working memory, response inhibition, and expressive language were assessed as cognitive development indicators. Sociability, prosocial behavior, internalizing, externalizing, and self-regulation were assessed as social-emotional development indicators. Regression models were conducted that adjusted for relevant covariates. Additional models further adjusted for outdoor MVPA. Parental-reported total OP, OP in summer/fall months, and OP on weekdays were negatively associated (small effect sizes) with response inhibition and working memory. After adjusting for outdoor MVPA, these associations were no longer statistically significant. OP on weekdays was negatively associated with externalizing (B = -0.04; 95% confidence interval, -0.08 to -0.00; P = .03) after adjusting for outdoor MVPA. A similar pattern was observed for device-based measured total OP (B = -0.49; 95% confidence interval, -1.05 to 0.07; P = .09). Future research in preschool-aged children should take into account MVPA and contextual factors when examining the association between OP and health-related indicators.

Associations of Accelerometer-Measured Sedentary Behavior and Gray Matter Volume in Healthy Young Adults.

Sedentary lifestyles can be seen as one of the central risk factors for poor health in the 21st century. Previous studies indicated negative associations between sedentary behavior and brain health. However, the neurological link between sedentary behavior and gray matter volume remains unclear. This study aimed to assess the relationship between device-based measured sedentary time and gray matter volume in healthy young adults. A total of 181 participants wore a move-II hip-accelerometer to measure sedentary time and physical activity over seven consecutive days. Following the study week, participants underwent a structural magnetic resonance imaging (MRI) scan to assess gray matter volume. Whole-brain voxel-based morphometry analysis was conducted on the MRI data, and group comparisons focused on a region of interest to examine the potential association of moderate-to-vigorous intensity physical activity (MVPA). On a daily average, participants spent 6.04h (SD=2.2) in sedentary and 1.2h (SD=0.51) in MVPA. More sedentary time was associated with lower gray matter volume in the left superior frontal gyrus (pFWE=0.007). Furthermore, participants with high levels of MVPA demonstrated higher gray matter volume in the left (pFWE=0.028) and right (pFWE=0.022) superior frontal gyrus compared to the sedentary group with low MVPA engagement. Sedentary behavior may be linked to smaller gray matter volume in brain structure, particularly in the superior frontal gyrus, which plays an important role in motor and cognitive brain networks. Intriguingly, people with high sedentary behavior but concurrently high levels of MVPA did not exhibit this negative gray matter association.

Association Between Volume, Intensity and Rhythm of Physical Activity Measured by Accelerometer and Risk of All-Cause and Cause-Specific Mortality in Individuals With MASLD.

Individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) have a higher mortality risk, and physical activity is important to MASLD management. However, a comprehensive exploration of associations of volume and intensity of physical activity and rest-activity rhythm (RAR) based on an accelerometer with all-cause and cause-specific mortality in MASLD individuals was scarce. We included 10,143 individuals with MASLD from the UK Biobank. Volume and intensity of physical activity [low-intensity physical activity (LPA), moderate-to-vigorous-intensity physical activity (MVPA) and sedentary time] and RAR (amplitude, mesor, pseudo-F statistics and acrophase) were computed from accelerometer data. The Cox proportional hazards model was used to estimate the relationships of volume and intensity of physical activity and RAR with all-cause, cardiovascular disease (CVD) and cancer mortality risk in individuals with MASLD and further in common subtypes of cardiometabolic abnormalities. The population attributable risk and relative importance of physical activity were estimated. Higher LPA, MVPA and normal RAR (amplitude and mesor) were associated with decreased risk of all-cause and CVD mortality among individuals with MASLD (HRs: 0.712-0.805), especially of all-cause mortality in those with common subtypes of more than two metabolic abnormalities (overweight/obesity-elevated blood pressure-hyperlipidemia and all the four abnormalities). Furthermore, we found MVPA and amplitude represented relatively important contributors to all-cause and CVD mortality risk in individuals with MASLD. In individuals with MASLD, a higher volume and intensity of physical activity, as well as normal RAR supported lower all-cause and CVD mortality risk, which provided insights for management guidelines.

Predicting sport and physical activity commitment and participation during early parenthood

ABSTRACT Despite considerable benefits of regular moderate-to-vigorous intensity physical activity (MVPA) and sport participation, adult participation rates remain low. Drawing from the sport commitment model (SCM), the purpose of this study was to examine predictors of sport commitment and MVPA, among parents of children (<13 years of age) across 3-months. Participants were randomly assigned to a team sport (n = 58, asked to select and participate in an adult team sport program), individual PA (n = 60, asked to select and participate in individual PA) or control (n = 66, asked to select a “date-night” activity) group and completed measures of the SCM (commitment, enjoyment, involvement opportunities, social constraints, investment, involvement alternatives) and self-reported MVPA at baseline, and post-randomization at six weeks and three months. Commitment and investment were significant predictors of MVPA over time, and enjoyment, involvement alternatives, and investment predicted commitment over time, controlling for group assignment. Individuals assigned to the team sport group reported greater commitment and investment at week 6 compared to the control group and higher investment partly mediated the relationship with MVPA. Interventions fostering enjoyment, and that can help support parents to make an investment to build commitment in sport and PA may be particularly effective when promoting MVPA in this population.

Compositional associations of 24-h physical activities, sedentary time and sleep with depressive symptoms in urban and rural residents: a cross-sectional study

BackgroundStudies investigating the associations of 24-h movement behaviours (including moderate-to-vigorous-intensity physical activity (MVPA), light-intensity PA (LPA), sedentary time (ST) and sleep) with depressive symptoms are scarce. It is also unclear whether possible associations differ between urban and rural residents. Hence, we aimed to investigate these associations in a population-based sample of middle-aged Finnish adults.MethodsThe study population consisted of 4295 adults, aged 46 years, from the Northern Finland Birth Cohort 1966. The participants wore a hip-worn accelerometer for 14 days. Time spent in sedentary, LPA and MVPA was obtained from accelerometer data and then combined with self-reported sleep duration to obtain the 24-h composition. The residential environment was classified as urban or rural based on the participants’ home addresses. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Multivariable adjusted regression analysis using a compositional data analysis approach based on isometric log-ratio transformation was used to determine the associations between movement behaviours and depressive symptoms in urban and rural residential environments.ResultsThe 24-h movement behaviour composition was significantly associated with the BDI-II score both in urban and rural residential environment. More time spent in sleep relative to other behaviours was associated with lower BDI-II score in rural residential environments. More time spent in ST among urban residents and in LPA among rural residents was associated with higher BDI-II scores. When modelling pairwise reallocations of time, more MVPA or more sleep at the expense of LPA or ST was associated with lower BDI-II score among rural residents. For urban residents, reallocating time from ST to any other behaviour was associated with lower BDI-II score.ConclusionsOur findings showed that more relative time spent in MVPA and sleep was associated with lower levels of depressive symptoms among rural residents, and more relative time spent in any other behaviour at the expense of ST was associated with lower levels of depressive symptoms among urban residents. These differences should be considered in the prevention and treatment of depressive symptoms. Due to the cross-sectional design of this study, causality cannot be inferred, and further research exploring the mechanisms underlying these associations in diverse populations and longitudinal study settings are needed.

Adolescent Time Use and Cardiometabolic Health: A Cross-Sectional Compositional Analysis to Explore Associations Between 24-Hour Activity Behaviors and Biomarkers of Cardiometabolic Health.

Adolescent Time Use and Cardiometabolic Health: A Cross-Sectional Compositional Analysis to Explore Associations Between 24-Hour Activity Behaviors and Biomarkers of Cardiometabolic Health.

Interaction of accelerometer-measured physical activity and genetic risk on cardiovascular diseases: a prospective cohort study from UK Biobank.

This study aimed to evaluate the interactions of physical activity and polygenic risk score (PRS) on risks of atrial fibrillation, coronary heart disease (CHD), hypertension, and ischaemic stroke. This study included 91 629 participants from UK Biobank in this study, all of whom had worn a wrist-worn accelerometer for 7 consecutive days. We computed total volume of physical activity (TPA) and time spent in moderate to vigorous intensity physical activity (MVPA) and light intensity physical activity (LPA). Cox proportional hazard models were used to evaluate associations of physical activity with the four cardiovascular outcomes. Interactions between physical activity and PRS were investigated on multiplicative and additive scales. During a median follow-up of 7.9 years, 3811 atrial fibrillation, 3994 CHD, 7345 hypertension and 1001 ischaemic stroke cases were recorded. TPA, MVPA and LPA were all negatively associated with risks of the four cardiovascular outcomes, generally independent of genetic risk. Association between LPA and atrial fibrillation was U-shaped among low-PRS stratum (p=0.01), and association between TPA and hypertension was attenuated with genetic risk increasing (p=0.02). Attributable risk (AR) of inactivity was higher in the high-PRS population. For example, increasing MVPA resulted in a twofold greater reduction in CHD cases among individuals with high PRS (AR=2.17%) than among those with low PRS (AR=1.09%). Increasing physical activity, including LPA, was associated with a reduced risk of cardiovascular diseases. The extent of this benefit may differ among individuals with different genetic risks.

International Delphi study of clinical and exercise professionals’ opinion of physical activity prescreening and contraindications for participating in postpartum physical activity

ObjectiveTo establish expert consensus on prescreening and contraindications to moderate-to-vigorous intensity physical activity (MVPA) during the first year postpartum.MethodsA Delphi survey of clinical and exercise professionals working with postpartum women...

Amount and intensity of daily total physical activity, step count and risk of incident cancer in the UK Biobank

ObjectivesTo investigate associations between daily physical activity, activity intensity and step counts with incident cancer risk.MethodsProspective analysis of UK Biobank participants who wore wrist-based accelerometers for 7 days, followed for...

Children with high actual and perceived motor skill competence are more physically active: A pooled latent profile analysis of cross-sectional data

ABSTRACT The aim was to determine profiles according to actual and perceived motor competence and provide a comparison of profiles according to moderate-to-vigorous-intensity physical activity (MVPA) in children. Cross-sectional data were pooled from four Australian studies (481 children, 54.5% boys; 3.5 to 11.7 years). Motor skill competence, total, object control and locomotor (Test of Gross Motor Skill Development [TGMD)]), perceived motor skill (pictorial scale of Perceived Movement Skill Competence [PMSC]) and MVPA (ActiGraph data) were assessed. Latent profile analyses identified actual and perceived skill profiles and covariate-adjusted associations with MVPA were then assessed for all children, for boys and girls. For total skills, the two-profile solution was the best fit for all children (81% ‘high aligned’, i.e., high perception, high skills; 19% ‘low aligned, i.e., low perception, low skills’) and for girls (71% ‘high aligned’; 29% ‘low aligned’). For boys, a three-profile solution was the best fit (49% ‘under perceiver’- low perception, high skills; 42% ‘over perceiver’ - high perception, low skills; 9% ‘low aligned’). For the total skill, children in the ‘high aligned’ profile (65.3 minutes) were 14.6 minutes/day more active than the “low aligned” profile (50.8 minutes). Intervention efforts should focus on the “low aligned” profile to increase physical activity.

Social Determinants of Health and Parent and Child Physical Activity: A Cross-Sectional and Longitudinal Exploration among Socioeconomically and Racially and Ethnically Diverse Families.

PurposeTo examine the associations between baseline social determinants of health (SDOH) and physical activity (PA) in children and parents cross-sectionally (baseline) and longitudinally (18-months later).DesignCross-sectional and longitudinal.SettingFamily Matters Cohort Study, Minneapolis-St. Paul, Minnesota.SampleParents with children aged 5-9 years (n = 1146).MeasuresParent self-reported (1) 25 SDOH factors mapped across 5 domains and (2) parent and children moderate-to-vigorous intensity physical activity (MVPA).AnalysisAdjusted linear regression models.ResultsEach of the SDOH domains were positively associated with parents and children MVPA levels (all P < 0.05), except Economic Stability (all P > 0.05). Families with high family functioning reported higher MVPA among children, cross-sectionally (β 1.27; 95% CI [0.67, 1.87]) and longitudinally (β 0.87; 95% CI [0.29, 1.46]). Parents exhibited higher levels of MVPA both cross-sectionally (β 0.66; 95% CI [0.11, 1.21]) and longitudinally (β 0.73; 95% CI [0.21, 1.26]) when they had greater social capital. Children also exhibited increased MVPA (β 1.10; 95% CI [0.41, 1.79]) when living in areas with high walkability to recreational places.ConclusionResults indicate that SDOH may shape the PA habits of parents and children in a racially/ethnically diverse population. To advance health equity and support engagement in PA, researchers and clinicians should take into consideration SDOH factors related to a family's educational, social, home, family functioning, and neighborhood environments.

Do publicly funded community physical activity programs for middle-aged and older adults in Ireland work?

To strengthen practice-based evidence, pragmatic, yet rigorous, evaluation of real-world programs is necessary. This study sought to add to the evidence for the effectiveness of physical activity programs for middle-aged and older adults offered by publicly funded local sports partnerships (LSPs) in Ireland. We analysed data from 468 individuals aged 50 + years, who took part in the Move for Life cluster randomised feasibility trial. Outcomes were accelerometer-based moderate-to-vigorous intensity physical activity (MVPA), light intensity physical activity (LiPA), standing time, and sedentary time; self-reported compliance with physical activity guidelines, body composition, physical function, and mental well-being. LSP programs included Women on Wheels/Bike for Life, Go for Life Games, Get Ireland Walking, and Men on the Move. We used a difference-in-differences approach to estimate program effects. We found evidence of positive program effects on accelerometer-derived MVPA (Women on Wheels/Bike for Life, Get Ireland Walking), LiPA (Go for Life Games), and sedentary time (Women on Wheels/Bike for Life, Go for Life Games) (p < .05), plus evidence of positive effects on self-reported physical activity for all LSP programs (p < .05). We did not find evidence of program effects on body composition. Outcomes related to physical function were mixed. Men on the Move was the only program where mental well-being scores increased significantly relative to the control group. Despite sample size limitations, the results support the effectiveness of LSP programs over a 6-month period, notably in terms of energy expenditure outcomes, while identifying areas for improvement regarding outcomes related to body composition, physical function and, particularly, mental well-being.

MVPA as the most influential factor for myocardial infarction through Bayesian Mendelian randomization among 11 behaviors.

The causal associations between behavioral factors (BF) and myocardial infarction (MI), as well as the potential mediators and dose-response relationships, are incompletely clear. Therefore, this study aimed to evaluate the association of 11 BF with MI. We used two-sample Mendelian randomization (2SMR) to investigate he associations between BF and MI and applied a two-sample multivariable MR approach based on Bayesian model averaging (MR-BMA) to prioritize the BF identified by 2SMR. For significant BF, we conducted extra conducted mediation analysis and restricted cubic spline (RCS) analysis to reveal potential mediating pathways and their dose-response relationships. Furthermore, we conducted replication analysis and meta-analysis to further support the results. Among 11 BF, 2SMR identified 3 BF that were significantly associated with MI. Among them, MR-BMA identified moderate to vigorous intensity physical activity (MVPA) (Marginal inclusion probability (MIP) = 0.77) as the most influential factor. A potential mechanism underlying the MVPA-MI association was waist-hip ratio (WHR, 7.26%). RCS analysis further revealed that an MVPA of 1094-2043 MET minutes/week was associated with the lowest risk of MI. Finally, replication analysis and meta-analysis further supported the 3 BF and identified an extra association between tea intake and MI risk (Meta: OR = 0.991, P = .003). Of the 11 BF, MVPA was the most influential factor independently associated with the reduced risk of MI, with WHR mediating this association. At least 39minutes of MVPA per day is recommended to reduce the risk of MI. In addition, tea intake is a potential protective factor for MI that warrants further investigation. Key messages What is already known on this topic? Previous studies have shown an association between behavioral factors and the risk of myocardial infarction (MI). However, the exact causal relationship, which behavioral factors is most influential for MI, and the potential dose-response relationship are incompletely clear. Mendelian randomization can provide genetic evidence of causal associations and reveal the underlying mechanisms. What this study adds? This study provides novel genetic evidence that smoking initiation, leisure sedentary time, and moderate to vigorous intensity physical activity (MVPA) are associated with MI. MVPA is the most influential factor. Only MVPA is independently associated with MI, and waist-to-hip ratio mediated the association. In addition, we found that at least 39minutes of MVPA per day resulted in the greatest reduction in MI. Finally, we also found a potential protective effect of tea drinking on MI. How this study might affect research, practice, or policy? This study suggests that MVPA is independently associated with MI. In addition, this provides a basis for clinical exercise intervention. Finally, these results respond to the policy that "exercise is medicine", providing new insights into the advancement of that slogan.

Wearable device-measured physical activity and incident cardiovascular disease in cancer survivors

ObjectiveTo explore the association of wearable device-measured moderate-to-vigorous intensity physical activity (MVPA) with cardiovascular disease (CVD) risk in long-term cancer survivors.MethodsThis retrospective analysis involved a prospective cohort of 6109 cancer...