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

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• Consider the use of wearables to measure physical activity levels and facilitate behaviour change.

• Encourage a variety of physical activity to include vigorous and moderate intensities due to increased risk reduction equivalence per minute compared to light physical activity. One minute of vigorous activity is equivalent to 4-9 minutes of MA and 53-156 minutes of LA.

• Health practitioners may consider recommending lifestyle behaviour change to include vigorous activity to populations who are at high risk

Introduction:

A dose-response relationship between physical activity (PA) intensity and risk reduction of non-communicable disease and mortality is well-reported. Current recommendations for the amount of PA at different intensities rely on non-empirical data such as self-reports, where each minute of vigorous activity is given twice the weight of moderate intensity activities. With the emergence of wearable device-based data, this study aims to determine the equivalence of different PA intensities and examine them against a range of mortality and health outcomes.

Methods:

• This prospective cohort study included 73,485 UK Biobank adults wearing an accelerometer on their dominant wrist continuously for 7 days, aged 40-69 at baseline, mean age of 61.6.

• 41,420 (56.4%) females and 32,065 (43.6%) males gave informed consent. Ethical approval was granted (Ref:11/NW/0382).

• PA intensities were categorised into light PA (LPA), moderate PA (MPA) and vigorous PA (VPA) using a validated 2-stage machine learning-based classification system. The equivalent of LPA and MPA against VPA was examined against a range of key mortality, cardiometabolic and cancer related outcomes.

Results.

• The sample included 2675 all-cause mortality (ACM) events, 545 cardiovascular disease (CVD) mortality events, 2359 major adverse cardiovascular events (MACE), 1836 Type 2 diabetes (T2D) events, 538 PA related cancer mortality events and 2662 PA related cancer incidence events.

• Findings show that, based on evidence from wearable devices, 1 minute of VPA is associated with risk reduction levels comparable to 4-9 minutes of MPA and 53-156 minutes of LPA, dependent on cause of mortality and health outcomes.

• For a standardised 5%–35% risk reduction in mortality and health outcomes measured in this study, the median MPA equivalent per minute of VPA for ACM = 4.1 (95% CI: 4.1–4.2), CVD mortality = 7.8 (7.7-8.0), MACE = 5.4 (5.3–5.5), T2D = 9.4 (9.3-9.6), and cancer mortality = 3.5 (3.4-3.5) and PA related cancer incidence = 1.6 minutes.

• For non-cancer outcomes, the median LPA equivalent per minute of VPA was ACM = 53 minutes, CVD = 72.5 minutes, MACE = 86.1 minutes and T2D = 94 minutes.

Conclusion

PA prescription and personalised health initiatives may be supported by wearables and integrating device-based equivalence on PA intensity.

• Using device-based evidence on the health equivalence of different PA intensities, suggests that the current convention of 1 minute of VPA:2 minutes of MPA is low.

• Findings support the use of wearables to monitor physical activity levels, which may help to inform lifestyle interventions and facilitate behaviour change.

• Moderate and vigorous physical activity, where appropriate, may be considered as a more effective and time-saving strategy than light intensity to lower the risk of many lifestyle-related chronic diseases, particularly for those at high risk or those who are time-poor.

• Physical activity can include daily activities such as stair climbing, house maintenance, gardening and walking with short bursts of more intense activity, as well as a wide range of other types of exercise.

•Randomised controlled trials of physical activity interventions to evaluate the effects of different types and intensity of physical activity on cardiometabolic parameters and other relevant biomarkers in different age categories.

• Interventions using different types of wearables to measure physical activity levels, which may facilitate behaviour change and reduce the risk of a range of key mortality, cardiometabolic and cancer related outcomes