What Is VILPA?

VILPA = Vigorous Intermittent Physical Activity

One of the potentially overlooked changes in the 2018 Physical Activity Guidelines for Americans concerns the minimum amount of physical activity that improves health. The old minimum of 10 minutes (unsupported by data) went by the wayside but was not replaced with another number. Recent research suggests that even tiny amounts of daily physical activity, especially if it's strenuous, can enhance health. Even short-duration, everyday activities that people normally do, such as walking upstairs, or cycling to work, or grocery shopping with the bike, performed at a rapid pace across 5-6 days per week, can potentially account for two-thirds of the minimum recommended weekly physical activity – with zero additional time commitment! Thus, busy people who think they don’t have enough time to exercise can get most of their minimum weekly exercise simply by performing some of their normal daily activities at a rapid pace. What a deal!

Incorporate short bouts of vigorous activity into daily life

The recently revised Physical Activity Guidelines for Americans recognize the health value of short periods of vigorous physical activity (less than 10 minutes). Preliminary evidence suggests that short bouts of vigorous physical activity can reduce risk of cardiovascular disease. A flock of physical activity researchers recently proposed a potentially major role for vigorous intermittent lifestyle physical activity (VILPA). It refers to activities performed as part of daily life, without the need for specialized equipment or planning and not done with the explicit purpose of being physically active. Such activities could include short periods (1-3 minutes) of brisk walking to catch a bus to work, climbing stairs at work, or running errands on a bicycle. VILPA could become a beneficial complement to planned and structured physical activity in that that it might be more appealing to people who reject exercise for one reason or another,

A few minutes each day

Overwhelming evidence shows that Keep Moving predicts better health and lower risk of chronic conditions. Nonetheless, middle-aged and older adults have low participation rates in structured, vigorous physical activity. Alas, questionnaires that typically provide data for physical activity participation do not often capture incidental, short-duration vigorous activities, such as climbing stairs, which are part of daily life. Wearable devices can capture brief periods of vigorous physical activity. Researchers used data from wearable devices in the UK Biobank Study to determine if vigorous, intermittent lifestyle physical activity (VILPA) of participants who reported no physical activity on questionnaires would predict risk of premature death, cardiovascular disease or cancer.

During an average follow-up of 7 years and compared to participants with zero VILPA, participants who had about 3 bouts of VILPA lasting one minute each per day had 49 percent lower risk of all-cause mortality. For cardiovascular disease mortality and cancer mortality, the comparable reductions in risk were 49 and 30 percent, respectively. While these results may seem implausibly good, this study aligns with results of previous studies of high-intensity interval training and intermittent stair climbing. Overall, two or three short bursts of VILPA lasting a total of 3-4 minutes each day predicted substantial declines in all-cause, cardiovascular, and cancer mortality. Physicians could easily share this information with their middle-paged and older patients who are non-exercisers and possibly motivate them to find brief opportunities for vigorous physical activity, such as stair climbing, in daily lives

The sweet spot: 8 minutes a day

What might be the minimum amount of dailly vigorous physical activity what would significantly and meaningfully reduce risk of premature death? Researchers in Australia, the US, and Denmark addressed this question using accelerometer-measured data in 10-second increments from 71,893 participants with a median age of 62 years in the UK Biobank Study. Over an average follow-up of six years, participants with a mere 15 minutes per week (about 2 minutes a day) of vigorous physical activity had significant 18 and 16 percent lower risks of all-cause and cancer-related mortality, respectively. The story gets better. The optimal dose of vigorous physical activity (54 minutes per week or about 8 minutes a day) predicted a 44 percent reduction in the risk of premature death compared to getting 2.2 minutes per week of vigorous physical activity and after adjusting for confounding factors. This is stunning news! For example, during your 22-minute after-dinner walk, you could walk as fast as you can for 8 minutes then resume your normal brisk pace. If you’re similar to the UK Biobank participants, you’ll cut your risk of premature death by nearly half. Can you think of other uses of 8 minutes of your day that would provide such an outsized benefit?

Modifiable barriers and enablers to VILPA

VILPA appears to be a time-efficient and effective way to maintain better health and avoid adverse outcomes such as dying before your time. But what are the perceived barriers and enablers for making VILPA part of daily life? Researchers addressed this question with 19 online focus group interviews with 78 Australian volunteers across three age groups: 35-44, 45-59, and 60-76 years. The 90-minute interviews were video recorded and analyzed thematically according to the Capability, Opportunity, Motivation, and Behavior model. Six themes related to barriers emerged according to capability-physical (physical limitations); capability-psychological (perceptions of aging, need for information); opportunity-physical (environmental constraints); and motivation-automatic (perceptions of effort and energy, fear). For example, a participant might express concern that he can’t walk without a cane (physical limitations), that he’s probably too old for VILPA (perceptions of aging), and that he’s concerned about falling (fear).

Ten themes emerged with respect to enablers according to opportunity-physical (convenience, reframing physical activity, use of prompts and reminders); opportunity-social (normalization of taking the active option, gamification); motivation-reflective (sense of achievement, health improvement, personally salient rewards); and motivation-automatic (changing from effortful deliberation to habitual action). For example, a participant might think that an after-dinner brisk walk would fit with her other activities (convenience), especially if she left her walking shoes by her front door (prompts and reminders), and would feel a sense of satisfaction for walking a few blocks after dinner to visit with her neighbors (sense of achievement, personally salient rewards). Happily, most of the identified barriers and enablers are potentially modifiable. Interventions could be developed to help participants identify and understand barriers and enablers then identify tactics to overcome the barriers and embrace the enablers

Really, folks. Eight minutes of VILPA can change your life. Integrate it into your daily life and live better.


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