“A significant non-linear interaction between MVPA and CRF was observed (p<0.001). Meeting the 150 min/week guideline yielded a modest ~8%–9% risk reduction across fitness levels, whereas achieving a >30% risk reduction required threefold to fourfold higher volumes (~560–610 min/week).”
“Conclusion Current MVPA guidelines provide a universal but modest safety margin, whereas optimal cardiovascular protection may require substantially higher activity volumes. The fitness-stratified prescription matrix offers quantitative behavioural targets, and genetic findings reinforce the independent importance of CRF in cardiovascular risk reduction.”
I finally took a look at it. The takeaway that the curve may not flatten so quickly is a useful perspective for further research but it is lacking a larger functional context. I take issue ranging from considerable to minor on some detail:
Accelerometer MVPA is not equivalent to guideline MVPA. These are different yardsticks.
The 8–9% benefit at 150 min contradicts established meta-analyses. TBD with subsequent research.
UK Biobank sample is selected three layers above the general population. That contaminates much.
Mendelian randomization is underpowered and likely overlapping samples.
The outcome is dominated by 71% AFIB which is not “heart attacks and strokes.”
The personalizing headline results are underwhelming (this is a bigger discussion).
Reverse causation from subclinical disease is not adequately ruled out.