Vigorous Intermittent Lifestyle Physical Activity (VILPA) and Its Association with Cardiovascular Disease, Cancer and Premature Mortality Risk in Physically Inactive Adults: A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.63.73399Keywords
VILPA, vigorous intermittent lifestyle physical activity, exercise snacks, physical activity, sedentary behavior, cardiovascular disease, cancer, mortality, accelerometryAbstract
Background
Vigorous intermittent lifestyle physical activity (VILPA) consists of very short bouts of vigorous effort embedded in daily routines and may be a feasible way to increase activity in adults who do not exercise.
Aim
This narrative review summarizes evidence linking VILPA with mortality, cardiovascular outcomes, and cancer incidence in physically inactive adults, and discusses mechanisms, implementation, and limitations.
Materials and methods
A non-systematic search of PubMed, Scopus, and Google Scholar identified studies published in 2020-2026 on VILPA, short vigorous bouts, exercise snacks, stair climbing, and interruptions of prolonged sitting.
Results
Accelerometer-based cohort studies indicate that brief daily VILPA is associated with lower all-cause, cardiovascular, and cancer mortality, lower risk of major adverse cardiovascular events, and lower cancer incidence in non-exercising adults. Indirect evidence from exercise snacks and sitting-interruption studies supports biological plausibility through favorable effects on cardiorespiratory fitness, glycemic control, insulinemia, postprandial metabolism, and vascular responses.
Conclusions
VILPA may be a simple, low-cost, and realistic entry point to increase physical activity in inactive adults, but it should complement rather than replace standard physical activity recommendations. Further intervention studies are needed to establish causality, safety, optimal dose, and long-term effectiveness.
Key words: VILPA; vigorous intermittent lifestyle physical activity; exercise snacks; physical activity; sedentary behavior; cardiovascular disease; cancer; mortality; accelerometry
References
1. Stamatakis E, Ahmadi MN, Gill JMR, Thogersen-Ntoumani C, Gibala MJ, Doherty A, Hamer M. Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality.Nat Med. 2022;28(12):2521-2529. https://doi.org/10.1038/s41591-022-02100-x PMID: 36482104.
2. Stamatakis E, Huang BH, Maher C, Thogersen-Ntoumani C, Stathi A, Dempsey PC, et al. Untapping the health enhancing potential of vigorous intermittent lifestyle physical activity (VILPA): rationale, scoping review, and a 4-pillar research framework. Sports Med. 2021;51(1):1-10. https://doi.org/10.1007/s40279-020-01368-8 PMID: 33108651.
3. Ahmadi MN, Holtermann A, Tudor-Locke C, Koster A, Johnson N, Chau J, et al. Time to elicit physiological and exertional vigorous responses from daily living activities: setting foundations of an empirical definition of VILPA. Med Sci Sports Exerc. 2024;56(12):2413-2420. https://doi.org/10.1249/mss.0000000000003521 PMID: 39160703.
4. Thogersen-Ntoumani C, Grunseit A, Holtermann A, Steiner S, Tudor-Locke C, Koster A, et al. Promoting vigorous intermittent lifestyle physical activity (VILPA) in middle-aged adults: an evaluation of the MovSnax mobile app. BMC Public Health. 2024;24(1):2182. https://doi.org/10.1186/s12889-024-19549-9 PMID: 39135030.
5. Thogersen-Ntoumani C, Kritz M, Grunseit A, Chau J, Ahmadi M, Holtermann A, et al. Barriers and enablers of vigorous intermittent lifestyle physical activity (VILPA) in physically inactive adults: a focus group study. Int J Behav Nutr Phys Act. 2023;20(1):78. https://doi.org/10.1186/s12966-023-01480-8 PMID: 37403160.
6. Pang B, McVeigh JA, Thompson C, et al. An exploration of adults transitioning into retirements' perspectives on vigorous intermittent lifestyle physical activity. Health Promot J Austr. 2025;36:e957. https://doi.org/10.1002/hpja.957 PMID: 39776160.
7. Khurshid S, Weng LC, Nauffal V, Pirruccello JP, Venn RA, Al-Alusi MA, et al. Wearable accelerometer-derived physical activity and incident disease. NPJ Digit Med. 2022;5(1):131. https://doi.org/10.1038/s41746-022-00676-9 PMID: 36056190.
8. Biswas RK, Ahmadi MN, Bauman A, Milton K, Koemel NA, Stamatakis E. Wearable device-based health equivalence of different physical activity intensities against mortality, cardiometabolic disease, and cancer. Nat Commun. 2025;16(1):8315. doi:10.1038/s41467-025-63475-2. Erratum in: Nat Commun. 2025;16(1):9581. https://doi.org/10.1038/s41467-025-63475-2 PMID: 41057301.
9. Stamatakis E, Ahmadi MN, Friedenreich CM, Blodgett JM, Koster A, Holtermann A, et al. Vigorous intermittent lifestyle physical activity and cancer incidence among nonexercising adults: the UK Biobank accelerometry study. JAMA Oncol. 2023;9(9):1255-1259. https://doi.org/10.1001/jamaoncol.2023.1830 PMID: 37498576.
10. Stamatakis E, Ahmadi M, Biswas RK, del Pozo Cruz B, Thogersen-Ntoumani C, Murphy MH, et al. Device-measured vigorous intermittent lifestyle physical activity and major adverse cardiovascular events: evidence of sex differences. Br J Sports Med. 2025;59(5). https://doi.org/10.1136/bjsports-2024-108484 PMID: 39467622.
11. Ahmadi MN, Hamer M, Gill JMR, Murphy MH, Sanders JP, Doherty A, Stamatakis E. Brief bouts of device-measured intermittent lifestyle physical activity and its association with major adverse cardiovascular events and mortality in people who do not exercise: a prospective cohort study. Lancet Public Health. 2023;8(10):e800-e810 https://doi.org/10.1016/s2468-2667(23)00183-4 . PMID: 37777289.
12. Jones MD, Clifford BK, Stamatakis E, Gibbs MT. Exercise snacks and other forms of intermittent physical activity for improving health in adults and older adults: a scoping review of epidemiological, experimental and qualitative studies. Sports Med. 2024;54(4):813-835. https://doi.org/10.1007/s40279-023-01983-1 PMID: 38190022.
13. Islam H, Gibala MJ, Little JP. Exercise snacks: a novel strategy to improve cardiometabolic health. Exerc Sport Sci Rev. 2022;50(1):31-37. https://doi.org/10.1249/jes.0000000000000275 PMID: 34669625.
14. Koemel NA, Ahmadi MN, Biswas RK, Thogersen-Ntoumani C, Teixeira-Pinto A, Chow CK, et al. Vigorous intermittent lifestyle physical activity (VILPA) and mortality risk among US adults: a wearables-based national cohort study. Int J Behav Nutr Phys Act. 2026;23:17. https://doi.org/10.1186/s12966-026-01876-2 PMID: 41612409.
15. Weston KL, Little JP, Weston M, McCreary S, Kitchin V, Gill A, et al. Application of exercise snacks across youth, adult and clinical populations: a scoping review. Sports Med Open. 2025;11(1):27. https://doi.org/10.1186/s40798-025-00829-6 PMID: 40102333.
16. Koemel NA, Ahmadi MN, Biswas RK, Koster A, Atkin AJ, Sabag A, Stamatakis E. Can incidental physical activity offset the deleterious associations of sedentary behaviour with major adverse cardiovascular events? Eur J Prev Cardiol. 2025;32(1):77-85. https://doi.org/10.1093/eurjpc/zwae316 PMID: 39325719.
17. Loh R, Stamatakis E, Folkerts D, Allgrove JE, Moir HJ. Effects of interrupting prolonged sitting with physical activity breaks on blood glucose, insulin and triacylglycerol measures: a systematic review and meta-analysis. Sports Med. 2020;50:295-330. https://doi.org/10.1007/s40279-019-01183-w PMID: 31552570.
18. Gillen JB, Estafanos S, Williamson E, Hodson N, Malowany JM, Kumbhare D, Moore DR. Interrupting prolonged sitting with repeated chair stands or short walks reduces postprandial insulinemia in healthy adults. J Appl Physiol (1985). 2021;130(1):104-113. https://doi.org/10.1152/japplphysiol.00796.2020 PMID: 33180640.
19. Rafiei H, Omidian K, Myette-Cote E, Little JP. Metabolic effect of breaking up prolonged sitting with stair climbing exercise snacks. Med Sci Sports Exerc. 2021;53(1):150-158. https://doi.org/10.1249/mss.0000000000002431 PMID: 32555024.
20. Caldwell HG, Coombs GB, Rafiei H, Ainslie PN, Little JP. Hourly staircase sprinting exercise snacks improve femoral artery shear patterns but not flow-mediated dilation or cerebrovascular regulation: a pilot study. Appl Physiol Nutr Metab. 2021;46(5):521-529. https://doi.org/10.1139/apnm-2020-0562 PMID: 33242251.
21. Zhou J, Gao X, Zhang D, Jiang C, Yu W. Effects of breaking up prolonged sitting via exercise snacks intervention on the body composition and plasma metabolomics of sedentary obese adults: a randomized controlled trial. Endocr J. 2025;72(2):183-192. https://doi.org/10.1507/endocrj.ej24-0377 PMID: 39537176.
22. Rodriguez MA, et al. Effect of exercise snacks on fitness and cardiometabolic health in physically inactive individuals: systematic review and meta-analysis. Br J Sports Med. 2026;60(2):133-140. https://doi.org/10.1136/bjsports-2025-110027 PMID: 41057224.
23. Pang B, Moullin JC, Thompson C, Thogersen-Ntoumani C, Stamatakis E, Ahmadi M, McVeigh JA. Testing a vigorous intermittent lifestyle physical activity intervention in adults transitioning to retirement: a pilot randomised controlled trial. Age Ageing. 2025;54(9):afaf244. https://doi.org/10.1093/ageing/afaf244 PMID: 40966620.
24. Pang B, Moullin JC, McVeigh JA, Thogersen-Ntoumani C, Stamatakis E, Thompson C. Refining and implementing a vigorous intermittent lifestyle physical activity intervention: views of key stakeholders. J Aging Phys Act. 2025. https://doi.org/10.1123/japa.2024-0126 PMID: 40962287.
25. Wang T, Laher I, Li S. Exercise snacks and physical fitness in sedentary populations. Sports Med Health Sci. 2025;7(1):1-7. https://doi.org/10.1016/j.smhs.2024.02.006 PMID: 39649791.
26. Yin M, Deng S, Chen Z, Zhang B, Zheng H, Bai M, et al. Exercise snacks are a time-efficient alternative to moderate-intensity continuous training for improving cardiorespiratory fitness but not maximal fat oxidation in inactive adults: a randomized controlled trial. Appl Physiol Nutr Metab. 2024. https://doi.org/10.1139/apnm-2023-0593 PMID: 38569204.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Dominik Tarczyński, Miłosz Cisłak, Natalia Zięba, Mateusz Czech, Michał Chojęta, Jakub Czmok, Dominika Ciesielska, Anna Mazur, Mikołaj Brzusek, Katarzyna Kociuba, Wiktoria Biskup
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 71
Number of citations: 0
