对不同强度的有氧运动和肌肉加强活动（MSA）的不同组合与全因及特定原因死亡之间的关联进行研究的报道很少；现有的估计结果也是不一致的。本研究旨在探讨中等有氧运动（MPA）、剧烈有氧运动（VPA）和MSA的不同组合与全因死亡、心血管疾病（CVD）死亡和癌症死亡之间的潜在关联。本研究使用美国国家健康访问调查的数据进行了全国范围的前瞻性队列研究。从1997年到2018年，共有500705名合格美国成年人参加了研究，并进行了为期10.0年的随访（共560万人年）。数据分析时间为2022年9月1日至9月30日。采用自报的MPA和VPA的累积时间（每周75分钟）以及符合推荐MSA指南的情况（是或否）得出48个互不重叠的暴露类别。主要结局为全因死亡、CVD死亡和癌症死亡。通过与国家死亡指数链接，参与者的随访时间截至2019年12月31日。研究共纳入500705名参与者（平均[标准差]年龄46.4 [17.3]岁；210803 [58%]女性；277504 [77%]白人）。与参照组（不进行MPA或VPA并且不符合推荐的MSA）相比，与全因死亡风险比（HR）最低相关的类别是MPA累计时间在0至75分钟、VPA累计时间在150分钟以上和每周进行2次或更多次MSA（HR为0.50，95% CI为0.42-0.59）。降低CVD和癌症死亡风险的最佳组合是MPA累计时间在150至225分钟、VPA累计时间在0至75分钟和每周进行2次或更多次MSA（HR为0.30，95% CI为0.15-0.57），以及MPA累计时间在300分钟以上、VPA累计时间在0至75分钟和每周进行2次或更多次MSA（HR为0.44，95% CI为0.23-0.82）。校正后的死亡率显示，全因和癌症死亡率降低了约50%，CVD死亡率降低了约3倍。该队列研究表明，适度的MPA、VPA和MSA的平衡组合可能与降低死亡风险的最佳效果相关。对于癌症和全因死亡风险，超过推荐水平的MPA和VPA可能进一步降低风险。

Studies examining the associations of different combinations of intensity-specific aerobic and muscle strengthening activity (MSA) with all-cause and cause-specific mortality are scarce; the few available estimates are disparate.To examine the prospective associations of different combinations of moderate aerobic physical activity (MPA), vigorous aerobic physical activity (VPA), and MSA with all-cause, cardiovascular (CVD), and cancer mortality.This nationwide prospective cohort study used data from the US National Health Interview Survey. A total of 500 705 eligible US adults were included in the study and followed up during a median of 10.0 years (5.6 million person-years) from 1997 to 2018. Data were analyzed from September 1 to September 30, 2022.Self-reported cumulative bouts (75 weekly minutes) of MPA and VPA with recommended MSA guidelines (yes or no) to obtain 48 mutually exclusive exposure categories.All-cause, CVD, and cancer mortality. Participants were linked to the National Death Index through December 31, 2019.Overall, 500 705 participants (mean [SD] age, 46.4 [17.3] years; 210 803 [58%] female; 277 504 [77%] White) were included in the study. Compared with the reference group (doing no MPA or VPA and less than recommended MSA), the category associated with the lowest hazard ratio (HR) for all-cause mortality was more than 0 to 75 minutes of MPA combined with more than 150 minutes of VPA and 2 or more MSA sessions per week (HR, 0.50; 95% CI, 0.42-0.59). The optimal combinations for CVD and cancer mortality risk reduction were more than 150 to 225 minutes of MPA, more than 0 to 75 minutes of VPA, and 2 or more MSA sessions per week (HR, 0.30; 95% CI, 0.15-0.57), and more than 300 minutes of MPA, more than 0 to 75 minutes of VPA, and 2 or more MSA sessions per week (HR, 0.44; 95% CI, 0.23-0.82), respectively. Adjusted mortality rates represented an approximately 50% lower mortality rate for all-cause and cancer mortality and an approximately 3-fold lower mortality rate for CVD mortality.This cohort study demonstrated that balanced levels of MPA, VPA, and MSA combined may be associated with optimal reductions of mortality risk. Higher-than-recommended levels of MPA and VPA may further lower the risk of cancer and all-cause mortality, respectively.