Climbing stairs is vigorous activity

I nearly always take the stairs for up to 5 stories. Climbing stairs (Figure 1) is an example of Vigorous Intermittent Lifestyle Physical Activity (VILPA) which refers to short bursts of intense physical activity that are part of one’s daily routine, and not separate structured exercise sessions. VILPA typically results in an increased heart rate and breathing, but they are done intermittently throughout the day (Figure 1). Other examples of VILPA include: 

• Walking briskly to catch a bus
• Carrying heavy groceries
• Playing energetically with children or pets
• Doing yard work or household chores vigorously

To doctors, VILPA is appealing because accumulating these short, intense bouts of physical activity can provide health benefits similar to those obtained through longer, structured exercise sessions. In other words, VILPA can be a practical way for individuals to incorporate physical activity into their daily lives.

Whether performing wind sprints or climbing stairs, vigorous exercise provides numerous health benefits:

• Improved Cardiovascular Health: It strengthens the heart muscle, improves blood circulation, lowers blood pressure, and reduces the risk of heart disease and stroke.
• Enhanced Respiratory Function: Vigorous exercise increases lung capacity and efficiency, enhancing overall respiratory health and stamina.
• Weight Management: It helps burn more calories and fat, which can aid in weight loss or maintaining a healthy weight.
• Improved Metabolic Health: Regular vigorous exercise can enhance metabolism, improve insulin sensitivity, and reduce the risk of type 2 diabetes.
• Stronger Muscles and Bones: Engaging in intense physical activities can increase muscle mass, strength, and bone density, reducing the risk of osteoporosis and fractures.
• Mental Health Benefits: It can reduce stress, anxiety, and depression, improve mood, and boost overall mental well-being by releasing endorphins, often called "feel-good" hormones.
• Increased Longevity: Consistent vigorous exercise is associated with a lower risk of premature death and can contribute to a longer, healthier life.

One question is the extent of health benefits provided by VILPA. A new study investigated the association between brief bursts of vigorous intermittent lifestyle physical activity (VILPA) and mortality outcomes.

The study population consisted of  25,241 nonexercisers from the UK Biobank database, with a mean age of 61.8 years (14,178 women and 11,063 men). These nonexercisers, self-identified from questionnaires, reported no exercise during their leisure time. Their daily activity patterns were recorded using a wearable accelerometer. The average follow-up period was 6.9 years, during which there were 852 deaths (266 due to CVD and 511 due to cancer). Researchers calculated all-cause, cardiovascular disease (CVD) and cancer mortality risk.

From the activity tracker data, VILPA could be quantified into daily duration (total number of minutes engaged in VILPA) and bout frequency (number of VILPA episodes lasting 1 minute or 2 minutes). From these data, the authors could calculate VILPA dose-response curves with respect to mortality. Below we focus on the effect of bout frequency of at least 1 minute duration on all-cause mortality:

"The minimum frequency dose for length-standardized VILPA bouts lasting 1 min was 1.5 bouts per day corresponding to a HR of 0.75 (95% CI 0.66, 0.85). The median and maximum VILPA frequency for length-standardized bouts lasting 1 min were associated with a HR of 0.61 (0.50, 0.74) and 0.52 (0.37, 0.72), respectively."

The minimum dose was defined as eliciting 50% of the total effect. Increasing the amount (dose) of VILPA resulted in a concomitant decrease in mortality risk from 0.75 (minimum) to 0.61 (median) to 0.52 (maximum). Similar data were obtained for 2 minute duration bouts and total duration, as well as for CVD and cancer mortality risk. For example, engaging in the median VILPA frequency (3 bouts per day, each lasting 1-2 minutes) resulted in 38%–40% reduction in all-cause and cancer mortality risk, and 48%–49% reduction in CVD mortality risk.

In the Discussion section of the article, the authors list some caveats to these impressive results:

• "Some VILPA activities (for example, carrying heavy shopping bags) may not be perfectly captured by wrist-worn accelerometers."
• "The responses to the baseline leisure time physical activity questions (including recreational walking) that formed the basis of our sample selection are subject to measurement error like any other self-reported measure and were also collected 5.5 years before the accelerometry study." 
• "The UK Biobank had a very low response rate (5.5%) and it is not representative of the target population."

One additional complication arises from the observational (not randomized) nature of the study which can produce confounders. Namely, VILPA activity may correlate with other health variables, e.g. those with high VILPA may also engage in other healthful practices.

On the other hand, previous research is consistent with the overall benefits of VILPA and vigorous exercise more generally:

“Proof-of-concept trials have shown that very small doses of exercise-based intermittent VPA can have rapid and measurable effects on cardiorespiratory fitness, a key causal determinant of CVD. High-intensity interval training and studies of intermittent stair climbing have shown that VPA bursts lasting 20 s to a few minutes, performed three to five times a day, can result in substantial improvements in cardiorespiratory fitness in previously inactive adults within a few weeks, providing a plausible physiological basis for the associations we observed."

In summary, even a small amount of Vigorous Intermittent Lifestyle Physical Activity (VILPA), such as 2–3 short bouts or 3–4 minutes per day, is associated with significantly lower risks of all-cause, cardiovascular disease (CVD), and cancer mortality. The most substantial reductions in mortality risk are observed with lower amounts of VILPA, but benefits continue to increase in a near-linear fashion with more significant amounts of VILPA. The findings point to VILPA as a good option for getting more vigorous activity, especially for those who can't or don't want to do regular exercise.

So climbing stairs (Figure 1) is good for you, although you should be careful not to overexert yourself in the beginning.

Figure 1. Climbing stairs is an example of Vigorous Intermittent Lifestyle Physical Activity (VILPA). A recent study demonstrated a significant decrease in mortality risk for those who engage in VILPA.