Laddu DR, et al. - Analysts assess 25-year physical activity (PA) trajectories from young to middle age and aimed to evaluate the relationship with the prevalence of coronary artery calcification (CAC). In this study, white individuals who participated in 3 times the suggested PA guidelines more than 25 years had higher odds of developing coronary subclinical atherosclerosis by middle age. These findings warrant further exploration, particularly by race, into possible biological mechanisms for CAC risk at very high levels of PA.