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Deaths from lack of exercise double those from obesity
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Twice as many deaths could be attributed to lack of physical activity than obesity, according to research published in the American Journal of Clinical Nutrition.
Even modest increases in activity by inactive individuals could bring significant health benefits, based on findings from the prospective multi-center European Prospective Investigation into Cancer and Nutrition study.
“This is a simple message: just a small amount of physical activity each day could have substantial health benefits for people who are physically inactive,” Ulf Ekelund, PhD, of the University of Cambridge, United Kingdom, said in a press release.
Ulf Ekelund
Ekelund and colleagues from other institutions looked at a cohort of 334,161 European men and women over 12.4 years to assess the relationship between physical inactivity and premature death, along with its interaction with obesity. They examined whether overall and abdominal adiposity would alter the association between physical activity and all-cause mortality
The researchers measured height, weight and waist circumference (WC). Level of physical activity (physical activity) was quantified based on self-assessment. Patients were stratified by center and age group. The combined associations between physical activity, BMI and WC with mortality were analyzed using Cox proportional hazards models, with adjustments for sex, education, smoking and alcohol intake.
The biggest reduction in premature death risk occurred in the comparison between inactive and moderately inactive groups, based on activity at work and recreational activity together, with hazards for all-cause mortality reduced between 16 and 30%.
The researchers determined that avoiding all inactivity would theoretically reduce all-cause mortality by 7.35% (95% CI, 5.88-8.83%), whereas avoiding obesity (BMI >30) would decrease the rate by 3.66% (95% CI, 2.3-5.01%); estimates for avoiding high WC were similar to inactivity.
“Although we found that just 20 minutes would make a difference, we should really be looking to do more than this,” Ekelund said. “Physical activity has many proven health benefits and should be an important physical activity part of our daily life.”
Disclosure: Please see study for full list of disclosures.
Perspective
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Daniel L. Hurley, MD, FACE
This article on the importance of moderate activity on health in European men and women adds to the literature reported for US and Asian populations. Strengths of the study include its large population size, well-designed capture of baseline anthropomorphic measurements, and 12-year follow up.
The researchers found that people who were inactive, in each category of body weight (ie, normal, overweight, or obese), had a higher risk of death than those even modestly active. In the 334,000 men and women followed, the risk for increased mortality was a 22.7% risk for those who were inactive, 15.8% for those who were obese, and a 21.9% for those with increased abdominal girth (ie, waist circumference).
Abdominal adiposity contributes to a high risk for diabetes and cardiovascular disease, and therefore mortality. It is particularly interesting to see that moving from being inactive to moderate activity reduces risk of dying at any weight or waist circumference.
Most people think about activity in terms of exercise, or getting on a treadmill for 30 minutes, 3 days a week. The beauty of this article is that it talks about moderate activity, just to get moving, which fits in with Michelle Obama’s activity plan for children, teens, and young adults. This study supports that you don’t have to go “all out” with an exercise program for health benefits; benefits can occur with moderate daily activity.
It was interesting that the activity that was helpful had to be outside of normal occupation, or equivalent to about 20 minutes of brisk walking a day (eg, 10-15 minute mile pace).
A significant disadvantage of the study, as the authors mentioned, is that the anthropomorphic measures were only taken at baseline; we don’t really know what happened to adiposity (i.e., body weight and abdominal girth) over time to the study participants who were initially in the normal weight, overweight or obese weight categories, other than the endpoint of death.
This is an important population study, and supportive of what health providers recommend in practice. As physicians, we need to continue to encourage our patients to “just start moving” and then, if comfortable, go to the next level of exercise. People who aren’t moving need to find a way to move regularly — with brisk walking (ie, 10-15 minute mile) or its equivalent activity, such as yoga, walking during golf, or playing with children; it all counts as beneficial to our health.
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