September 22, 2017
3 min read

Moderate physical activity could prevent one in 12 deaths globally

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Physical activity of any form — whether a gym workout, walking to work or doing household chores — for 150 minutes per week reduces the risk for mortality and CVD, according to findings published in the Lancet.

Physical activity has a protective effect against CVD in high-income countries, where physical activity is mainly recreational, but it is not known if this is also observed in lower-income countries, where physical activity is mainly non-recreational,” Scott A. Lear, PhD, from Simon Fraser University and St. Paul’s Hospital in Vancouver, Canada, and colleagues wrote.

Furthermore, the WHO currently recommends that adults aged 18 to 64 years partake in at least 150 minutes of moderate-intensity aerobic physical activity per week; however, nearly a quarter (23%) of the world’s population do not meet such guidelines, according to the researchers.

Between Jan. 1, 2003, and Dec. 31, 2010, Lear and colleagues performed a prospective cohort study to determine the association between different amounts and types of physical activity and mortality and CVD in countries at different economic levels. The researchers enrolled 130,843 participants without preexisting CVD aged between 35 and 70 years from 17 countries. Countries were categorized as high-income (Canada, Sweden and United Arab Emirates), upper-middle income (Argentina, Brazil, Chile, Poland, Turkey, Malaysia and South Africa), lower-middle income (China, Colombia and Iran) and low-income (Bangladesh, India, Pakistan and Zimbabwe).

The researchers documented mortality and major CVD events, including CVD mortality, stroke, myocardial infarction or heart failure, during a mean of 6 to 9 years of follow-up. The analysis was adjusted from sociodemographic factors.

Participants completed the International Physical Activity Questionnaire, which was used to calculate total physical activity. Low physical activity was defined as less than 150 minutes of moderate intensity physical activity per week; moderate physical activity was defined as 150 to 750 minutes of moderate intensity physical activity per week; and high physical activity was defined as more than 750 minutes of moderate intensity physical activity per week.

Across all regions, the most common form of physical activity was through active transportation, occupation or domestic duties. Leisure time physical activity was common in high-income countries, but not other regions.

Results indicated that moderate and high physical activity were associated with a 28% reduction in the risk for death from any cause and a 20% reduction in the risk for heart disease compared with low physical activity. Moderate and high physical activity were also significantly associated with a reduction in major CVD events (HR = 0.86; 95% CI, 0.78-0.93). In high-, middle- and low-income countries, higher physical activity lowered the risk for CVD and mortality.


A total of 106,970 participants met the activity guidelines and 44% were highly active. Development of CVD was more likely in participants who did not meet the guidelines than those who did (5.1% vs. 3.8%). Risk for mortality was also higher in participants who did not meet the guidelines (6.4% vs. 4.2%).

These data suggest that 8% of deaths and 4.6% of CVD events could be prevented if the entire global population adhered to the physical activity guidelines. In addition, 13% of deaths and 9.5% of CVD events could be prevented if the entire population was highly active.

Benefits were seen for both recreational and nonrecreational physical activity. The researchers noted that there was no ceiling effect on the association and that extremely high levels of physical activity, defined as more than 2,500 minutes per week, posed no risks.

“Meeting physical activity guidelines by walking for as little as 30 minutes most days of the week has a substantial benefit, and higher physical activity is associated with even lower risks,” Lear said in a press release. “The affordability of other CVD interventions, such as generic drugs and consuming fruits and vegetables, is often beyond the reach of many people in low-income and middle-income countries. However, physical activity represents a low-cost approach to preventing CVD, and our study provides robust evidence to support public health interventions to increase all forms of physical activity in these regions.”

Physical activity needs to be incorporated into daily life for individuals to attain its full benefits, Lear said in a separate release.

“Going to the gym is great, but we only have so much time we can spend there. If we can walk to work, or at lunch time, that will help too,” he said.

In an accompanying editorial, Shifalika Goenka, PhD, from the Indian Institute of Public Health, New Delhi, and I-Min Lee, MD, MPH, of Brigham and Women’s Hospital, Boston, wrote that CVD “is known to have devastating effects on individuals and families. In low-income and lower-middle-income countries, CVD can push people to below the poverty line. ... Creating a physical, social and political environment where physical activity in daily living is desirable, accessible and safe should be a developmental imperative.”

Goenka and Lee added that promotion of physical activity, active transport and active living via interventions contextualized to culture and context will have powerful and long-lasting effects on population health and developmental sustainability. – by Alaina Tedesco

Disclosures: The researchers report no relevant financial disclosures.