Elsevier

Preventive Medicine

Volume 49, Issue 4, October 2009, Pages 280-282
Preventive Medicine

Review
Physical activity: Health outcomes and importance for public health policy

https://doi.org/10.1016/j.ypmed.2009.05.002Get rights and content

Abstract

This manuscript presents a brief summary of the substantial data supporting an inverse relationship between the amount of habitual physical activity performed and a variety of negative health outcomes throughout the lifespan. It points out that despite these data a large segment of the US population remain insufficiently active resulting in a high population attributable risk for chronic disease due to inactivity. The accumulated data support the need for more comprehensive health promoting physical activity policies and programs, especially for the economically and socially disadvantaged and medically underserved.

Introduction

Over the past half-century scientific data have continued to accumulate indicating that being physically inactive or unfit has major negative health consequences throughout the lifespan and is an important component of a comprehensive approach to chronic disease prevention and health promotion. Numerous well-conducted prospective observational studies have demonstrated that the least active and unfit are at greatest risk for a variety of chronic diseases, loss of function, and all-cause mortality; that this increased risk occurs independent of race/ethnicity, income, education, or body size and shape; and there is a dose–response across a wide range of activity and fitness levels (Physical Activity Guidelines Advisory Committee, 2008). Further, substantial data indicate that physical inactivity also contributes to disease by being a contributor along with excess caloric intake to weight gain and obesity (Giovannucci et al., 1995). These epidemiologic data are supported by experimental data showing that increases in physical activity improve a number of biological markers that are in the causal pathways for selected chronic diseases (e.g., blood pressure, atherogenic lipoprotein profile, blood clotting/fibrinolysis, insulin-mediated glucose uptake, bone and muscle strength, autonomic nervous system regulation) (Physical Activity Guidelines Advisory Committee, 2008).

Despite this growing body of evidence of benefit from being physically active, national surveillance data indicate that a substantial portion of youth and adults in the United States do not meet current recommendations (see Fig. 1; Centers for Disease Control and Prevention, 2007). Thus, when the risks of being physically inactive or unfit are combined with the low prevalence of activity in the US population, the population attributable risk for major causes of death and disability, such as heart disease and diabetes, is quite high and appears comparable to other well-established risk predictors (see Fig. 2; Blair, 2009).

Section snippets

Benefits and risks

By following the 2008 Physical Activity Guidelines for Americans (http://health.gov/paguidelines) many youth and adults who are now inactive or only sporadically active would substantially increase their health and fitness status contributing to less disability, premature morbidity and death due to major chronic diseases (see Fig. 3; Leitzmann et al., 2007). While just increasing life expectancy by itself does not insure any decrease in health care costs, the compression of morbidity during

Physical activity surveillance

To develop more effective and responsive policies and plans for enhancing the physical activity of target populations, more comprehensive and systematic long-term surveillance of physical activity is needed. Several special challenges regarding surveillance include the need for a national system that routinely samples diverse segments of the population and use of physical activity measurement tools, such as accelerometers, that capture all components of inactivity and activity (occupational,

Summary/conclusion

Existing data indicate that physical inactivity is widespread and a major contributor to chronic disease, disability, and premature mortality in the US. Moderate amounts of activities such as walking reduce chronic disease risk and enhance functional capacity. To realize the health-promoting benefits of increased activity by at-risk populations, major policies and programs need implementing that insure (1) the population at-large is educated about the health risks of inactivity and how best to

Conflict of interest statement

The authors declare that there are no conflicts of interest.

Acknowledgments

We acknowledge the enormous contributions made decades ago by Jeremy Morris and Ralph Paffenbarger who established and led the field of epidemiologic research on physical activity and health.

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