(Reuters Health) - Playing golf is associated with better strength and balance, a sharper mind, a lower risk of heart disease and a longer life, according to public health experts who say more people should take up the sport.

While an estimated 60 million people play golf at least twice a year, golfers are primarily middle aged and older, affluent, male, white, and living in North America, Europe and Australia, experts note in the 2018 International Consensus Statement on Golf and Health published in the British Journal of Sports Medicine.

“Golf can provide aerobic physical activity to persons of all ages, and strength and balance benefits to older adults,” said Dr. Andrew Murray of the University of Edinburgh in the UK.

“Regular physical activity is one of the best things you can do for your health, decreasing the risk of heart attacks, strokes, type 2 diabetes, as well as dementia, depression and anxiety,” Murray, lead author of the consensus statement, said by email.

“Golf is not unique in providing this, and anything involving physical activity can be of great benefit,” Murray added. “Golf additionally is green exercise, gives time to relax, and in a world where older adults are generally less active than youngsters, can be played from 3 to 103.”

To assess the physical and mental health benefits of golf and propose ways to make the sport more accessible to a wider population, Murray and more than two dozen other experts in public health, health policy and industry reviewed data from 342 previously published studies on the sport. The work was funded in part by the World Golf Foundation.

Compared with other sports, the risk of injury in golf is moderate, these experts conclude. But because golf is an outdoor activity, golfers may have a higher risk of skin cancer than people who take up indoor sports or activities that don’t involve as much time outside.

To get the most benefit from the sport, golfers should play for at least 150 minutes a week and avoid riding in the golf cart, the authors advise. Players should also do warm-up and strengthening exercises to lower their risk of injury and use sunscreen and protective clothing to limit their risk of skin cancer.

Cost and perceptions of the sport as the domain of older white men may put some people off the idea of playing golf, however. The sport is also perceived as difficult to learn and unwelcoming to women and people of color.

Leaders in golf should make a greater effort to make the sport more inclusive and welcoming of people from all walks of life and ethnic backgrounds, the experts advise.

“Golf is one of many sporting activities that may contribute to the lowering of global physical inactivity, and it is a sport that is particularly popular among middle-aged and older adults with the potential of lifelong participation,” said Peter Krustrup, a professor of sport and health sciences at the University of Southern Denmark in Odense who wasn’t involved in the consensus statement.

For people who need to improve cardiovascular fitness, however, golf may need to be supplemented with other exercise, Krustrup said by email.

“Golf is a low-impact sport and golfers never reach very high heart rates when playing golf, making golf a non-optimal sport (for improving) cardiorespiratory fitness and musculoskeletal fitness,” Krustrup said. “Therefore, it makes good sense that the consensus statement says that taking part in physical activities additional to golf is likely to offer further health benefits.”

SOURCE: bit.ly/2IdzHC2 British Journal of Sports Medicine, online September 23, 2018.