WHO recommends that adults aged between 18 and 64 engage in at least 150 minutes of aerobic physical activity of moderate intensity a week

Next time, don’t hit the snooze button when the alarm goes off and skip your morning workout. The consequences could be worse than what you thought, according to a new study.

The findings of the study suggest that a sedentary lifestyle is worse for one’s health than smoking, diabetes and heart disease. While it is common knowledge that physical inactivity is a leading cause of disease and disability, the study emphasises the extent to which it can impact health.

The study, conducted by researchers at Cleveland Clinic, United States, was published on October 19 in the Journal of the American Medical Association Network Open. It found that the risk associated with poor cardiorespiratory fitness was comparable to or even exceeded that of traditional clinical risk factors such as smoking, diabetes, and cardiovascular disease.

The findings emphasise the long-term benefits of exercise and fitness, regardless of age or coexistent cardiovascular disease, said Wael Jaber, Cleveland Clinic cardiologist and senior author of the study.

The researchers retrospectively studied 1,22,007 patients who underwent treadmill testing at Cleveland Clinic between January 1, 1991 and December 31, 2014. They measured all-cause mortality relating to the benefits of exercise and fitness. It was found that increased cardiorespiratory fitness was directly associated with reduced long-term mortality, with no limit on the positive effects of aerobic fitness. Extreme aerobic fitness was associated with the greatest benefit, particularly in older patients (70 and above) and those with hypertension.

“Aerobic fitness is something that most patients can control. And we found in our study that there is no limit to how much exercise is too much. Everyone should be encouraged to achieve and maintain high fitness levels,” Dr. Jaber told The Hindu in an email interaction.

‘Surprising’ findings

Terming the findings “surprising”, he said that being unfit on a treadmill or in an exercise stress test had a worse prognosis than being hypertensive, diabetic or a smoker. “It should be treated almost as a disease that has a prescription, which is called exercise,” he said.

“We also saw that the negative impact on survival from being in the lowest fitness group is worse than almost all known risk factors that we associate with death — hypertension, diabetes, cholesterol, and even kidney failure. Since the focus has always been on addressing these risks to improve mortality, we found that the biggest risk was just under our nose — being physically less fit,” Dr. Jaber said.

Corroborating the findings, C.N. Manjunath, director of Sri Jayadeva Institute of Cardiovascular Sciences, pointed out that a recent study in The Lancet had found that four out of 10 Indians were not sufficiently active. Some studies have even said that 52% of Indians are physically inactive, he said.

“There is a correlation between heart rate and longevity. With exercise, there will be reduced stimulation of the sympathetic nervous system (SNS). Increased SNS stimulation raises heart rate and blood pressure, promotes clotting of blood, and causes constriction of arteries. Exercise conditions the body,” he said.

Pointing out that anxiety, stress, disturbed sleep pattern and related factors stimulate the SNS, the doctor said: “A sedentary lifestyle is an unhealthy habit that is easy to beat, provided you break it down into small tasks. For instance, start your day with 15 minutes of stretching, yoga or walking. If you have a desk-bound job, keep an hourly reminder to take a five-minute ‘walk break’. Find a physical activity that makes you happy,” Dr. Manjunath said.

WHO recommendation

The World Health Organisation (WHO) recommends that adults aged between 18 and 64 engage in at least 150 minutes of aerobic physical activity of moderate intensity, or 75 minutes of vigorous aerobic activity, a week, or an equivalent combination of moderate- and vigorous-intensity activity.

While aerobic activity should be performed in bouts of at least 10 minutes, for additional health benefits adults should increase their moderate-intensity activity to 300 minutes a week, or engage in 150 minutes of vigorous activity a week, or an equivalent combination of both. Muscle-strengthening activities should be done involving major muscle groups for two or more days a week. The recommendations are relevant to all healthy adults, unless specific medical conditions indicate to the contrary.