Cited by 2,575Physical Activity and HealthCardiovascular and exercise physiologyExercise and Physiological Responses

The DOI matches its Crossref record; 587 of the 587 references it cites were found in a registry or an index; 3 of the 559 sources its claims cite were checked for support.

Lack of Exercise Is a Major Cause of Chronic Diseases

Open access
Booth, Frank W., Roberts, Christian K., Laye, Matthew J.·2012·Comprehensive Physiology

Abstract

Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause versus treatment; physical activity and inactivity mechanisms differ; gene‐environment interaction (including aerobic training adaptations, personalized medicine, and co‐twin physical activity); and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [accelerated biological aging/premature death, low cardiorespiratory fitness (V o 2 max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, nonalcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, pre‐eclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer‐term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life. © 2012 American Physiological Society. Compr Physiol 2:1143‐1211, 2012.

Overview

Integrity signals

Registry

Crossref · 10.1002/cphy.c110025

Cites

587 of 587 references verified0 citation errors · 0 not checkable

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Claims the paper makes

428 Not checked yet · 139 Own interpretation · 43 Sources not found · 17 No basis given · 7 Own result · 5 Own method · 3 Supported

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  • It may state two separate claims as one. 169
  • Probably not a substantial claim. 50
  • The quote only partly states this claim. 1
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  • The paper relies on this without support.

    Inherited genes and their interaction with activity levels determine physical fitness.

    “Inherited genes and their interaction with physical activity levels determine physical fitness.”
  • The paper relies on this without support.

    A direct link between functional capacity and survival is a cornerstone of general medicine theory.

    “Importantly, a direct relationship between functional capacity and survival is a cornerstone of general medicine theory.”
  • The paper relies on this without support.

    Contemporary hunter-gatherer and agrarian Amish physical activity levels are valid proxies for ancestral or modern active human activity levels.

    “The modern hunter-gatherers' daily estimated energy expenditures for physical activity are at least 600 kcal more than the average U.S. sedentary adult of today, as documented in column labeled “EE PA” (Table 7) (385).”
  • The paper relies on this without support.

    Findings from rodent models of voluntary wheel running generalize to human obesity prevention.

    “Obesity is primarily prevented in at least two genetically modified, obese rodent models by allowing natural, instinctive voluntary running.”
  • The paper relies on this without support.

    Bed rest and step reduction are valid models of chronic physical inactivity in free-living humans.

    “Conversely, more extreme physical inactivity such as strict bed rest for 24-hr/day lasting 5 days (216), 7 days (46, 342, 495), and 9 days (7) is also associated with substantial increases in insulin resistance.”
  • The paper relies on this without support.

    Caloric expenditure estimates from domestic mechanization and walking/standing can be annualized to fat gain.

    “The annualization of 110 kcal/day is the caloric equivalent of 11.5 pounds of fat/yr.”
  • The paper relies on this without support.

    The FTO polymorphism associations reflect a causal interaction between genotype and physical inactivity.

    “In summary then, physical inactivity is required to elicit the phenotype of obesity with polymorphisms predisposing to obesity for the human FTO gene.”
  • The paper relies on this without support.

    The Amish and general population differ primarily in physical activity rather than other lifestyle or dietary factors.

    “Thus, while caloric intake has dropped between 0 and 600 kcal/day in the general population it is the lack of 600 kcal/day of physical activity has led to a large discrepancy in the obesity rates between the modern general population and Amish societies.”
  • The paper relies on this without support.

    Type 2 diabetes progresses through a continuum from early prediabetes to late prediabetes to diabetes.

    “While early prediabetes, late prediabetes, and diabetes are in a continuum, they differ in success of primary prevention by physical activity.”
  • The paper relies on this without support.

    The modified Bergman figure's points A, B, and C represent stages of insulin resistance, prediabetes, and type 2 diabetes progression.

    “points B to A in the modified Bergman Fig. 12”
    “prevents movement from point A to B in the modified Bergman figure (Fig. 12), and of decreased beta-cell insulin secretion and of prediabetes (prevents movement from point B to C in Bergman's Fig. 12).”
  • The paper relies on this without support.

    Intent-to-treat values represent the sum of behavioral and biological mechanisms for all subjects.

    “Intent-to-treat values in both studies are the sum of behavioral and biological mechanisms for 100% of the subjects”
  • The paper relies on this without support.

    Type 2 diabetes has 18 candidate loci that account for less than 7% of the total identifiable genetic load.

    “A complex disease such as T2D has, at present, 18 multiple candidate loci that account for only a small percentage (< 7%) of the total identifiable genetic load.”
  • The paper relies on this without support.

    Hypertension precedes 75% of congestive heart failure cases.

    “Hypertension precedes 75% of CHF cases.”
  • The paper relies on this without support.

    The most physically active men and women have a 25% to 30% lower risk for stroke incidence and mortality.

    “The most physically active men and women have a 25% to 30% lower risk for stroke incidence and mortality.”
  • The paper relies on this without support.

    For every 1% reduction in LDL-C levels, a 1% reduction occurs in relative risk for major coronary heart disease events.

    “for every 1% reduction in LDL-C levels, a 1% reduction occurs in relative risk for major CHD events.”
  • The paper relies on this without support.

    Observational associations between physical inactivity and disease outcomes reflect a causal effect of inactivity rather than confounding or reverse causation.

    “Physical inactivity causes up to 1/3rd of depression.”
    “Physical inactivity is a primary cause of bone loss in weight-bearing bones.”
  • The paper relies on this without support.

    Findings from animal models and mechanistic studies can be generalized to humans.

    “Epidemiological, interventions, and mechanistic insights from human and rodent studies all suggest that physical inactivity can accelerate declines in cognitive function; a decline that be attenuated or potentially reversed by physical activity.”
  • The paper relies on this without support.

    Self-reported physical activity accurately classifies exposure in observational studies.

    “While many of the studies relied on self-questionnaires, 8 cohort studies contained clinical diagnosis of depression symptoms, which reported an increase of 40% in the inactive group.”
  • The authors state this as an assumption.

    The trend analysis assumes that the level of physical activity would be sustained.

    “assuming that the level of activity would be sustained”
  • The paper relies on this without support.

    Atherosclerosis results from lifetime accumulation of vascular lesions and plaques.

    “Atherosclerosis is a consequence of lifetime accumulation of vascular lesions and plaques.”
  • The paper relies on this without support.

    Increases in bone mineral mass, skeletal muscle mass, and cardiorespiratory fitness occur throughout childhood and adolescence, peak in the third decade of life, and then decline with aging.

    “Increases in bone mineral mass, skeletal muscle mass, and CRF occur throughout childhood and adolescence peaking and have their greatest lifetime values in the third decade of life. Thereafter with aging, their respective values progressively decline to lower values”
  • The paper relies on this without support.

    Skeletal muscle power peaks about the third decade of life and then declines.

    “Skeletal muscle power peaks about the third decade of life, and then declines thereafter”
  • The paper relies on this without support.

    VO2max peaks at the third decade of life and then declines.

    “VO2max peaks at the third decade of life, and thereafter declines”
  • The paper relies on this without support.

    Physical activity reduces prevalence of many conditions that are not obesity co-morbidities.

    “physical activity reduces prevalence of many conditions that are not obesity co-morbidities”
  • The paper relies on this without support.

    Exercise and chronic diseases are complex polygenic conditions.

    “Exercise and chronic diseases are complex polygenic conditions.”
  • The paper relies on this without support.

    The scientific and technical expertise to appreciate the complexity of exercise/inactivity and chronic diseases is limited within the scientific community.

    “The scientific and technical expertise to appreciate the complexity of exercise/inactivity and chronic diseases is limited within the scientific community.”
  • The paper relies on this without support.

    Physical activity, food, and reproduction are some of the minimal requirements for life.

    “Physical activity, food, and reproduction are some of the minimal requirements for life.”
  • The paper relies on this without support.

    Physical activity, food, and reproduction evolved as requirements for individual and species survival, not as choices.

    “They evolved not as choices, but as requirements for individual and species survival.”
  • The paper relies on this without support.

    Modern humans have been able to engineer most physical activity out of daily life.

    “Modern humans have been able to engineer most physical activity out of daily life.”
  • The paper relies on this without support.

    Humans now have a choice not to be physically active.

    “Humans now have a choice not to be physically active.”
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Research works printed but not linked: 3

  1. Brooks GA, 2005, Exercise Physiology
  2. Cameron C, 2007, Physical Activity and Sport: Encouraging Children to be Active, 14
  3. Cordain L, 2005, The Paleo Diet for Athletes: A Nutritional Formula for Peak Athletic Performance

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Metadata

Authors
Booth, F. W., Roberts, C. K., & Laye, M. J.
Affiliations
  • University of Missouri (US)
  • University of California, Los Angeles (US)
  • Buck Institute for Research on Aging (US)
Venue
Comprehensive Physiology
Publisher
Wiley
Published
2012-04
Volume
2
Issue
2
Pages
1143-1211
ISSN
2040-4603 (ISSN-L)
OpenAlex
W2135019055
Cited by
2,575
References
587
Citations by year
2026: 63 · 2025: 148 · 2024: 312 · 2023: 273 · 2022: 329 · 2021: 326 · 2020: 277 · 2019: 241 · 2018: 179 · 2017: 170 · 2016: 118 · 2015: 75 · 2014: 37 · 2013: 20 · 2012: 5
Type
other
Language
en
Open access
Locations
  • Comprehensive physiology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR019393)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
Keywords
physical inactivity, chronic disease prevention, physical activity, gene-environment interaction, cardiorespiratory fitness, sarcopenia, metabolic syndrome, type 2 diabetes, cardiovascular disease, depression, osteoporosis, sedentary behavior, public health policy, quality of life
MeSH terms
Adaptation, Physiological, Chronic Disease, Humans, Motor Activity, Pharmacogenetics, Physical Fitness, Risk Factors, Exercise, Twin Studies as Topic, Metabolic Syndrome, Sedentary Behavior, Gene-Environment Interaction

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