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Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy
Open accessAbstract
Background Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world's population is inactive, this link presents a major public health issue. We aimed to quantify the eff ect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level.Methods For our analysis of burden of disease, we calculated population attributable fractions (PAFs) associated with physical inactivity using conservative assumptions for each of the major non-communicable diseases, by country, to estimate how much disease could be averted if physical inactivity were eliminated. We used life-table analysis to estimate gains in life expectancy of the population.Findings Worldwide, we estimate that physical inactivity causes 6% (ranging from 3·2% in southeast Asia to 7·8% in the eastern Mediterranean region) of the burden of disease from coronary heart disease, 7% (3·9-9·6) of type 2 diabetes, 10% (5·6-14·1) of breast cancer, and 10% (5·7-13·8) of colon cancer. Inactivity causes 9% (range 5·1-12·5) of premature mortality, or more than 5·3 million of the 57 million deaths that occurred worldwide in 2008. If inactivity were not eliminated, but decreased instead by 10% or 25%, more than 533 000 and more than 1·3 million deaths, respectively, could be averted every year. We estimated that elimination of physical inactivity would increase the life expectancy of the world's population by 0·68 (range 0·41-0·95) years.Interpretation Physical inactivity has a major health eff ect worldwide. Decrease in or removal of this unhealthy behaviour could improve health substantially.Funding None.
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“On the other hand, it is well known that increased physical activity has significant health benefits and is associated with the prevention and delayed onset of many chronic diseases [4, 6].”
From Can consumer wearable activity tracker-based interventions improve physical activity and cardiometabolic health in patients with chronic diseases? A systematic review and meta-analysis of randomised controlled trials (2020) · cites this paper as [4]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Physical inactivity is one of the major contributing factors for the development of chronic diseases and is highly correlated with mortality and hospitalization [4, 5].”
From Can consumer wearable activity tracker-based interventions improve physical activity and cardiometabolic health in patients with chronic diseases? A systematic review and meta-analysis of randomised controlled trials (2020) · cites this paper as [4]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Physical inactivity is a key contributor to premature mortality and morbidity, increasing the risk of major non-communicable diseases, including coronary heart disease, stroke, type 2 diabetes, cancers, and mental illness. 1”
From Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses. (2022) · cites this paper as [1]
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“At the same time, only 30% of states parties had reported meeting the IHR requirements to develop core health system capacities,215 and states widely ignored WHO travel recommendations.”
From The legal determinants of health: harnessing the power of law for global health and sustainable development (2019) · cites this paper as [215]
Experimental — accuracy not yet measuredIn the citing paper
“A recent study estimated that 5·3 million deaths were attributable to physical inactivity in 2008.186”
In the citing paper
“It is associated with a range of common diseases including multiple cardiometabolic outcomes such as obesity, type 2 diabetes, and cardiovascular diseases3.”
From GWAS identifies 14 loci for device-measured physical activity and sleep duration (2018) · cites this paper as [3]
In the citing paper
“Physical activity has been found in several studies to assist individuals in maintaining both their physical and cognitive function throughout life, as well as preventing some important chronic conditions 76 .”
From Mental health care for older adults: recent advances and new directions in clinical practice and research (2022) · cites this paper as [76]
In the citing paper
“Conversely, the relationship between physical inactivity and major noncommunicable diseases has been well-evidenced globally.13,14”
From Reduced physical activity in young and older adults: Metabolic and musculoskeletal implications (2019) · cites this paper as [13]
In the citing paper
“It is also a risk factor for ASCVD such as CAD and cerebrovascular disease577–587).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [585]
In the citing paper
“Lack of physical activity is associated with increased body fat (obesity), dyslipidemia, metabolic syndrome, hypertension, diabetes/impaired glucose tolerance, vascular endothelial dysfunction, and decreased physical fitness.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [585]
In the citing paper
“Indeed, this high prevalence of insufficient activity has been estimated to cause as many deaths worldwide each year as smoking:[5]”
From Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges (2014) · cites this paper as [5]
In the citing paper
“Moreover, some forms of exercise are anti-inflammatory, and if repeated regularly over the lifespan, there is a lower morbidity and mortality from diseases with an immunological and inflammatory aetiology.”
From Is immunosenescence influenced by our lifetime “dose” of exercise? (2016) · cites this paper as Lee et al. 2012
In the citing paper
“Moreover, if this form of exercise is undertaken regularly, so that age-specific guidelines concerning the recommended duration and frequency of exercise are met (e.g., 30 min of moderate intensity exercise on 5 days of the week for adults), the result is a better functioning immune system and a lower incidence of disease (Arem et al. 2015; Lee et al. 2012; World-Health-Organisation 2010).”
From Is immunosenescence influenced by our lifetime “dose” of exercise? (2016) · cites this paper as Lee et al. 2012
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Metadata
- Authors
- Lee, I.-M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., & Katzmarzyk, P. T.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Centers for Disease Control and Prevention (US)
- Finnish Institute for Health and Welfare (FI)
- University of South Carolina (US)
- Pennington Biomedical Research Center (US)
- Corresponding author
- Lee, I-Min
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 380
- Issue
- 9838
- Pages
- 219-229
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC3645500
- OpenAlex
- W2096528587
- Cited by
- 8,215
- References
- 27
- Citations by year
- 2026: 394 · 2025: 558 · 2024: 683 · 2023: 555 · 2022: 672 · 2021: 809 · 2020: 817 · 2019: 671 · 2018: 668 · 2017: 612 · 2016: 568 · 2015: 462 · 2014: 408 · 2013: 283 · 2012: 47
- FWCI
- 257.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion, cc-by-nc-nd)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Funders
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Heart, Lung, and Blood Institute (HL-007575, T32HL007575)
- National Cancer Institute (CA154647, R01CA154647)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- physical inactivity, non-communicable diseases, coronary artery disease, type 2 diabetes, breast cancer, colon cancer, premature mortality, life expectancy, population attributable fraction, disease burden, mortality averted, global health
- MeSH terms
- Breast Neoplasms, Colonic Neoplasms, Coronary Disease, Diabetes Mellitus, Type 2, Female, Humans, Life Expectancy, Risk Factors, Global Health, Exercise, Life Tables, Cost of Illness
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