The physical activity paradox: six reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does
Open accessAbstract
Physical activity (PA) is well documented to improve health. However, this documentation is restricted to leisure time physical activity (LTPA; eg, sports, recreation and transportation). Increasing evidence shows that occupational physical activity (OPA) does not improve health.1 Actually, OPA can be detrimental. These contrasting health effects of LTPA and OPA constitute the so-called PA health paradox.2 For a considerable fraction of the adult population, work constitutes the main setting for PA. Workers in many occupations, such as construction, cleaning, refuse collection, elderly care, farming and manufacturing, are physically active for large parts of their working days, for most of the year. Despite this PA at work, these and other manual workers have relatively poor health. Many epidemiological studies document that high OPA increases the risk for cardiovascular disease (CVD) and mortality outcomes, even after extensive adjustments for other risk factors including socioeconomic status, LTPA and other health behaviours.1 This increased risk from high OPA has been shown to be particularly pronounced among workers with low job resources, low cardiorespiratory fitness3 or pre-existing …
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Occupational physical activity does not seem to have the required intensity to improve cardiorespiratory fitness.
“However, occupational physical activity does not seem to have the required intensity to improve cardiorespiratory fitness [35].”
From Improved cardiorespiratory fitness after occupational rehabilitation in merged diagnostic groups (2018) · cites this paper as [35]
Low socioeconomic status usually associated with high levels of occupational physical activity might have a confounding effect on the physical activity paradox.
“the low socioeconomic status usually associated with high levels of occupational PA might also have a confounding effect.47”
From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [47]
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Cites
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Coenen, P., Huysmans, M. A., Holtermann, A., Krause, N., van Mechelen, W., Straker, L. M., & van der Beek, A. J. (2018) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098540 · Cited by 360 · see citing works
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Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation
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Improved cardiorespiratory fitness after occupational rehabilitation in merged diagnostic groups
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“However, occupational physical activity does not seem to have the required intensity to improve cardiorespiratory fitness [35].”
Background
- Authors
- Holtermann, A., Krause, N., van der Beek, A. J., & Straker, L.
- Affiliations
- University of Southern Denmark (DK)
- University of California, Los Angeles (US)
- Curtin University (AU)
- Corresponding author
- Holtermann, Andreas
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2017-08-10
- Volume
- 52
- Issue
- 3
- Pages
- 149-150
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2742865113
- Cited by
- 667
- References
- 8
- Citations by year
- 2026: 105 · 2025: 92 · 2024: 82 · 2023: 89 · 2022: 75 · 2021: 92 · 2020: 64 · 2019: 45 · 2018: 21 · 2017: 1 · 2014: 1
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- British Journal of Sports Medicine (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, cc-by-nc)
- eSpace (Curtin University) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Safety in Workplaces
- Keywords
- occupational physical activity, leisure-time physical activity, cardiovascular health, cardiovascular risk, blue-collar workers, job resources, cardiorespiratory fitness, mortality, occupational health
- MeSH terms
- Cardiorespiratory Fitness, Cardiovascular Diseases, Humans, Leisure Activities, Occupations, Rest, Exercise
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