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Cited by 902Physical Activity and HealthCardiovascular and exercise physiologySports and Physical Education Studies

A systematic review of the evidence for Canada's Physical Activity Guidelines for Adults

Open access
Warburton, Darren ER, Charlesworth, Sarah, Ivey, Adam, Nettlefold, Lindsay, Bredin, Shannon SD·2010·International Journal of Behavioral Nutrition and Physical Activity
DOI 10.1186/1479-5868-7-39PMC PMC3583166
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Abstract

This systematic review examines critically the scientific basis for Canada's Physical Activity Guide for Healthy Active Living for adults. Particular reference is given to the dose-response relationship between physical activity and premature all-cause mortality and seven chronic diseases (cardiovascular disease, stroke, hypertension, colon cancer, breast cancer, type 2 diabetes (diabetes mellitus) and osteoporosis). The strength of the relationship between physical activity and specific health outcomes is evaluated critically. Literature was obtained through searching electronic databases (e.g., MEDLINE, EMBASE), cross-referencing, and through the authors' knowledge of the area. For inclusion in our systematic review articles must have at least 3 levels of physical activity and the concomitant risk for each chronic disease. The quality of included studies was appraised using a modified Downs and Black tool. Through this search we identified a total of 254 articles that met the eligibility criteria related to premature all-cause mortality (N = 70), cardiovascular disease (N = 49), stroke (N = 25), hypertension (N = 12), colon cancer (N = 33), breast cancer (N = 43), type 2 diabetes (N = 20), and osteoporosis (N = 2). Overall, the current literature supports clearly the dose-response relationship between physical activity and the seven chronic conditions identified. Moreover, higher levels of physical activity reduce the risk for premature all-cause mortality. The current Canadian guidelines appear to be appropriate to reduce the risk for the seven chronic conditions identified above and all-cause mortality.

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  • There is voluminous evidence that risks of remaining physically inactive, especially in those with chronic disease, are substantial.

    “There is voluminous evidence that risks of remaining physically inactive, especially in those with chronic disease, are substantial (38,45).”

    From Updating ACSM's Recommendations for Exercise Preparticipation Health Screening (2015) · cites this paper as [45]

    The Results section on physical inactivity and all-cause mortality describes extensive evidence linking inactivity to chronic disease and premature mortality. The Introduction also acknowledges benefits of activity for people with existing chronic conditions, but says the review emphasizes primary prevention; it does not establish that inactivity poses especially substantial risks for those already living with chronic disease. (LLM, conf=0.85)

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  • Using current prescreening algorithms can result in excessive referrals to physicians for medical clearance, which could be a barrier to adopting and maintaining a regular exercise program.

    “Recent studies have suggested that using the current ACSM exercise preparticipation health screening guidelines can result in excessive physician referrals, possibly creating a barrier to exercise participation.”

    From Updating ACSM's Recommendations for Exercise Preparticipation Health Screening (2015) · cites this paper as [45]

    The Methods > Screening passage concerns screening articles for the review, not screening people before exercise. The Introduction and Limitations discuss physical-activity guidelines and health outcomes, but the available copy does not address whether ACSM preparticipation screening causes excessive physician referrals or creates a barrier to exercise. Searches for ACSM, medical clearance, referrals, and participation barriers found no supporting passage; the copy is truncated. (LLM, conf=0.70)

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  • A large body of epidemiologic evidence shows that physically active individuals have a better cardio-metabolic risk profile, lower rates of major non-communicable diseases, better physical and mental function, and live longer than inactive individuals.

    “A large body of epidemiologic literature, accumulated over more than 60 years, shows that individuals who are physically active have a better cardio-metabolic risk profile, lower rates of major non-communicable diseases, better physical and mental function, and live longer, compared with those inactive.[1-3]”

    From Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges (2014) · cites this paper as [2]

  • Higher levels of physical activity are associated with lower rates of chronic diseases and increased longevity.

    “Many observational studies show an association between higher levels of physical activity and lower rates of chronic diseases and increased longevity (67).”

    From The CardioMetabolic Health Alliance (2015) · cites this paper as [67]

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Research works printed but not linked: 1

  1. Heart and Stroke Foundation of Canada Press Releases - Canadian leads effort to raise awareness of stroke as a global health epidemic 2007 Ottawa: Heart and Stroke Foundation of Canada

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Authors
Warburton, D. E., Charlesworth, S., Ivey, A., Nettlefold, L., & Bredin, S. S.
Affiliations
University of British Columbia (CA)
Corresponding author
Warburton, Darren ER
ORCID
Venue
International Journal of Behavioral Nutrition and Physical Activity
Publisher
Springer Science and Business Media LLC
Published
2010
Volume
7
Issue
1
Pages
39
ISSN
1479-5868 (ISSN-L)
DOI
10.1186/1479-5868-7-39
PMC
PMC3583166
OpenAlex
W2170267040
Cited by
902
References
382
Citations by year
2026: 13 · 2025: 25 · 2024: 34 · 2023: 43 · 2022: 47 · 2021: 68 · 2020: 81 · 2019: 69 · 2018: 83 · 2017: 77 · 2016: 75 · 2015: 70 · 2014: 80 · 2013: 64 · 2012: 43
FWCI
4.41
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • cIRcle (University of British Columbia) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Public Health Agency of Canada
  • Michael Smith Health Research BC
  • Public Health Agency
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Social Sciences › Life-span and Life-course Studies › Sports and Physical Education Studies
Keywords
physical activity guidelines, dose-response relationship, physical activity, all-cause mortality, cardiovascular disease, stroke, hypertension, colon cancer, breast cancer, type 2 diabetes, osteoporosis, chronic disease risk

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