![]() They were required to complete an exercise treadmill test (ETT) to establish their fitness level. The subjects included in the study had no personal history of MI, hypertension, diabetes, or stroke, and no resting or stress-induced electrocardiogram (ECG) changes. The relationship of fitness to all-cause mortality was examined in the Aerobics Center Longitudinal Study of 13 344 healthy people. Thus, cardiorespiratory fitness (referred to simply as “fitness” in this article) can be used as an objective surrogate measure of recent physical activity patterns. ![]() (See the Box for a definition of MET and other fitness-related terms used in this article.) Although determinants of cardiorespiratory fitness include age, sex, health status, and genetics, the principal determinant is habitual physical activity levels. While physical activity can be difficult to estimate, fitness can be assessed readily using the metabolic equivalent task (MET) to provide an objective measure of a subject’s fitness. Physical activity is an important determinant of cardiorespiratory fitness and fitness is related to physical activity patterns. Physical activity and primary prevention of all-cause mortalityĬontemporary studies have consistently demonstrated the inverse relationship between physical activity and rates for all-cause mortality and cardiovascular death (CVD). These observations were the first formal studies to link physical inactivity and heart disease. Based on these findings, Morris and colleagues postulated that physically active work offered a protective effect, predominantly related to sudden cardiac death as a first manifestation of disease. Similarly, it was shown that physically active postal workers had lower rates of incident CHD and SCD than their less active co-workers. Furthermore, sudden cardiac death (SCD) occurred less often in conductors than drivers (0.5/1000 versus 1.1/1000), and the conductors’ CHD were more likely to manifest as angina than SCD. Despite coming from similar social classes, the physically active conductors had lower rates of CHD than the physically inactive drivers (overall annual incidence of 1.9/1000 for conductors versus 2.7/1000 for drivers). Dr Jeremy Morris examined the differences in CHD incidence between two groups of men working on London’s double-decker buses: the drivers, who were sedentary (sitting for more than 90% of their shifts), and the conductors, who were physically active (climbing roughly 500 to 750 steps a day). It was not until landmark epidemiological studies in the 1950s that physical inactivity was associated with increased risk of coronary heart disease (CHD). Moreover, the recommended treatment of the time after myocardial infarction was complete bed rest. However, by the mid-20th century it was believed that physical activity might be harmful to health. Given the significant health benefits afforded by physical activity, considerable efforts should be made to promote this vital agent of health.Īncient philosophers and physicians such as Plato and Hippocrates believed in the relationship between physical activity and health, and the lack of physical activity and disease. ![]() However, the most unfit individuals have the potential for the greatest reduction in risk, even with small increases in physical activity. The benefits of physical activity exhibit a dose-response relationship the higher the amount of physical activity, the greater the health benefits. Because the health benefits of activity have been established and physical inactivity is a modifiable risk factor central to the development of many chronic diseases, it is imperative that we encourage regular physical exercise for optimal health. An extensive effort to ascertain the benefits from the current Canadian physical activity guidelines on all-cause mortality and seven chronic diseases suggests that the current recommendation for at least 150 minutes of moderate-to-vigorous aerobic physical activity per week in sessions of 10 minutes or more is associated with a 20% to 30% lower risk for premature all-cause mortality and incidence of many chronic diseases. Additionally, physical activity can promote healthy cognitive and psychosocial function. Furthermore, physical activity can reduce the development of chronic diseases such as hypertension, diabetes, stroke, and cancer. High levels of physical activity and cardiorespiratory fitness (referred to simply as “fitness” in this article) are associated with lower all-cause and cardiovascular mortality. ABSTRACT: The benefits of physical activity are plentiful and significant. ![]()
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