Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Physical Activity and Risk of Multiple Diseases
BMJ; ePub 2016 Aug 9; Kyu, Bachman, et al
Increasing total physical activity levels is associated with a significant reduction in the risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events, a recent study showed. The prospective cohort studies examined the associations between physical activity and at least 1 of the 5 diseases studied. Researchers found:
• While higher levels of total physical activity were significantly associated with lower risk for all outcomes, major gains occurred at lower levels of activity (up to 3,000 to 4,000 metabolic equivalent (MET) minutes per week).
• Individuals with a total activity level of 600 MET minutes per week had a 2% lower risk of diabetes compared with those reporting no physical activity; this risk was reduced by an additional 19% when total activity level increased from 600 to 3,600.
• The same amount of increase yielded much smaller returns at higher levels of activity.
• Compared with insufficiently active individuals (total activity <600 MET minutes per week), the risk reduction for those in the highly active category (>8,000 MET minutes per week) was:
◊ 14% for breast cancer.
◊ 21% for colon cancer.
◊ 28% for diabetes.
◊ 25% for ischemic heart disease.
◊ 26% for ischemic stroke.
Kyu HH, Bachman VF, Alexander LT, et al. Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: Systematic reviews and dose-response meta-analysis for the Global Burden of Disease Study 2013. [Published online ahead of print August 9, 2016]. BMJ. doi:10.1136/bmj.i3857.
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The health benefits of physical activity are impressive. This study furthers existing data demonstrating the importance of exercise. The article also shows that one does not have to run marathons to achieve this benefit, and that the improvement in outcomes is graded with the greatest proportion of benefit occuring with modest increases in physical activity. The benefits of lifestyle modification shown in this study supports the AHA Science Advisory that “health is being lost from childhood through young adulthood and that the major reasons are adverse health behaviors related to diet, physical activity, healthy weight maintenance, and smoking…The elimination of these health risk behaviors would make it possible to prevent at least 80% of heart disease, stroke, and type 2 diabetes mellitus, and even 40% of cancers.”1 If we want to substantially decrease the disease burden experienced by our patients, there is no question that advising exercise needs to be an essential part of our approach. —Neil Skolnik, MD
1. Spring B, Ockene JK, Gidding SS, et al. Better population health through behavior change in adults. A call to action. Circulation. 2013;128(19):2169. doi:10.1161/01.cir.0000435173.25936.e1.