Lack of exercise costs $67.5b, 5m lives a year

To reverse damage of sitting, take a brisk, hour-long walk

LONDON, July 28, (Agencies): A study of one million people has found that physical inactivity costs the global economy $67.5 billion a year in healthcare and productivity losses, but an hour a day of exercise could eliminate most of that.

Sedentary lifestyles are linked to increased risks of heart disease, diabetes and cancer, researchers found, but activity - such as brisk walking - could counter the higher likelihood of early death linked with sitting for eight or more hours a day.

Such inactivity is estimated to cause more than 5 million deaths a year - almost as many as smoking, which the World Health Organization (WHO) says kills 6 million a year.

Giving details of their findings at a briefing in London, the international team of researchers warned there has been too little progress in tackling a “pandemic of physical inactivity”.

Ulf Ekelund, a professor at the Norwegian School of Sports Sciences and Cambridge University, said that WHO recommendations for at least 150 minutes of moderate exercise a week was probably not enough. A quarter of adults worldwide do not meet even the WHO’s recommendations.

“You don’t need to do sport or go to the gym ... but you do need to do at least one hour a day,” he said, giving walking at 5.6 km an hour (km/h) or cycling at 16 km/h as examples of what was needed.

People who sat for eight hours a day but were otherwise active had a lower risk of premature death than people who spent fewer hours sitting but were also less active, suggesting that exercise is particularly important, no matter how many hours a day are spent sitting.

The greatest risk of premature death was for people who sat for long periods of time and did not exercise, according to the findings, published in The Lancet on Wednesday.

It has been long suspected that sitting a lot, at work or at home, is not healthy. Previous studies have found that prolonged sitting can raise the chances of heart disease, various cancers and an earlier death.

In the new research, experts combed through 13 papers with data on factors including how long people spend sitting, their physical activity levels and their television-watching habits. The majority of studies included people older than age 45. All except one were done in the US, Western Europe and Australia.

Researchers found that people with the highest levels of moderate physical activity — 60 to 75 minutes daily— erased the higher risk of death linked to being seated for more than eight hours a day. But even that exercise regime was not enough to counter the hazards of also watching more than five hours of television a day.

The paper was published Wednesday in the journal Lancet.

Research

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Lars Bo Andersen, who co-authored an accompanying commentary, called the new research “very convincing,” explaining that too much sitting increases the risk of problems including diabetes and heart disease because it can make insulin levels spike and might slow the body’s metabolism.

Andersen said that watching lots of television was probably even worse than sitting at the office all day because it likely includes other unhealthy habits.

“A lot of people don’t just watch TV, they eat fatty snacks at the same time,” said Andersen, of Sogn and Fjordane University College in Norway.

Andersen said that some cultures make it easier than others to squeeze in an hour of exercise every day, noting that in Denmark and much of Scandinavia, about half of all people either cycle or walk to work. But he said that getting the recommended amount of physical activity shouldn’t be overly arduous and doesn’t necessarily mean going to the gym for an intense work-out.

“If you are walking and can feel yourself getting a little warm and your breathing is a little heavier, that’s enough,” he said. “You don’t have to be sweaty and out of breath to get the benefits.”

In another of the series of four studies, researchers estimated healthcare costs and productivity losses for five major diseases linked to lack of exercise - heart disease, stroke, diabetes, breast cancer and colon cancer - cost $67.5 billion globally in 2013.

Melody Ding of the University of Sydney, who led this part of the research, said the costs occur largely in wealthier countries, but as poorer countries develop, so too will the economic burden of chronic diseases linked to inactivity.

Population

The research relied on economic and population data from 142 countries, representing 93 percent of the world’s population, its authors said.

But the figure was likely an underestimate as the data covered only five diseases — coronary heart disease, stroke, type 2 diabetes, breast cancer and colon cancer — at least the percentage attributable to physical inactivity.

The “cost calculations are based on conservative estimates, and the true cost may be even higher,” said a statement.

The paper was the first to estimate the monetary cost of the global “pandemic” of inactivity, and was part of a special series timed for release ahead of the August 5 opening of the Rio Olympic Games.

Of the total estimated cost, $31.2 billion was tax revenue lost to public healthcare spending, $12.9 billion in spending by the private sector, including health insurance companies, and $9.7 billion in direct medical costs for households.

The amounts were listed in “international dollars” — the equivalent of what an American dollar could buy in the United States in any given year.

The burden for rich countries was proportionally higher in money terms, while for poor and middle-income countries the cost was mainly in disease and premature death, the study found.

“Generally, poorer countries don’t have their health needs met due to less developed health and economic systems,” said Melody Ding from the University of Sydney, who led the research.

As these countries develop economically, “so too will the consequent economic burden, if the pandemic of physical inactivity spreads as expected,” she said.

A second study in the series said people who sit for eight hours a day may cancel out the increased risk of death this carries by doing at least an hour of exercise per day.

The World Health Organization advises 150 minutes or more of physical activity per week — much less than the daily 60 minutes recommended by the study, which analysed data from over a million people.