It has been gold standard wisdom — stamped by the World
Health Organisation (WHO), no less — that a half hour of moderate exercise a
day goes a long way in keeping cardiovascular disease (CVD) at bay. However,
the evidence for this was based on studies in western Europe and the United
States and on people who took time out of their routine to exercise. In a study
published in The Lancet last week, that panned 17 countries and over a 100,000
people including India, a team of experts have established these benefits
across populations. Even better, they report, exercise doesn’t necessarily mean
a tedious treadmill routine but can include physical activity performed while
tidying up your house, commuting to work and even tending to your plants.
There was also no such thing as ‘too much exercise’, and
working out an hour-or-so over the minimum meant even more protection against
CVD, including death from cardiovascular disease, heart attack, stroke, or
heart failure, and reduced overall mortality in the sample of people studied.
The data
Of the 1,06,970 people studied over seven years who
conformed to the norms of various grades of exercise (moderate, heavy), the
risk of mortality was higher for people who did not meet the recommended amount
of activity — 6.4% compared to 4.2% for people who met guidelines. Also only
3.8% of those who met exercise criteria developed CVD compared to 5.1% of
people who did not meet exercise requirements.
Dr. R.M. Anjana, diabetologist at the Madras Diabetes
Research Foundation, said the benefit was “statistically significant” given the
large sample size involved. A co-author of the study, she said that the study
underlined the importance of integrating any form of physical activity into
one’s daily routine. “Previous studies have focussed on western populations
exercising in their leisure time. In countries such as India, a lot of physical
activity is part of work schedules and yes, that too contributed to a reduced
risk of CVD,” she told The Hindu. However the researchers didn’t break down the
health gains by country and instead “pooled” data across low-income and
high-income countries.
Were the entire population to meet physical activity
guidelines, 8% of deaths (equivalent to around one in 12 cases) and 4.6% of
cardiovascular disease cases (almost one in 20 cases) could be prevented.
Furthermore, if the entire population was highly active (completing more than
750 minutes of physical activity a week), 13% of deaths (around one in 8 cases)
and 9.5% of cardiovascular disease cases (around one in 10) could be prevented.
WHO recommendation
The WHO recommends that adults aged between 18-64 do at
least 150 minutes of moderate-intensity aerobic physical activity throughout
the week, as well as muscle strengthening exercises at least two days a week.
But estimates suggest that nearly a quarter of the world’s population is not
meeting physical activity guidelines.
The benefits of moderate exercise were significant — or
nearly 20% in reducing CVD risk — over not exercising, says Shifali Goenka, a
specialist in non-communicable diseases at the Public Health Foundation of
India, and who independently reviewed the study. “The work shows how important
it is to have better infrastructure and investment in community health,” she
added.
Cardiovascular disease is the leading cause of death
worldwide and a major economic burden globally. It is estimated that 70% of
cardiovascular disease deaths occur in low- and middle-income countries, where
it is the most common cause of death.
For the analysis, 130,843 participants aged between 35-70
from urban and rural areas in 17 countries across the world completed
questionnaires on their levels of physical activity. At the start of the study,
each participant provided information on their socioeconomic status, lifestyle
behaviours, medical history, family history of cardiovascular disease, weight,
height, waist and hip measurements, and blood pressure. They also completed a
questionnaire on the types of physical activity they completed over a typical
week, which the researchers used to calculate their average activity levels.
Participants completed follow-up visits with the research team at least every
three years to record information on cardiovascular disease and death for 6.9
years. The team analysed rates of cardiovascular events including death from
cardiovascular disease, heart attack, stroke, or heart failure and deaths.
Overall, almost a fifth of people in the study — (18%, 23631
people) — did not meet physical activity guidelines, but almost half — (44%,
57868 people) — were highly active.
