Movement and physical activity
The body was made to move. Regular movement sustains strength, mobility and cardiovascular health, and is associated with a lower risk of several chronic diseases.2
It is the pillar closest to Health Lab's clinical work.
Any movement counts, and the more time sitting, the higher the risk.
Physical activity, even in relatively small amounts, is associated with lower mortality risk.3 The evidence also shows that the benefit grows as we accumulate more movement through the day, although the biggest gains come when we go from very low levels of activity to some regular movement.1,3
Movement and function are closely linked. How we use the body shapes what we are able to do, which is why movement is so close to the work we do in the appointment.
6 to 10 thousand: where the gain levels off.
- 3.6k
- reference
- 5.8k
- 0.60
- 7.8k
- 0.55
- 10.9k
- 0.47
The four values are the ones published in the study, by quartile of steps (each quartile's median, and the risk relative to the lowest quartile), for the population studied. The curve is schematic. The site does not classify your case.
Between 6,000 and 8,000 steps the gain starts to level off from age 60; before that, the curve keeps falling until about 8,000 to 10,000.
This is what the meta-analysis shows for the population studied; it is not an assessment of you. On the platform, what we build with you is the habit, with consistency.
What is asked and what is measured.
Frequency and type of exercise
How many times a week you do physical activity and what kind: strength training, aerobic exercise or sport. Different types of exercise have distinct, complementary effects on health.2
Sitting time per day
How long you sit through the day. It is a different dimension from physical activity and is therefore assessed separately: activity attenuates the risk of long sitting time without eliminating it.4
Resting heart rate
In population studies, a higher resting heart rate is associated with higher cardiovascular and all-cause mortality.6 It should be interpreted together with other factors, such as physical activity, sleep, stress and smoking.
VO2 max
A measure of cardiorespiratory fitness which, in population studies, is associated with cardiovascular risk and mortality.7 Some wearables can estimate it: the estimate is right on average, but the error for one person can be large.8 It should be interpreted in the context of the person and the device used.
Tobacco
Smoking weighs on cardiovascular health: smoking about one cigarette a day is already associated with close to half the excess risk of coronary heart disease and stroke of smoking twenty.9 It should be considered when reading the other indicators.
Reported signs
Fatigue with light effort, stiffness when moving, loss of strength or other changes felt day to day help put the other data in context.
None of these pieces is read alone.
Resting heart rate is interpreted together with physical activity, cardiorespiratory fitness, sleep, stress, smoking and sitting time.
None of these indicators defines, on its own, a person's state of health. Context and change over time are fundamental to interpreting them.
The platform organises and presents the information. Interpreting the whole belongs to the health professional.
Habits that help you stay active.
Moderate aerobic activity
Walking, cycling or swimming. The general recommendation for adults is to accumulate 150 to 300 minutes of moderate aerobic activity a week.2
Strength training
Work the main muscle groups at least twice a week.2
Movement breaks
Break up long periods of sitting with short moments of movement through the day.2 In a trial with overweight adults, 2-minute walking breaks every 20 minutes lowered glucose and insulin after a standardised drink, compared with sitting without a break.5
What people ask about movement and physical activity.
How many steps a day make a difference?
In the meta-analysis of 15 cohorts by Paluch et al. (2022), the risk of death from any cause falls with steps up to about 6,000 to 8,000 a day from age 60, and 8,000 to 10,000 before that. The biggest gain is in leaving very low levels of activity: you do not need to be an athlete, you need not to stop.
How much exercise does the WHO recommend?
For adults, 150 to 300 minutes of moderate aerobic activity a week and strength training of the main muscle groups at least twice a week (WHO, 2020). Any movement counts, and the benefit grows with the amount accumulated through the day.
How much sitting is too much?
There is no single number, and sitting is a different dimension from physical activity: activity attenuates the risk of long sitting time without eliminating it (Ekelund et al., 2016). Breaking up long periods of sitting with short movement breaks helps: in a trial, 2-minute walking breaks every 20 minutes lowered glucose and insulin after a standardised drink (Dunstan et al., 2012).
Is the VO2 max on my watch reliable?
On average it is right, but the error for one person can be large (Molina-Garcia et al., 2022). It is worth reading as a trend over time, in the context of the person and the device, not as a single value.
References (9)
- Paluch AE, et al. Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. Lancet Public Health. 2022;7(3):e219-e228. doi:10.1016/S2468-2667(21)00302-9
- Bull FC, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-1462. doi:10.1136/bjsports-2020-102955
- Ekelund U, et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ. 2019;366:l4570. doi:10.1136/bmj.l4570
- Ekelund U, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? Lancet. 2016;388(10051):1302-1310. doi:10.1016/S0140-6736(16)30370-1
- Dunstan DW, et al. Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care. 2012;35(5):976-983. doi:10.2337/dc11-1931
- Zhang D, Shen X, Qi X. Resting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis. CMAJ. 2016;188(3):E53-E63. doi:10.1503/cmaj.150535
- Ross R, et al. Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign. A scientific statement from the American Heart Association. Circulation. 2016;134(24):e653-e699. doi:10.1161/CIR.0000000000000461
- Molina-Garcia P, et al. Validity of estimating the maximal oxygen consumption by consumer wearables: a systematic review with meta-analysis and expert statement of the INTERLIVE network. Sports Med. 2022;52(7):1577-1597. doi:10.1007/s40279-021-01639-y
- Hackshaw A, Morris JK, Boniface S, Tang JL, Milenković D. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ. 2018;360:j5855. doi:10.1136/bmj.j5855
The references describe results observed in populations. They do not determine what happens to each person. Individual interpretation belongs to the health professional.
Caring for health means thinking long term.
In the appointment, we look at your health, movement and context to define an approach suited to your needs.