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British Journal of Sports Medicine

Clinical Articles, Lead Article

Moderate physical activity “as good as giving up smoking”

30 minutes of physical activity ¬– irrespective of its intensity – six days a week is linked to a 40% lower risk of death from any cause among elderly men, according to research published recently in the British Journal of Sports Medicine.1

Boosting physical activity levels in this age group seems to be as good for health as giving up smoking, the findings suggest. The researchers base their findings on people taking part in the Oslo Study, which invited almost 26,000 men born between 1923 and 1932 for a health check in 1972–3 (Oslo I).

Some 15,000 agreed. Their height, weight, cholesterol and blood pressure were all assessed, and they were asked whether they smoked. They were also asked to respond to a validated survey (Gothenburg questionnaire) on their weekly leisure time physical activity levels.

These were categorised as sedentary (watching TV/reading); light (walking or cycling, including to and from work for at least 4 hours a week); moderate (formal exercise, sporting activities, heavy gardening for at least 4 hours a week); and vigorous (hard training or competitive sports several times a week).

Professor Ingar Holme (Norwegian School of Sport Sciences)

Professor Ingar Holme (Norwegian School of Sport Sciences)

Some 6,000 of the surviving men repeated the process in 2,000 (Oslo II) and were monitored for almost 12 years to see if physical activity level over time was associated with a lowered risk of death from cardiovascular disease, or any cause, and if its impact were equivalent to quitting smoking.

During the monitoring period, 2,154 out of the 5,738 men who had gone through both health checks died. The analysis indicated that less than an hour a week of light physical activity was not associated with any meaningful reduction in risk of death from any cause. But more than an hour was linked to a 32% to 56% lower risk.

Less than an hour of vigorous physical activity, on the other hand, was linked to a reduction in risk of between 23% and 37% for cardiovascular disease and death from any cause. The more time spent doing vigorous exercise the lower the risk seemed to be, falling by between 36% and 49%.

Men who regularly engaged in moderate to vigorous physical activity during their leisure time lived five years longer, on average, than those who were classified as sedentary. Factoring in that the risk of death from heart disease/stroke rises with age, made only a slight difference to the results.

Overall, these showed that 30 minutes of physical activity – of light or vigorous intensity – 6 days a week was associated with a 40% lower risk of death from any cause.

The impact would seem to be as good for health as quitting smoking among this age group, suggest the researchers. This is an observational study so no definitive conclusions can be drawn about cause and effect, and the researchers point out that only the healthiest participants in the first wave of the study took part in the second wave, which may have lowered overall absolute risk.

But the differences in risk of death between those who were inactive and active were striking, even at the age of 73, they suggest. More effort should go into encouraging elderly men to become more physically active, with doctors emphasising the wide range of ill health that could be warded off as a result, conclude the researchers.

Speaking to BJC Arrhythmia Watch, co-author Professor Ingar Holme (Norwegian School of Sport Sciences, Norway) said that the findings reflect “activity patterns in 1972/73 and year 2000 with mortality experience 12 years thereafter. The degree of PA may historically have been larger than in many other large European cities, but nowadays these contrasts are probably much wiped out, since degree of the PA has been reduced also in Norway.”

“We have few PA studies where objective methods have been used, but according to measurement methods such as accelerometers we know that both Norway and Sweden have about the same volume of PA, but well below 50% of us follow the recommendations of PA in our two countries. This is probably also the case for the rest of Europe, but such data are scarce,” he added.

“The benefits of PA are frequently cited in media in Norway, so people are well informed. Historically, we like to look on ourselves as active people, but the truth today is actually a bit different. Questionnaires measuring PA are highly questionable, but are our main source of information. They show a high degree of PA in all EU countries as in Norway, but they differ largely when in the same study objective and questionnaire data are compared,” Professor Holme concluded.


1. Holme I, Anderssen SA. Increases in physical activity is as important as smoking cessation for reduction in total mortality in elderly men: 12 years of follow up of the Oslo II study.  Br J Sports Med 2015;49:743–8.

Published on: June 26, 2015

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