Scientific Statement From the American Heart Association

A pproximately 60 years ago, the foundational works of Jeremy Morris and colleagues showed that the incidence of coronary heart disease in bus conductors who climbed up and down stairs of double-deck buses collecting tickets and in postal carriers who delivered the mail on foot was lower than that of the relatively inactive bus drivers or postal office workers who spent most of their occupational time sitting. Since then, numerous other investigators have confirmed the strong link between physical activity and health in a variety of populations. 3 The accumulation of evidence connecting physical activity to health led the American Heart Association to include physical inactivity as a major risk factor for coronary artery disease in 1992. 4 A recent report characterized the impact of physical inactivity as similar to that of smoking in relation to the burden of noncommunicable diseases worldwide. 5 The deleterious effects of physical inactivity are associated with many of the most common chronic diseases and conditions, includ-In the United States, chronic diseases cause 7 in 10 deaths and account for ≈75% of all healthcare spending. 7 Chenoweth and Leutzinger 8 used data from direct medical expenditures, workers' compensation, and productivity loss to calculate that in 2003, the financial impact of physical inactivity for all US adults was ≈$251 billion. A physically active lifestyle is 1 of the top 10 health indicators for Americans in the Healthy People 2020 objectives 9 and is 1 of the 7 goals listed for ideal cardiovascular health in the 2020 American Heart Association Impact Goals. 10 In September 2012, the Global Cardiovascular Disease Taskforce, which comprises an international panel of experts in cardiovascular and noncommunicable disease communities , released a joint communication that set a goal of a 10% relative reduction in the prevalence of insufficient physical activity, which is 1 of the top 4 evidenced-based global targets to reduce noncommunicable disease. 11 The first public health recommendations for physical activity in the United States were released in 1995, 12 and these were followed by additional and updated recommendations in 1996 3 and 2007. In 2008, the body of evidence culminated in the first-ever federal guidelines for physical activity. 6 These guidelines simplified the message for the general public concerning health-enhancing levels of physical activity and included the following recommendations: (1) Adults should avoid inactivity (ie, some physical activity is better than none); (2) substantial health benefits are obtained from …