Why Physical Activity Remains One of the Most Powerful Tools Against Chronic Disease

Islamabad (GNP): Chronic diseases have become the leading cause of death worldwide, with their prevalence rising across all age groups, genders, and ethnicities. While most chronic disease deaths occur in middle- and low-income countries, developed nations continue to face a significant burden as well, and multiple chronic conditions now affect children and adolescents alongside adults.

Being physically inactive is directly associated with this rising risk, and societies worldwide are increasingly affected by higher healthcare expenditures, reduced workforce productivity, military recruitment challenges, and declining academic performance linked to poor health.

The scale of the problem is considerable. Nearly one third of the world’s adult population, an estimated 1.8 billion people, do not meet the recommended levels of physical activity, a figure that has risen five percentage points since 2010 and is projected to reach 35 percent by 2030 if current trends continue.

Adolescents are affected even more heavily, with roughly 80 percent falling short of recommended activity levels. Women remain less active than men by an average of five percentage points, a gap that has persisted since 2000, while inactivity increases further after the age of 60 in both sexes. Left unaddressed, physical inactivity is expected to cost public healthcare systems close to 300 billion US dollars globally between 2020 and 2030.

Understanding why activity matters starts with recognising what inactivity does to the body. People who are insufficiently active face a 20 to 30 percent higher risk of death compared with those who meet activity guidelines.

In children and adolescents, regular activity supports bone health, healthy muscle growth, and improved motor and cognitive development, while inactivity is linked to increased body fat, poorer cardiometabolic health and reduced sleep. In adults, regular movement lowers the risk of cardiovascular disease, hypertension, type 2 diabetes, several site-specific cancers and falls, while also improving mental health, cognitive function and sleep quality.

For pregnant and postpartum women, staying active reduces the risk of pre-eclampsia, gestational diabetes, excessive weight gain and postpartum depression, with no evidence of harm to birthweight or increased stillbirth risk.

Sedentary behaviour compounds these risks independently of exercise levels. Increasingly sedentary lifestyles, driven by motorised transport and greater screen use for work, education and recreation, are associated with poorer cardiometabolic health and reduced sleep in young people, and with higher all-cause mortality, cardiovascular disease and cancer risk in adults.

This helps explain why global health guidelines now emphasise two complementary messages: any amount of activity is better than none, and time spent sedentary should be limited across all age groups, with muscle-strengthening activity recommended for everyone regardless of age.

The physiological explanation for these benefits lies in how the body responds to regular movement. Exercise improves myocardial strength and oxygen delivery while reducing the heart’s oxygen demand, lowers resting and submaximal heart rate, and reduces blood pressure and circulating stress hormones at rest and during exertion, effects that in some respects mirror medications such as beta-blockers but without their side effects.

Structured activity has been associated with substantial reductions in disease risk, including up to an 80 percent reduction in cardiovascular disease risk, a 90 percent reduction in type 2 diabetes risk, and a 33 percent reduction in cancer risk when incorporated as a preventive measure.

For those already living with chronic conditions, exercise-based rehabilitation programmes have been linked to meaningful reductions in cardiac mortality, hospital readmissions and the need for follow-up procedures.

Beyond the cardiovascular and metabolic systems, activity’s reach extends into the brain and immune system. Regular movement supports learning, memory and cognitive function through structural changes in the brain, and is associated with a lower risk of dementia and Parkinson’s disease.

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It also strengthens immune function, improves bone density and reduces the risk of osteoporosis-related fractures, while easing symptoms of depression and anxiety, an effect increasingly recognised as an important component of mental health care alongside physical health.

Addressing physical inactivity at a population level requires coordinated policy action rather than individual effort alone. WHO calls for governments to improve access to walking, cycling and public transport, expand activity opportunities within schools, workplaces and healthcare settings, and increase the availability of community sports facilities and public open spaces.

Achieving this requires collaboration across health, transport, education, employment and urban planning sectors, alongside sustained engagement from non-governmental organisations, to ensure policies are tailored to each country’s social and cultural context and that disparities in activity levels are directly addressed.

With a WHO of a 15 percent relative reduction in physical inactivity by 2030, closing this gap remains one of the most cost-effective public health opportunities available, offering benefits that extend from individual longevity to broader economic and social wellbeing.