Study: Lack of Exercise Is Worse Than Smoking

Written by Dr. Joseph Mercola Fact Checked

exercise lengthens life

Story at-a-glance -

  • Analysis of research data from over 120,000 patients demonstrated a lack of fitness, as measured by a treadmill test, was predictive of premature death to a greater degree than smoking, heart disease or high blood pressure
  • Exercise is one of the best preventive strategies against many physical and mental disorders. Nonexercise movement is an independent risk factor for disease and early death and may be as important to your longevity
  • Many sit each day for up to 12 hours in 16 hours of waking time, increasing their risk of premature death and chronic disease independently of any exercise they may do during the day
  • Exercise and nonexercise movement are important to prevent disease and lengthen life; high-intensity interval training, the nitric oxide dump and using creative strategies to stay moving during the day help to improve your health and reduce your risks

Exercise is one of the best preventative strategies you can use against many common ailments, from psychiatric disorders to heart disease, diabetes and cancer.1 Studies2 have also confirmed prolonged sitting is an independent risk factor for disease and early death.3

This has a high cost on society, contributing to billions of dollars each year in health care costs and lost productivity.4 In one study,5 data from over 1 million individuals worldwide found a lack of physical activity had a global price tag of $67.5 billion in 2013. According to the researchers, activity is also the cause of more than 5 million deaths per year.

To put this into perspective, smoking kills nearly 6 million annually. However, while getting exercise each day, during which your heart and breathing rate increase, is important, nonexercise movement is also critical to your overall health.

A recent study published in the Journal of the American Medical Association6 evaluated over 120,000 patients and found cardiovascular fitness was a modifiable factor that had a greater impact on your risk of death than smoking, diabetes or heart disease.

Lack of Exercise Raises Risk of Death Greater than Smoking, Diabetes or Heart Disease

The study was led by Dr. Wael Jaber, a cardiologist at the Cleveland Clinic. His team retrospectively studied over 120,000 patients who had previously undergone exercise treadmill testing at the Cleveland Clinic between 1991 and 2014.7 They measured all-cause mortality relating to the benefit of exercise and fitness, finding 12 percent of the participants had the lowest exercise rate.

Although science has studied how a sedentary lifestyle is bad for your health, the authors of the featured study were specifically interested in the effects of aerobic exercise. Data collection and analysis on sitting for long hours sparked adaptations in the workplace, such as standing desks and walking workstations.8 Results of the featured study indicate aerobic fitness is as important.

An analysis of the data from Cleveland Clinic revealed those with a sedentary lifestyle had a 500 percent higher risk of premature death than those who were extremely fit.9 This is three times higher than the risk posed by smoking.10 The researchers warned the results do not imply smoking is acceptable, but rather exercise and movement are imperative to good health.

In their findings, the researchers explained those with extremely high aerobic fitness had the greatest survival rates and fitness was associated with benefits in senior seniors and those with hypertension. Jaber commented on the results, saying:11

“Being unfit on a treadmill or in an exercise stress test has a worse prognosis, as far as death, than being hypertensive, being diabetic or being a current smoker. We’ve never seen something as pronounced as this and as objective as this.

Being unfit should be considered as strong of a risk factor as hypertension, diabetes and smoking, if not stronger than all of them. It should be treated almost as a disease that has a prescription, which is called exercise.”

Your Desk Job May Be Killing You

In another study,12 researchers found those who are in a desk job are almost twice as likely to die young. What’s more, their results indicated this applies even if you exercise regularly. Those who participated in the study used a fitness tracker at least four days each week, which revealed most were inactive for 12.3 hours out of a 16-hour waking day.

Data were collected from nearly 8,000 people aged 45 throughout the U.S. Individuals who were more sedentary, sitting for 13.2 hours each day, were 2.6 times more likely to die early than those who spent less than 11.5 hours of their day inactive. Your body has nearly 300 joints and was made for movement.

However, the rising tide of technology has created an amazing number of ways to share information and increased the number of hours you remain seated. Sitting between nine and 12 hours each day cannot be counteracted by one 30- to 60-minute workout. While sitting is not inherently dangerous, the danger is in the amount of time you spend in the chair.

Consider the number of hours you spend commuting to work, sitting behind a desk, eating meals and watching TV in the evening. It's easy to see how 10 to 12 hours of time can accumulate quickly. Brief periods of sitting is more natural than the extended number of hours to which most have become accustomed.

Proper Posture While Sitting Reduces Strain and Engages More Muscle

While many recommend standing for 10 minutes out of every hour, I believe this is far from ideal. It seems far wiser to strive to sit as little as possible each day to enjoy a significant number of benefits I discuss in my previous article “The Importance of Standing More, Sitting Less.”

When it is necessary to sit, it's important to use good posture to help reduce problems with lower back pain, wrist strain and other physical challenges. Correct posture activates more muscle and prevents muscle strain that may lead to chronic pain. Remember when sitting do not cross your knees and avoid twisting at the waist, but instead turn your whole body. In a correct posture you:13

  • Sit with your back straight and shoulders back, pulling your shoulder blades down. Your buttocks should touch the back of your chair and your head should remain upright, all of which engage your core muscles. Distribute your body weight evenly over both hips, with your knees bent at right angles, your feet flat to the floor.
  • Place your computer screen at a height allowing your head to remain level. This may mean getting an external keyboard to allow the keyboard at hand level and the screen at eye level.
  • Avoid sitting for more than 20 minutes. Get up, walk, stretch or walk briskly for several minutes. This not only helps to reduce the effects of sitting, but it increases your blood flow and improves your creativity.
  • When standing from the sitting position, move to the front of your seat and then stand up by straightening your legs. Avoid bending forward at your waist as this places additional pressure on your lower back.
  • Consider a lumbar roll or back support while driving. Your knees should be at the same level or slightly higher than your hips. Move the seat as close to the steering wheel as necessary to support the curve of your back while keeping your elbows bent and your feet easily reaching the pedals.

Exercise Lengthens Life and Improves Quality of Life

While working out helps you to burn a few more calories each day, the truth is you’ll never be able to out-exercise what you eat. The magic behind losing weight includes exercise, but does not rely on it. Consider making several changes to your diet to attain optimal health and weight, many of which you’ll find in My Updated Nutrition Plan.

If you’ve never included exercise in your daily routine, you may be surprised by the benefits you’ll experience resulting in gains to your physical and mental health. Some believe it may be difficult to include exercise in their schedule, but after enjoying improvements in their health, wonder why they didn’t start earlier. Here are just a few health gains you can expect:

Boost your brain health — In a study14 of adults aged 60 to 80, researchers found those who were most physically active had better brain oxygenation and better patterns of brain activity. These improved patterns were associated with greater cognitive function. The participants got their benefits from staying active and moving each day, such as walking, gardening and moving about.

Exercise has also been linked to lower rates of depression, dementia and Alzheimer's disease. One reason for the benefits is the activation of brain-derived neurotrophic factor (BDNF) in your brain,15 which preserves existing brain cells and activates brain stem cells to convert into new neurons, effectively making your brain grow larger.

Feel happier — Exercise helps improve your mental outlook. A study by Princeton University researchers16 revealed exercising creates new neurons designed to release the GABA neurotransmitter, which inhibits excessive neuronal firing and helps to induce a natural state of calm. Anandamide levels also increase with exercise,17 which may be involved in increasing BDNF.

Slow aging — Exercise helps you look and feel younger as it helps improve your sleep patterns, lowers your risk of chronic disease and helps you become more flexible. Exercise also changes mitochondrial enzyme content and activity, increasing your cellular energy production and triggering mitochondrial biogenesis,18 the process of forming new mitochondria in your cells.

These changes significantly reverse age-associated decline. Greater circulation and oxygen flow to your skin promotes overall skin health and helps to heal wounds. Greater skin improvements are experienced using resistance training, such as lunges, pushups and planks. This increases lean muscle mass under the surface, making your skin appear more taut and lifted.

Recover faster from chronic disease — Those suffering from chronic diseases used to be cautioned against exercise. However, it is a crucial part of cancer treatment19 that may speed successful recuperation and lower the risk of recurrence. Exercise also benefits those who suffer from joint pain,20 may be a key treatment for people suffering depression or anxiety21 and helps those recovering from stroke.22

Shrink your fat cells — Exercise is one pillar in a plan for weight management. One of the benefits of consistent high-intensity exercise is the use of fat as a preferred source of fuel. Research data23 suggest when healthy but inactive people exercise intensely but briefly, it produces an immediate change in their DNA, some of which specifically promotes fat-burning.

Your Exercise Program Need Not Be Time Consuming

Even eating the best diet, you need to stay active and exercise on a regular basis to optimize your health and longevity. As the featured study demonstrated, a significant risk factor for premature death — exercise — is both modifiable and reversible.

Both cardiovascular exercise and nonexercise movement are essential. One way of looking at the benefits is nonexercise movement helps to optimize your health and quality of life, while cardiovascular exercise may help you to live healthy significantly longer.

One of the keys to optimal health is to remain as active as you can during the day and use an exercise program you will consistently follow. If you are new to exercising and fitness, working out for 45 minutes a day may seem overwhelming.

However, using high intensity interval training (HIIT) workouts yields greater fitness benefits in less time than longer low- or moderate-intensity workouts. Your body is biologically programmed to respond to intense bursts of activity.

But, since this is something many no longer do in the course their daily routine, consider seeking it out in a HIIT program. You’ll find a seven-minute exercise program you can do at home suggested in my previous article, “Can 7 Minutes of Exercise Really Help Keep You Fit?

A secondary option to include with HIIT is the nitric oxide dump, which stimulates your body's release of nitric oxide to improve your mitochondrial health, slow age-related muscle decline and boost your heart health.

The exercise involves just four movements, which I demonstrate in the video below. It takes just three to four minutes and should be repeated three times a day with a minimum of two hours between each session.

How to Creatively Include Movement in Your Daily Routine

Standing and moving helps with weight management and productivity. If you're at a loss as to how to creatively incorporate more movement into your day, there are several ways to accomplish this at home and at work.

Discuss the options of walk and talk meetings with your company's administration, stressing the increased creativity and lower health costs they may enjoy. At home and at work, you may consider moving objects you commonly use out of your immediate reach so you must get up to throw something away or to grab something off the printer.

Make it a habit of drinking 4 to 6 ounces of water every hour and place your container of pure, clean water from home in the refrigerator. This way you'll have to get up to fill your glass and will likely have to use the bathroom on a more frequent basis.

Some companies are moving toward allowing employees to use standing desks or treadmill desks. Rather than sitting all day, you have the option of getting up and down. Keep in mind may take a couple of weeks to build a stamina to stand for several hours during the day.

If your employer is not open to a standing desk, consider standing at your current desk when speaking on the phone or when you otherwise do not need your keyboard. Ask your employer to consider an exercise ball chair. These are chairs with an open seat bottom where a Swiss exercise ball can be lodged.

This provides you with an unstable platform on which to sit and increases your core muscle engagement while sitting. Consider using a Swiss ball at home while watching TV or on the computer.

Although this next option does not offer additional weight-bearing and does not take the place of getting out of your chair, consider using a seated pedal exerciser. This is an under the desk apparatus that looks like the pedals on a bicycle and allows you to keep your legs moving while seated.

If used, it is important your chair is placed high enough to ensure proper posture while seated and engaged on the pedals while using your computer. Some desks and chair systems cannot accommodate these requirements.