Not too late

Physical inactivity is associated with increased incidence of obesity, diabetes mellitus, cardiovascular diseases, osteoporosis and cancer. Consequently, the American Heart Association, the American College of Sports Medicine and the US Department of Health and Human Services recommended that adults engage in at least 30 minutes of moderate physical activity preferably on all days of the week. In a study, published in 2007, by the National Institute of Health, involving 252, 925 individuals, adherence to the above physical activity guidelines resulted in a 50% reduction in the overall mortality risk (Arch Intern Med 2007; 167: 2453 – 2460). Having been stuck in a sedentary lifestyle in one’s younger days, will increased exercise level later in life reduce one’s mortality rate?

Researchers from Uppsala University and Karolinska Institutet studied 2322 men aged 49 – 51 years at baseline and followed them up for more than 35 years (BMJ 2009; 338: b688). These men were studied again at ages 60, 70, 77 and 82 years. At baseline almost half of the men reported a high level of physical activity (at least 3 hours of recreational sports or heavy gardening a week), 36% reported medium activity (walk or cycle for pleasure) and 15% were sedentary (spending most of the time reading, watching TV and going to the cinema). The study found that the relative mortality rates were highest among sedentary men and lowest among the most active men. When converted into differences in remaining life expectancies from age 50, high physical activity men were expected to live 3.8 years longer than sedentary men and 1.8 years longer than medium physical activity men. Men who increased their physical activity to a high level at 50 and maintained it till age 60 had the same mortality rate as the men who had been at high physical activity before entering the trial. In other words, if you adopt a high physical activity lifestyle at 50, by the time you reach 60 you will have ‘caught up’ and have the same mortality rate as someone who has embraced a high physical activity lifestyle before 50 years of age. After > 10 years of follow-up, the mortality rate in men who had increased their physical activity to a high level both from a medium or low level had halved. After > 10 years of follow-up, compared to current smokers, smoking cessation was associated with a 40% reduction of mortality rate. Men who never smoked had a 60% lower mortality rate than current smokers.

To those middle aged men who smokes and exercise little, the excuse that ‘The damage is done. It is too late for me to stop smoking and start exercising.’ may seem a bit flimsy now. You might wish to heed the saying ‘It is never too late to try’.