The effects of physical inactivity on other risk factors for chronic disease: A systematic review of reviews

Abstract

Background

The Global Burden of Disease (GBD) 2021 study updated methods for attributing burden to physical inactivity, to include all conditions from fasting plasma glucose (FPG) due to physical inactivity. However, physical inactivity influences several additional GBD risk factors that also effect other diseases. This study estimated effects of physical activity on high blood pressure (hypertension), FPG (as diabetes), osteoporosis, and LDL-cholesterol, to enable mediation effects modelling.

Methods

MEDLINE, ProQuest Central, Scopus, EMBASE, SPORTDiscus, and Cochrane Library databases were searched from inception to 29 June 2024 for systematic reviews reporting total physical activity levels as an exposure and at least one of the above GBD risk factors or BMI as outcomes.

Results

There were 25 systematic reviews that met the inclusion criteria (3 for hypertension, 5 for diabetes, 1 for osteoporosis, and 16 for LDL-cholesterol). Physical activity reduced levels of the risk factors investigated, with dose–response effects observed for blood pressure (6 % for every 600 MET-min/week; 19 % for high versus low activity level) and diabetes (14–28 % if active versus being inactive). Relative to adults not reporting any activity, approximately 600 METs/week reduced levels of LDL-cholesterol by 3.2 % (95 % CI: 1.0 % to 5.4 %) and reduced low bone mineral density by an odds ratio of 0.76 (0.64 to 0.91). No studies of high BMI were identified.

Conclusion

Current risk factor models do not comprehensively assess indirect effects of physical activity through all of the relevant biomedical risk factors. Our study estimated input parameters that can be used to assess these indirect pathways.