Basics topics (see "Patient education: Exercise and movement (The Basics)" and "Patient education: Physical activity for people with arthritis (The Basics)" and "Patient education: Rhabdomyolysis (The Basics)") Beyond the Basics topics (See "Patient education: Exercise (Beyond the Basics)" and "Patient education: Arthritis and exercise (Beyond the Basics)".) SUMMARY AND RECOMMENDATIONS Health effects of physical inactivity and sedentary behavior Physical inactivity is a major health problem worldwide, particularly in developed countries and among females, older persons, and those with lower incomes. (See 'Physical inactivity and health' above.) Sedentary behavior is prevalent and is also associated with a variety of poor health outcomes, including increased mortality and increased risk for diabetes and cardiovascular disease. Some of these risks do not appear to be mitigated by participation in physical activity, although adding moderate- to vigorous-intensity physical activity may reduce the association with increased all-cause mortality. https://www.uptodate.com/contents/the-benefits-and-risks-of-aerobic-exercise/print 12/25 7/6/23, 1:46 PM The benefits and risks of aerobic exercise - UpToDate Health benefits of exercise Moderate and/or vigorous exercise is associated with several beneficial health outcomes, including improved bone health and decreased risk of obesity, coronary heart disease, stroke, certain types of cancer, and all-cause mortality ( table 1 and figure 1 and figure 2). Exercise may also increase the likelihood of stopping tobacco use, improve cognitive function, decrease the risk of falls and fall related injuries in older adults, and reduce stress, anxiety, and depression. (See 'Benefits of exercise' above.) Potential risks of exercise Musculoskeletal injury is the most common risk of exercise. More serious, but less common, risks include arrhythmia, sudden cardiac arrest, and myocardial infarction (MI). However, the benefits of exercise outweigh the potential risks. (See 'Risks of exercise' above.) Use of UpToDate is subject to the Terms of Use. REFERENCES 1. Kodama S, Saito K, Tanaka S, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA 2009; 301:2024. 2. US Department of Health and Human Services. 2008 physical activity guidelines for America ns. Hyattsville, MD: US Department of Health and Human Services 2008. Available at: www.h ealth.gov/PAGuidelines/guidelines/default.aspx (Accessed on October 17, 2011). 3. Wee CC, McCarthy EP, Davis RB, Phillips RS. Physician counseling about exercise. JAMA 1999; 282:1583. 4. Eakin E, Brown W, Schofield G, et al. 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Topic 2786 Version 105.0 https://www.uptodate.com/contents/the-benefits-and-risks-of-aerobic-exercise/print 20/25 7/6/23, 1:46 PM The benefits and risks of aerobic exercise - UpToDate GRAPHICS Health benefits of regular physical activity Lower risk of all-cause mortality Lower risk of cardiovascular disease mortality Lower risk of cardiovascular disease (including heart disease and stroke) Lower risk of hypertension Lower risk of type 2 diabetes Lower risk of adverse blood lipid profile Lower risk of cancers of the bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach Improved cognition Reduced risk of dementia (including Alzheimer disease) Improved quality of life Reduced anxiety Reduced risk of depression Improved sleep Slowed or reduced weight gain Weight loss, particularly when combined with reduced calorie intake Prevention of weight regain following initial weight loss Improved bone health Improved physical function Lower risk of falls (older adults) Lower risk of fall-related injuries (older adults) For pregnant women, reduced risk of excessive weight gain, gestational diabetes, and postpartum depression For people with various chronic medical conditions, reduced risk of all-cause and disease-specific mortality, improved physical function, and improved quality of life Reproduced from: US Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition, US Department of Health and Human Services, Washington, DC 2018. Graphic 59285 Version 2.0 https://www.uptodate.com/contents/the-benefits-and-risks-of-aerobic-exercise/print 21/25 7/6/23, 1:46 PM The benefits and risks of aerobic exercise - UpToDate Lifestyle factors and survival Additional years of life according to age associated with adoption or maintenance of a favorable physical-activity ( 4.5 metabolic equivalents, or METS) level and other characteristics between 1962 or 1966 and 1977, as estimated from mortality rates among 10,269 male Harvard alumni from 1977 through 1985. Prolongation of life was greater in younger men and with cessation of smoking, alone or particularly with exercise. The effect of each individual factor was adjusted for differences in other factors. HTN: hypertension. Data from Pa enberger RS Jr, Hyde RT, Wing AL, et al. The association of changes in physical- activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993; 328:538. Graphic 56864 Version 3.0 https://www.uptodate.com/contents/the-benefits-and-risks-of-aerobic-exercise/print 22/25 7/6/23, 1:46 PM The benefits and risks of aerobic exercise - UpToDate The risk of dying prematurely declines as people become physically active Reproduced from: Physical Activity Guidelines for Americans. US Department of Heath and Human Services. Available at https://health.gov/sites/default/ les/2019- 09/paguide.pdf. Graphic 74679 Version 4.0 https://www.uptodate.com/contents/the-benefits-and-risks-of-aerobic-exercise/print 23/25 7/6/23, 1:46 PM The benefits and risks of aerobic exercise - UpToDate Beneficial effects of any physical activity on coronary heart disease Coronary events are less frequent among those who exercise. In a study of 5159 men, aged 40 to 49 years, followed for an average of almost 19 years, the age-adjusted coronary heart disease event rate per 1000 person-years is lower in those who perform any physical activity compared with inactive subjects. Data from: Wannamethee SG, Shaper AG, Alberti KG. Arch Intern Med 2000; 160:2108. Graphic 81608 Version 4.0 https://www.uptodate.com/contents/the-benefits-and-risks-of-aerobic-exercise/print 24/25 7/6/23, 1:46 PM The benefits and risks of aerobic exercise - UpToDate Contributor Disclosures Douglas M Peterson, MD, MBA, FACP, FACSM No relevant financial relationship(s) with ineligible companies to disclose. Mark D Aronson, MD No relevant financial relationship(s) with ineligible companies to disclose. Francis G O'Connor, MD, MPH, FACSM, FAMSSM No relevant financial relationship(s) with ineligible companies to disclose. Sara Swenson, MD No relevant financial relationship(s) with ineligible companies to disclose. Contributor disclosures are reviewed for conflicts of interest by the editorial group. When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content. Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence. Conflict of interest policy https://www.uptodate.com/contents/the-benefits-and-risks-of-aerobic-exercise/print 25/25