Every Little Step Helps – Any Physical Activity Linked to Decreased Mortality Interview with:

Prof. Ulf Ekelund PhD Professor in Physical Activity and Health Department of Sport Medicine Norwegian School of Sport Sciences Oslo, Norway

Prof. Ekelund

Prof. Ulf Ekelund PhD
Professor in Physical Activity and Health
Department of Sport Medicine
Norwegian School of Sport Sciences
Oslo, Norway What is the background for this study?

Response: We know that physical activity of a moderate or vigorous intensity (such as brisk walking) is good for your health. More recently, it has also been shown that prolonged sitting is also linked to an increased risk for many chronic diseases and premature death.

Current physical activity recommendations suggest that all adults should participate in at least 150 minutes per week of moderate intensity physical activity and that prolonged sitting should be avoided. However, how much sitting is too much? This is not specified and is widely debated. In addition, are levels of physical activity below those recommended still beneficial for health and does light intensity physical activity still count? Answering these questions have huge relevance for health promotion.

We therefore performed a study analysing data from eight studies in which physical activity was assessed precisely with an activity monitor in about 36000 individuals followed for about six years during which more than 2500 died. What are the main findings? 

Response:  Our results suggest strong associations between total physical activity and the risk of dying irrespective of the intensity of activity. This means that all activity including light intensity physical activity or moderate to vigorous physical activity substantially contributed to a lower risk of dying. The observation that light intensity physical activity also provided substantial health benefits is a novel finding and important for public health as this suggests that older people and those who are not able to be physically active at higher intensities will still benefit from just moving around.

Our results also suggested much stronger associations between physical activity and the risk of death the previously reported from studies assessing physical activity by self-report. For example, the number of deaths was about five times higher in the least active quarter compared with the most active. We also estimated how much time being physically active was associated with a maximally reduced risk. For moderate to vigorous intensity activity about 24 minutes per day (168 minutes per week) was associated with the greatest risk reduction. We also found that high amounts of sedentary time (e.g. sitting) above 9.5 hours per day was associated with an increased risk of death, whereas sitting levels below this threshold did not seem to be strongly linked to a difference in risk. What should readers take away from your report?

Response: Every little step helps reducing the risk and those who are most inactive have the most to gain from increasing their activity levels. A simple public health message would be to “sit less—move more and more often.” What recommendations do you have for future research as a result of this work?

Response: Our results are only applicable to middle aged and older individuals from high income countries. Future research including younger individuals and those from low and middle income countries are needed to confirm if our findings are generalisable to these populations. Also, the benefits from more vigorous intensity activity, such as jogging, couldn’t be properly addressed in our study. Is there anything else you would like to add?

Response: This was a systematic review followed by a harmonized meta-analysis in which participating studies reanalysed their data according to our standardized protocol. This approach overcome issues with normal meta-analyses where the exposure variable (in this case physical activity) usually is measured and analysed differently across studies.

I have not conflict of interest to declare related to this work.


Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality:  systematic review and harmonised meta-analysis
BMJ 2019366 doi: (Published 21 August 2019)Cite this as: BMJ 2019;366:l4570



Last Modified: [last-modified]




The information on is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.


Last Updated on August 23, 2019 by Marie Benz MD FAAD