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predictive early death

Story at-a-glance -

  • More than 10,000 studies confirm excessive sitting is an independent risk factor for illness and premature death. Overall, chronic inactivity has a mortality rate similar to smoking
  • Physical inactivity raises your risk of general ill health by 114 percent, your risk of Alzheimer’s disease by 82 percent and your risk of depression by 150 percent
  • If entire populations met exercise guidelines of 30 minutes of moderate-intensity exercise (such as walking) five days per week, 5 percent of heart disease cases and 8 percent of premature deaths could be prevented
  • Increasing activity levels to nearly two hours per day could reduce heart disease by 10 percent and prevent 13 percent of premature deaths
  • Exercise also helps improve mental health. Compared to inactivity, strength training is associated with fewer symptoms of anxiety

By Dr. Mercola

Your body is designed for near-continuous movement during the day, and there are over 10,000 papers in the medical literature confirming that excessive sitting is an independent risk factor for illness1,2  and premature death. For example, physical inactivity raises your risk of general ill health by 114 percent, your risk of Alzheimer's disease by 82 percent, and your risk of depression by 150 percent.

Overall, chronic inactivity has a mortality rate similar to smoking.3 According to the latest statistics,4,5,6,7 life expectancy has declined in the U.S., dropping from 76.5 years in 2014 to 76.3 in 2015 for men, and from 81.3 to 81.2 for women. This means American women now die, on average, about one month earlier than they did in 2014, and men have lost about two months of life span.8

While this decline is likely to have a number of contributing factors, inactivity may well be one of them. As noted by Dr. Jiaquan Xu, the report's lead author, the decline in life expectancy is primarily caused by a rise in several categories of preventable deaths.9

30 Minutes of Daily Exercise Could Prevent 1 in 12 Premature Deaths

Considering the ill effects of inactivity, it comes as no surprise that daily recreational and nonrecreational physical activity can help extend your life span.10,11,12 As reported by Reuters:13

"People who exercise five days a week for 30 minutes significantly reduce their risk of dying early and of developing heart disease, even if a sports club or gym is not an option, according to a new international study.14 Tracking 130,000 people in 17 countries, both rich and poor, the study found that whether it's going to the gym, walking to work, or tackling household chores like laundry or gardening, being physically active extends life and reduces illness."

While previous meta-analyses concluded there's a Goldilock's Zone for exercise, above which returns diminish or disappear, this effect was not found here. On the contrary, the more physical activity people reported getting, the greater their risk reduction for heart disease and premature death.

They also found that exercise had a "no ceiling effect," meaning there was no level above which exercise started producing health risks. Even extremely high levels of physical activity, defined as more than 41 hours per week, had no discernible health risks.

According to lead author Scott Lear, a heart specialist at St. Paul's Hospital in Canada, "Walking for as little as 30 minutes most days of the week has a substantial benefit, and higher physical activity is associated with even lower risk." He also noted that daily walking is among the most affordable preventive measures out there. While drugs, and even eating more vegetables, can be costly, walking is free.

The study concluded that if entire populations were to meet exercise guidelines of 30 minutes of moderate-intensity exercise (such as walking) five days per week, 5 percent or 1 in 20 cases of heart disease and 8 percent or 1 in 12 premature deaths could be prevented, worldwide.

Even greater gains could be made were populations to increase activity levels to one or two hours per day, seven days a week. People who walked for more than 750 minutes per week (just over an hour and 45 minutes per day) reduced their risk of early death by 36 percent. On a global scale, 10 percent of heart disease cases and 13 percent of premature deaths could be prevented were populations to get nearly two hours of physical activity each day.


How Do You Squeeze in 2 Hours of Exercise Per Day?

If you're like most people, you're probably scratching your head right now, wondering how you could possibly squeeze in up to two hours of exercise in an already packed schedule. The key to the equation is to focus on nonexercise movement — physical activity that does not involve changing clothes and hitting the gym. As reported by The Guardian:15

"[T]he study showed that those people who have the highest activity levels are those for whom it is part of their everyday working lives. In developing countries, more people still have physically taxing jobs but as they become more economically prosperous, their activity levels fall. 'They are going from sweeping the floor to buying a vacuum,' said Lear.

He does not advocate selling the vacuum cleaner, but we could all incorporate more activity into our lives rather than relying on occasional forays to the gym … 'We spend a lot of time in meetings. If it is just two or three people, why not have a walkaround meeting?' He also suggests playing with children in the park rather than sitting watching them, increasing the walk to work by getting off the tube or bus early and taking the stairs rather than the lift."

Intense Exercise Helps Prevent Breast Cancer

In related news, recent research16 again confirms that exercise lowers your risk of breast cancer. What's more, this study specifically investigated the mechanisms involved.

Based on a combination of animal testing and collection of serum samples from healthy women and breast cancer patients before and after exercise, they concluded that brief, intense exercise that elevates your heart rate and breathing activates molecular and gene-signaling pathways that inhibit the growth of cancer cells. Senior author Pernille Hojman from the University of Copenhagen told Reuters Health:17

"It is important to highlight that exercise training and epinephrine did not completely prevent tumor formation, but induced a 50 percent reduction. Thus, exercise training can never replace anti-cancer therapy, but could be an effective supportive strategy, which in addition to the biological effects, also has been shown to increase the patients' quality of life and sense of empowerment."

Strength Training Linked to Improved Mental Health

Exercise also plays an important role in mental health. Most recently, researchers concluded that resistance or strength training helps reduce anxiety. The analysis18 included 16 published studies involving a total of 922 participants.

Compared to inactivity, strength training (done anywhere from two to five days per week for an average of 11 weeks) was associated with fewer symptoms of anxiety, whether individuals were diagnosed with a mental health problem or not. Lead author Brett Gordon, a physical education and sports researcher at the University of Limerick in Ireland told Reuters:

"RET (resistance exercise training) significantly reduced anxiety in both healthy participants and those with a physical or mental illness, and the effect size of these reductions is comparable to that of frontline treatments such as medication and psychotherapy. RET is a low-cost behavior with minimal risk, and can be an effective tool to reduce anxiety for healthy and ill alike."

How Exercise Benefits Cognitive Performance and Mood

While this study did not focus on mechanisms of action, other studies have demonstrated how exercise helps optimize your brain function and improve your mood. Mechanisms by which exercise produces beneficial changes in your brain include:

Increasing brain-derived neurotrophic factor (BDNF)

BDNF preserves existing brain cells19 and promotes development of new neurons, effectively making your brain grow larger.20 Another mechanism at play here relates to a substance called β-hydroxybutyrate, which your liver produces when your metabolism is optimized to burn fat as fuel.


When your blood sugar level declines, β-hydroxybutyrate serves as an alternative source of energy. That said, β-hydroxybutyrate also blocks histone enzymes that inhibit the production of BDNF. So, it seems your body is designed to improve BDNF production via a number of different pathways in response to physical exercise.

Decreasing bone-morphogenetic protein (BMP) and increasing noggin


Reducing plaque formation


Triggering genetic changes

Many of the genetic changes triggered have been shown to help protect against brain diseases such as Alzheimer's and Parkinson's.

Triggering release of neurotransmitters


Activating PGC1 alpha

This is the stimulus to increase mitochondrial biogenesis and increase the number and quality of these vital energy producing parts of your cells.

Super Simple Way to Boost Your Health in Less Than 10 Minutes a Day

If lack of time is a concern, consider implementing the nitric oxide (NO) dump exercise into your daily routine. It's a super easy and efficient way to reap most if not all of the benefits of a more elaborate high-intensity interval training (HIIT) routine using just four simple movements — no weights or equipment required. It's a strategy that can be done by just about anyone, regardless of your current level of fitness or age.

Since you're just using your body to perform simple knee bends and arm lifts, the exercise is more or less automatically customized to your current level of ability. Best of all, it only requires three minutes of your time, twice or three times a day. Just make sure you have at least two hours between sessions, as it takes that long for the NO to be generated from eNOS (endothelial nitric oxide synthase).


  • Stimulates your brain by increasing BDNF
  • Kills bacteria and defends against tumor cells
  • Improves immune function
  • Decreases platelet aggregation and helps prevent blood clots

For a demonstration, see the video above. Remember to breathe through your nose and not your mouth. Your nose actually regulates more than 30 physical processes, including the release of NO, and of course serves to filter the airy you breathe. Dr. Zach Bush, creator of he calls the "four-minute workout," has recently posted his training video and I am pleased to show it to you for the first time below.

Can Mere Minutes of HIIT Really Be as Effective as 150 Minutes of Moderate Exercise?

You might be wondering whether mere minutes could actually compare to the recommended 150 minutes of moderate exercise. According to a number of studies, the answer is a resounding yes — provided the intensity is high enough. When doing the NO dump exercise above, you do want to exert yourself so you're breathing heavy. As you will notice in my demonstration, it's not a Qigong-like exercise of slow, fluid motions. 

A 2016 study24 involving three groups of exercising men — a control group, a group doing sprint interval training and a group doing moderate-intensity continuous training (MICT) — underscored the value of HIIT. After three months of workouts, the researchers concluded that three minutes of interval sprints per week (totaling 30 minutes in the gym) were as effective as 150 minutes of MICT, improving insulin sensitivity, cardiorespiratory fitness and the mitochondrial content in skeletal muscle to the same extent.

HIIT also triggers mitochondrial biogenesis,25 which is important for longevity. By reversing age-associated declines in mitochondrial mass, you effectively slow down the aging process.

As explained in my latest book, "Fat for Fuel," because mitochondrial dysfunction seems to be at the core of most chronic disease, activities like HIIT that support mitochondrial biogenesis will strengthen your body and help it fight the ravages of time. I believe that, for most part, the NO dump described in the previous section is all that most people need for a HIIT workout.

Daily Movement Is Foundational for Optimal Health

Considering all the evidence, you'd be wise to take stock of how much you move throughout each day. Do you sit down during work and commuting and then spend most of the evening on the couch? If so, your inactivity is likely taking a significant toll on your health. What's more, research clearly shows that an hour or two of exercise each week cannot outweigh the damage incurred by sitting down for 10 hours or more each day.

The key really lies in getting DAILY movement. If you think about it, the reason we need exercise at all is to compensate for our modern lifestyles, where inactivity is the norm. Our ancestors didn't have to "exercise" because they rarely sat down. They moved all day long, and research shows this near-continuous movement is absolutely key for biological functioning.

So, nonexercise movement is now recognized as a foundational piece for optimal health — even more so than a regimented fitness routine. Ideally, you'd do them both, but if you're currently sedentary, I recommend you simply start by sitting less. I recommend getting at least 7,000 to 10,000 steps each day, and limit sitting to less than three hours.

If you have an office job, consider getting a stand-up desk. This alone could go a long way toward improving your health and reducing your risk of an early death. For example, one study found that standing six hours per day can reduce your risk of obesity by one-third.

Other ways to get more "nutritional movement" into your day include the following. I'm sure you can come up with all sorts of other ways to boost your activity. Part of the equation is being willing to relinquish convenience. If you've come up with some inventive ideas to get more movement into your life, please share it with the Vital Votes community below.

Walking across the hall to talk to a co-worker instead of sending an email, and taking a longer, roundabout way to your desk

Taking the stairs instead of the elevator

Parking your car further away from the entrance

At-work workouts — simple movements that can be done at your desk throughout the day

Organizing the layout of your office space in such a way that you must stand up to reach oft-used files, the telephone or your printer, rather than having everything within easy reach


Alternatively, use an upright wooden chair with no armrest, which will force you to sit up straight and encourage shifting your body more frequently than a cushy office chair

Conduct walking rather than sit-down meetings if there are few participants involved and/or if you're doing conferences by phone. Buying a windscreen for your microphone is a great investment so you can walk outside while on a conference call. I can go out in 20-mile per hour winds and people still think I'm in my office

If you watch TV at night, make it a habit to stand up and/or do some kind of movement exercise during commercials