Effects of too little movement: what it does in your body, what the large studies show and what a heart and vascular scan measures

In this article you will read about the effects of too little physical activity: what it does in your body, what the large studies show about risk and how much physical activity the Dutch guidelines ask for. That matters, because the first changes are measurable within two weeks and the hours you sit count separately from the hour you spend on sport. The heart and vascular scan from BioProfile measures how much these symptoms affect you, and gives you an indication of where you stand today in this area, as the first of the 11 health areas the full scan assesses. This is not a diagnosis. It is insight, to see where you stand today. And to help you make better choices in your food and your lifestyle. What this scan does not do: point to a cause or make a diagnosis. Only a doctor can do the latter.

Consequences of too little exercise: what it does in your body

Ten healthy older adults, average age 72 plus or minus 1 year, cut their daily steps by about 76 per cent to 1,413 a day, fourteen days in a row.⁠¹ After those two weeks the fat-free mass in their legs was about 3.9 per cent lower, muscle protein synthesis after a meal about 26 per cent lower and insulin sensitivity after a meal about 43 per cent lower.⁠¹ In plain words: two weeks of sitting still took measurable muscle mass off the legs of healthy adults.

The other way round, it works within days. Eighteen healthy young adults each did three regimes of four days: 14 hours of sitting a day, 13 hours of sitting plus an hour of intensive cycling, or 8 hours of sitting with 4 hours of walking and 2 hours of standing.⁠⁵ The days with walking and standing gave the lowest area under the insulin curve of the three (p = 0.010 against sitting) and 22 per cent lower triglycerides, 10 per cent lower non-HDL cholesterol and 8 per cent lower apolipoprotein B than the sitting days.⁠⁵ An hour of hard training counts. Over these four days, it stayed behind long, light movement spread across the day.

The effects of too little physical activity: what the large studies show

Eight studies pooled accelerometer data from 36 383 adults, with 2149 deaths over a median of 5.8 years.⁠⁶ Across the rising quarters of total daily movement, the hazard ratios for death were 1.00 (reference), 0.48, 0.34 and 0.27, and for light movement alone 1.00, 0.60, 0.44 and 0.38.⁠⁶ A hazard ratio of 0.48 means that quarter had roughly half the death rate of the least active group.

Steps make it countable: fifteen cohorts with 47 471 adults and 3013 deaths over a median of 7.1 years had quartile medians from 3553 to 10 901 steps a day, with hazard ratios of 0.60, 0.55 and 0.47 compared with the lowest quartile.⁠² The falling risk levelled off at around 6000 to 8000 steps a day from age 60, and at around 8000 to 10 000 steps under 60.⁠² The biggest difference lies between the lowest group and the group just above it.

Movement can be seen in the brain too: over a year, the hippocampus of 120 older people in the walking group was 2.12 per cent larger on the left and 1.97 per cent larger on the right, while the hippocampus in the control group was 1.40 per cent and 1.43 per cent smaller, against a usual shrinkage of 1 to 2 per cent a year.⁠⁷ People in that study with a larger left and right hippocampus also had a better memory, so a year of walking is measurable in the brain as well.⁠⁷

Sitting counts separately

Dutch people aged 4 and over sit 9.2 hours on an average working day, the figure for 2025.⁠⁸ In the same pooled data, the hazard ratios across the rising quarters of sitting time were 1.00 (least sitting), 1.28, 1.71 and 2.63.⁠⁶ The Gezondheidsraad adds the nuance that counts here: the association becomes weaker when people also move more.⁠⁴ In people who move a great deal, the association is gone.⁠⁴

Breaking up a day of sitting is measurable within the day: seven studies, with 461 participants in the glucose analysis and 358 in the insulin analysis, tested breaks of 2 minutes every 20 minutes or 5 minutes every 30 minutes.⁠⁹ Against uninterrupted sitting, glucose after a meal was about 9.5 percent lower with standing breaks and about 17 percent lower with light walking breaks, while for insulin only the walking breaks reached statistical significance.⁠⁹ Standing up helps, walking a little helps more, and Thuisarts turns it into a desk rule: if you sit a lot at home or at work, stand up every half hour and walk a little.⁠¹⁰

How much physical activity the guidelines ask for

‘Moving is good, moving more is better’ is how the Dutch Beweegrichtlijnen open: at least 150 minutes a week of moderate intensity movement such as walking and cycling, spread over several days, muscle and bone strengthening activities at least twice a week, for older people with balance exercises, and avoiding a lot of sitting still.⁠⁴ Thuisarts puts it in hours: at least 2.5 hours a week of active movement, for example five days of thirty minutes, plus bone and muscle work twice a week.⁠¹⁰ In 2025, 46.1 per cent of people in the Netherlands aged 18 and over met the guidelines, the share was highest among 18 to 34 year olds and lower in every older age group, and both parts count.⁠³ Relatively, the most health gain sits in the step from inactive to at least moderately active, the step from almost nothing to something.⁠⁴

What the heart and vascular scan measures, and what it does not

The scan asks you questions about this area of your health and turns your answers into a score with the reading band that goes with it, where higher is better. What you get is a baseline you can repeat in a few weeks.

A questionnaire cannot look inside a blood vessel: cholesterol values, blood pressure and what your heart does under exertion are measurements, and whether the cause of a symptom lies in your habits or somewhere else is a question for a doctor. The scan does not make a diagnosis. Between scans your resting heart rate is a number you can follow yourself, and what a normal heart rate is explains what that number says.

Four signals are a reason to contact your GP about exercise or sport: you become short of breath or can only breathe with difficulty, you hear a wheezing sound when you breathe, you get chest pain, or your joints start playing up.⁠¹⁰

In summary

In this article you read what two weeks of sitting almost still does to leg muscles and to the way a meal is processed, what pooled data on physical activity, steps and sitting show about dying earlier, what a year of walking did for memory, and what the Dutch guidelines ask for. More physical activity goes with a lower death rate, more sitting with a higher death rate, and the biggest difference is between the least active group and the group just above it. The scan gives you a starting value for this area of your health. It is not a diagnosis. Only a doctor can give you that.