Why exercise matters: what exercise does for your lifespan, heart, blood sugar and mood, and how much is enough

Why is exercise important

In this article you will find the answer to the question ‘why is exercise important’: what large studies link to moving more and sitting less, from lifespan to heart, blood sugar, cholesterol and mood, and how much activity the Dutch physical activity guideline asks for. That matters, because fewer than half of people in the Netherlands are as active as the guideline recommends: 44 per cent of people aged 4 and over in 2022, down from 47 per cent a year earlier.⁠⁴ BioProfile’s lifestyle scan gives you an indication of where you stand in this area today. The scan is not a diagnosis. It is insight, to see where you stand today and to help you make better choices in your diet and lifestyle. What the scan does not do is point to a cause. Only a doctor can do that.

Exercise and a longer life

The largest measured link is the one with lifespan. A meta-analysis brought together 8 cohort studies with 36,383 adults whose activity was recorded with a small device worn on the body. Over a median period of 5.8 years, 2149 of them died. In that time, the most active quarter had a much lower risk of dying than the least active quarter. Light activity counted too: the people who did the most light activity also died less often than those who did the least.⁠¹

Measured in steps, the picture is the same. In 15 cohorts with 47,471 adults, followed for a median of 7.1 years, the quarter who took the most steps a day had about half the risk of dying of the quarter who took the fewest. From age 60, the benefit levelled off at about 6,000 to 8,000 steps a day, and under 60 at about 8,000 to 10,000.⁠⁵

Put simply: every bit of movement counts, a walk too, and you don’t need to be sporty to end up in the group that does well. These studies follow people over time and show a link. They cannot prove that being active alone made the difference. How long you live is one measure and how your body ages is another; biological age versus calendar age explains that difference.

Sitting still for long periods

In the same pooled cohorts, the quarter who sat the most had a risk of dying more than twice as high as the quarter who sat the least.⁠¹ That is why Thuisarts advises you not to sit still for too long: stand up every half hour and walk a little.⁠⁶ For your day, this means it pays to break up a long stretch at your desk or on the sofa with a short walk.

Exercise, diabetes, heart and stroke

A review of 174 articles on cohort studies compared very active people with people who did too little exercise. The very active group had roughly a quarter less risk of diabetes, ischaemic heart disease and ischaemic stroke, roughly a fifth less risk of colon cancer and a smaller reduction for breast cancer. Most of the gain came with moderate amounts of exercise, and above that the curve levelled off.⁠²

What this means for you: moving more goes hand in hand with less diabetes, heart disease and stroke, and the first step up from very little activity brings the biggest gain.

Exercise and cholesterol

In 25 randomised studies, regular endurance training went hand in hand with a modest rise in HDL cholesterol. A clear rise took at least about 120 minutes of training a week, or about 900 kilocalories of training a week, and longer sessions went with slightly more HDL.⁠⁷ Put simply: about two hours of endurance training a week goes hand in hand with a small, measurable shift in your cholesterol.

Exercise and mood

In 49 prospective studies with 266,939 people, those who were very active developed depression slightly less often than those who were not very active. The link held for young people, adults and older people, and in Asia, Europe, North America and Oceania.⁠⁸ For you, this means that being active goes with a lower chance of depression, at any age and in very different countries.

How much exercise is healthy

The Gezondheidsraad advises adults to do at least 2.5 hours of moderate-intensity exercise a week and children at least an hour a day, with muscle- and bone-strengthening activities for both. The evidence behind that advice concerns diabetes, cardiovascular disease, depressive symptoms and fractures in older people, and the advice is to move more and sit less, for the long term.⁠³ Thuisarts puts it in everyday terms: for example 30 minutes on 5 days, sometimes 20 minutes of very vigorous activity, and twice a week something that makes your bones and muscles stronger.⁠⁶ Put simply: half an hour on most days, plus strength training twice a week.

Since 2020, fewer people in the Netherlands have met the guideline. Young people, young adults, people in paid work and people with a higher education in particular were less active than in 2019.⁠⁴ A lot of Dutch activity happens on the bike: cycling in the Netherlands is linked to about 6,500 fewer deaths a year and to a life expectancy that is half a year longer.⁠⁹ Your ride to work or to the shops is part of the reason being active pays off here. To read what else changes in the body over the years, see healthy ageing: what changes over the years.

When to see your GP

Call your GP if you become short of breath or find it hard to breathe during exercise or sport, hear a wheezing sound when you breathe, get chest pain or have trouble with your joints.⁠⁶

In summary

This article showed why exercise matters. Large studies link moving more and sitting less with a longer life, with less diabetes, heart disease and stroke, with a small rise in HDL cholesterol and with a lower chance of depression. The Dutch guideline asks adults to do 2.5 hours of moderate-intensity exercise a week plus strength training, and less than half of the people in the Netherlands reach that. Chest pain, shortness of breath, wheezing or trouble with your joints during exercise is a reason to call your GP. The lifestyle scan shows where you stand today.