March 22, 2023

Public health messages have long promoted the importance of physical activity, which can improve quality of life in the short and long term. Moving our bodies regularly promotes better sleep, protects from chronic disease, improves mental health and so much more.

Dr. Kelly Evenson

Dr. Kelly Evenson

While it might be hard to make time for exercise, incorporating physical activity can start with small tweaks in daily routines, according to Professor Kelly Evenson, PhD, and those changes can lead to longer, healthier lives.

Evenson is an epidemiologist at the UNC Gillings School of Global Public Health and an expert on the health impacts of physical activity and sedentary behavior. Her research has aided several agencies in designing public health guidance, including the Department of Health and Human Services’ (HHS) Physical Activity Guidelines for Americans.

She has a particular interest in finding the best strategies that can help people get moving, and her work has shown that the benefits are vast.

Research has identified strong evidence that any physical activity can reduce the risk of chronic conditions, and more activity can lead to a reduction in risk for multiple health conditions, according to Evenson. She and fellow collaborators have demonstrated physical activity’s association with a reduced risk of diabetes and cardiovascular disease, and a 2021 study led by epidemiology student Chris Moore found that more steps per day were associated with higher longevity regardless of whether the steps were taken in one bout or spread throughout the day.

A more recent study, led by Assistant Professor Amanda Paluch, PhD, at the University of Massachusetts Amherst, also found that taking fewer than the widely promoted 10,000 steps per day may still bring significant protection against cardiovascular disease for older adults.

“This is a really important message,” Evenson said. “Being active as an older adult – on average, around age 72 – can make a favorable impact on your health. And even if you can’t do moderate or vigorous activity, we’ve found that being active overall is beneficial. We also found, with East Carolina University’s Dr. Carmen Cuthbertson as lead author, that taking more steps per day at younger ages, among participants with an average of 39 years, was beneficial for lowering the risk of diabetes.”

“I think for some people, physical activity goals like 10,000 steps per day can be a motivator, but for those who are very far from reaching that goal, it might make them wonder whether it’s even worth it to try,” said Kennedy Peter-Marske, a doctoral student in epidemiology who collaborated with Evenson on newly published research that supports the link between physical activity and lower cardiovascular disease risk in older women. “When it comes to the dose-response relationship that we observed with physical activity and cardiovascular disease – there doesn’t seem to be any magical threshold where you start to get benefits. Even small amounts of moderate-to-vigorous physical activity were associated with lower risk of cardiovascular disease among older women.”

Physical activity also lowers the risk of certain types of cancers. Evenson and Associate Professor Annie Green Howard, PhD, at the Gillings School recently collaborated with San Diego State/University of California San Diego doctoral student Eric Hyde, MPH, on research that demonstrated a link between more physical activity and lower rates of breast cancer among postmenopausal women. Evenson and fellow experts are working on similar projects that study the impact on other site-specific cancers, like ovarian, colon, endometrial and lung cancer.

While Evenson’s research on exercise and disease risk has often involved older populations, preventing chronic disease is a goal everyone can adopt. Physical activity carries a benefit regardless of age, according to the Centers for Disease Control and Prevention. That means any time is a good time to start getting active.

Pregnancy, for example, is another area where research into physical activity is uncovering benefits, and Evenson has recently collaborated to synthesize public health guidance around physical activity during and after pregnancy. Though some may be concerned that physical activity may harm their infant, Evenson pointed to guidance from around the world that suggests moderate amounts of physical activity – around 150-300 minutes per week – has a positive impact.

She and Peter-Marske also co-authored a study that found physical activity and changes in physical activity during pregnancy had no significant impact on infant birthweight, which Peter-Marske says may help assure pregnant people who are not on bed rest that moderate exercise during pregnancy is safe.

Overall, moving more carries benefits for everyone, and new research from the University of Cambridge has found that just 11 minutes a day of moderate exercise – enough to increase your breathing and heart rate without preventing you from speaking normally – can significantly reduce the risk of death from any cause. For people with busy schedules, 11 minutes might be an attainable goal.

“There is not an age in which physical activity isn’t useful,” Evenson said, and the message she wants to emphasize from her work is that if you can be physically active, then “every little bit helps.” Even setting a timer on your phone to remind you to get up and walk around for a few minutes each hour is a good place to start.

Support from agencies and public health institutions is also critical to improve physical activity rates across populations.

“There are definitely intrapersonal and interpersonal motivational factors that impact whether a person is active,” she explained, “But thinking broader – the policies and environments that impact daily activities, such as whether you can walk safely to a bus stop, whether you have access to a park nearby – those things will also influence how much physical activity you do.”

“It’s important to make physical activity more accessible to the public; not just promote it,” said Peter-Marske. “That requires more creative policy approaches that go beyond saying ‘get X amount of minutes per day.’ Because for people who experience environmental, socioeconomic or other barriers to physical activity, that’s just not doable.”

Our unique lives and hectic schedules can make it tough to start an exercise routine, but public health guidelines are aiming to make it easier. The HHS Office of Disease Prevention and Health Promotion has created a resource hub, Move Your Way, with helpful tips for people of all ages to start making those small changes, all informed by the latest research and guidance.

Learn more at health.gov/moveyourway.


Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.

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