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Physical Inactivity

Physical Inactivity among Indians 

  • A coalescence of anthropological estimations of Homo sapiens’ phenotypes in the late Paleolithic era 10,000 years ago, with Darwinian natural selection synergized with Neel’s idea of the so-called thrifty gene suggests that humans inherited genes that were evolved to support a physically active lifestyle.1
  • The advent of modernization has resulted in more sedentary lifestyles and occupations requiring less energy expenditure.
  • Physical inactivity in sedentary societies directly contributes to at least 20 of the most deadly chronic disorders.1 The magnitude of risk from physical inactivity is similar to high cholesterol (>240 mg/dl)  tobacco use (2 packets of cigarettes) or high blood pressure.2
  • Physical inactivity is a major risk factor for obesity, abdominal obesity, metabolic syndrome, diabetes and cardiovascular disease (CVD).3 Nearly a quarter of all global coronary artery disease e (CAD ) is related to physical inactivity.4
  • Sudden bursts of moderate to intense physical activity ─ such as jogging or having sex ─ significantly increase the risk of having a heart attack, or sudden cardiac death especially in people who do not get regular exercise.
  • Although such activities increase the relative risk 3-fold the absolute risk is very small and transient (1-2 hours). For every 10,000 people, each individual session of physical or sexual activity per week can be associated with an increase of 1 to 2 cases of heart attack or sudden cardiac death per year.5
  • Habitual activity levels significantly reduce risk of heart attack and sudden death resulting from episodic physical and sexual activity by 30-40%.5
  • Numerous studies have documented reduced physical activity among South Asians in the UK compared with the Europids especially in children and girls with the notable exception in the CADI Study.6-23


1. Booth F. W., Chakravarthy MV, Gordon SE, Spangenburg EE. Waging war on physical inactivity: using modern molecular ammunition against an ancient enemy. J Appl Physiol. Jul 2002;93(1):3-30.

2. Blair SN, Kampert JB, Kohl HW, 3rd, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. Jama. 1996;276(3):205-210.

3. Merchant AT, Anand SS, Vuksan V, et al. Protein intake is inversely associated with abdominal obesity in a multi-ethnic population. J Nutr. May 2005;135(5):1196-1201.

4. World Health Organization. Preventing Chronic Disease: A Vital Investment  World Heath Organization, Geneva 2005. 2005.

5. Dahabreh IJ, Paulus JK. Association of episodic physical and sexual activity with triggering of acute cardiac events: systematic review and meta-analysis. JAMA. Mar 23 2011;305(12):1225-1233.

6. Barnett AH, Dixon AN, Bellary S, et al. Type 2 diabetes and cardiovascular risk in the UK south Asian community. Diabetologia. Oct 2006;49(10):2234-2246.

7. UKPDS 12. UK Prospective Diabetes Study. XII: Differences between Asian, Afro- Caribbean and white Caucasian type 2 diabetic patients at diagnosis of diabetes. UK Prospective Diabetes Study Group. Diabet Med. 1994;11(7):670-677.

8. Dhawan J, Bray CL. Asian Indians, coronary artery disease, and physical exercise. Heart. 1997;78(6):550-554.

9. Fischbacher CM, Hunt S, Alexander L. How physically active are South Asians in the United Kingdom? A literature review. J Public Health (Oxf). Sep 2004;26(3):250-258.

10. Yagalla MV, Hoerr SL, Song WO, Enas E, Garg A. Relationship of diet, abdominal obesity, and physical activity to plasma lipoprotein levels in Asian Indian physicians residing in the United States. J Am Diet Assoc. 1996;96(3):257-261.

11. Owen CG, Nightingale CM, Rudnicka AR, Cook DG, Ekelund U, Whincup PH. Ethnic and gender differences in physical activity levels among 9-10-year-old children of white European, South Asian and African-Caribbean origin: the Child Heart Health Study in England (CHASE Study). Int J Epidemiol. Aug 2009;38(4):1082-1093.

12. Duncan E. K., Scott Duncan J, Schofield G. Pedometer-determined physical activity and active transport in girls. Int J Behav Nutr Phys Act. 2008;5:2.

13. Bettiol H., Rona RJ, Chinn S. Variation in physical fitness between ethnic groups in nine year olds. Int J Epidemiol. Apr 1999;28(2):281-286.

14. Rogers A., Adamson JE, McCarthy M. Variations in health behaviours among inner city 12-year-olds from four ethnic groups. Ethn Health. Nov 1997;2(4):309-316.

15. Williams R, Shams M. Generational continuity and change in British Asian health and health behaviour. J Epidemiol Community Health. Sep 1998;52(9):558-563.

16. Hayes L, White M, Unwin N, et al. Patterns of physical activity and relationship with risk markers for cardiovascular disease and diabetes in Indian, Pakistani, Bangladeshi and European adults in a UK population. J Public Health Med. Sep 2002;24(3):170-178.

17. Lean ME, Han TS, Bush H, Anderson AS, Bradby H, Williams R. Ethnic differences in anthropometric and lifestyle measures related to coronary heart disease risk between South Asian, Italian and general- population British women living in the west of Scotland. Int J Obes Relat Metab Disord. 2001;25(12):1800-1805.

18. Riste L, Khan F, Cruickshank K. High prevalence of type 2 diabetes in all ethnic groups, including Europeans, in a British inner city: relative poverty, history, inactivity, or 21st century Europe? Diabetes Care. 2001;24(8):1377-1383.

19. Pomerleau J, McKeigue PM, Chaturvedi N. Factors associated with obesity in South Asian, Afro-Caribbean and European women. Int J Obes Relat Metab Disord. 1999;23(1):25-33.

20. Knight T., Smith Z, Lockton JA, et al. Ethnic differences in risk markers for heart disease in Bradford and implications for preventive strategies. J Epidemiol Community Health. Apr 1993;47(2):89-95.

21. Misra A., Khurana L. Obesity-related non-communicable diseases: South Asians vs White Caucasians. Int J Obes (Lond). Jul 20 2010.

22. McKeigue PM, Pierpoint T, Ferrie JE, Marmot MG. Relationship of glucose intolerance and hyperinsulinaemia to body fat pattern in south Asians and Europeans. Diabetologia. Aug 1992;35(8):785-791.

23. Khan SN, Grace SL, Oh P, et al. A comparison of physical activity environments between South Asians and white Caucasians with coronary heart disease. Ethn Dis. Autumn 2010;20(4):390-395.

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