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Physical Inactivity / Sedentary Lifestyle- the Grim Reaper of Bad Health

In this world of modern technology and massive urbanisation, the focus of men has changed from just mere survival to making massive fortunes. The hustling and bustling of everyday life compounded with the advent of better technologies (and making availability of many things at the fingertips) have caused most to lead a sedentary lifestyle. Physical activity and health status appear to have a linear relation, where a further increase in physical activity will result in further improvement in health status. Physical inactivity is a modifiable risk factor for many chronic diseases such as cardiovascular disease, diabetes, obesity, bone and joint diseases and also mental illness.  

The Malaysia National Health and Morbidity Survey 2015 stated that 40% of Malaysians are physically inactive. Therefore, it is not surprising that physical inactivity coupled with abundance of food choices available to Malaysians, that we are ranked first for nations with the highest number of obesity incidence in Asia. 45% of Malaysian are obese, meaning that close to every 1 in 2 Malaysians are obese.

According to WHO, the reasons for physical inactivity are due to insufficient involvement in physical activity during leisure time and increase in sedentary behaviour in daily activities, including during occupational and domestic time. Apart from this, environmental factors resulted from urbanization and modernization may also be the reason to physical inactivity. High density traffic, violence and air pollution are some of the examples that may discourage participation in physical activity.  


Despite the doom and gloom, there is a solution. Exercise. Exercise has many benefits. Being physically active not only helps to maintain weight after losing weight, but can also lower the risk of early death, stroke, high blood pressure, abnormal cholesterol levels, and even type 2 diabetes mellitus to name a few. However exercise goes beyond lowering the cardiovascular risk factors as mentioned and evidence has shown that regular physical activity can even lower the risk for depression, dementia, colon cancer, breast cancer and endometrial cancer. The link between the rising incidence of cancer and lack of exercise, in particular has been growing global attention. It has been shown that exercise is able to reduce cancer-related mortality, recurrences and even treatment-related side effects. It has been postulated that exercise may help prevent cancer by inducing the reduction in circulating levels of multiple hormones, especially insulin growth factor, which usually triggers proliferation of cancer cells through its activation. Another proposed mechanism is that exercise works is by inactivating tumour suppressor genes which is the pathophysiology observed in cancer development. This will then inactivate suppression of tumour growth and apoptosis in cancer cells.

Regular physical activity can also improve sleep quality and even improve the cognitive function of the elderly. A systematic review of exercise interventions for elderly people living in nursing homes showed a significant benefit in terms of improvement of well-being and health of individuals with dementia. It showed that exercise had a significant and positive effect on cognition, mood, agitation, mobility and functional ability in these residents. It has been suggested that exercise possesses a neuroprotective effect and attenuate cognitive decline in the elderly by mitigating cerebrovascular risk including the contribution of small vessel disease.


 A meta-analysis on exercise in the treatment of depression, showed that physical exercise was an effective intervention in the management of depression, and even suggested that it could be used as an adjunct treatment in combination with antidepressants. Similar results was also seen in a larger scale meta-analysis which suggested that exercise was effective in the improvement of  anxiety symptoms or stress-related disorders.


There are a few solutions to combat this menace of physical inactivity. These include:

  1. Start with walking. Brisk walking (100 steps per minute) is a good start for exercising and has been shown to have many benefits
  2. Introducing physical activity programs during or after office hours
  3. Encouraging exercise during lunch hour and extending the lunch hour to one and a half hours
  4. Rewarding workers who are physically active and have achieved certain targets
  5. Enhancing the once a month traffic free Sunday morning to more weekends as well as to more cities
  6. More health campaigns especially advertised in the mass media to educate the public on the importance of exercise
  7. Encouraging active participation in physical education subject at school, thereby stimulating students at a young age to adopt a healthy living
  8. Providing basic amenities for exercise at workplace to encourage the culture of exercise at workplace
  9. Encouraging students and staffs to use the staircase instead of lifts to increase the energy expenditure
  10. Organisation of fun run at the workplace or school level to promote healthy lifestyle
  11. Encourage staffs to park their vehicle further to once again increase energy expenditure
  12. Encouraging staff to stop at the bus stand that one stop further than the nearest stop to the workplace
  13. Reminding the public that even household activities including house cleaning, washing cars or gardening also lead to burning of calories and thereby increases the physical activity level and aids in weight loss

All is not lost yet in the battle against physical inactivity. Every segment of the society must take a proactive step to promote healthy living, so as to be able to (in the words of Mr. Spock) live a life that is long and prosper.


  1. Institute for Public Health MoHM. The Fifth National Health and Morbidity Survey 2015 (NHMS 2015).
  2. Ministry of Health Malaysia, “Malaysian Clinical Practice Guidelines for the Management of Obesity,” 2004
  3. Kvam S, Kleppe CL, Nordhus IH, Hovland A. Exercise as a treatment for depression: A meta-analysis. J Affect Disord. 2016 Sep 15;202:67-86. doi: 10.1016/j.jad.2016.03.063. Epub 2016 May 20. Review.
  4. Stubbs B, Vancampfort D, Rosenbaum S, Firth J, Cosco T, Veronese N, Salum GA, Schuch FB An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Res. 2017 Mar;249:102-108. doi: 10.1016/j.psychres.2016.12.020. Epub 2017 Jan 6. Review.
  5. Brett L, Traynor V, Stapley P.Effects of Physical Exercise on Health and Well-Being of Individuals Living With a Dementia in Nursing Homes: A Systematic Review. J Am Med Dir Assoc. 2016 Feb;17(2):104-16. doi: 10.1016/j.jamda.2015.08.016. Epub 2015 Oct 1. Review.
  1. Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc. 2011 Sep;86(9):876-84. doi: 10.4065/mcp.2011.0252. Review.
  2. Hojman P. Exercise protects from cancer through regulation of immune function and inflammation. Biochem Soc Trans. 2017 Aug 15;45(4):905-11. doi: 10.1042/BST20160466. Epub 2017 Jul 3. Review.
  3. Cormie P, Zopf EM, Zhang X, Schmitz KH. The Impact of Exercise on Cancer Mortality, Recurrence, and Treatment-Related Adverse Effects. Epidemiol Rev. 2017 Jan 1;39(1):71-92. doi: 10.1093/epirev/mxx007. Review.



  1. Dr Navin Kumar A/L Devaraj (MMA Member, Selangor Branch)a – Corresponding author
  2. Dr Abdul Hadi Abdul Manapa
  3. Dr Dhashani Sivaratanam (MMA life member)b


  1. Medical Lecturer and Clinical Specialist, Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
  1. Senior Lecturer and Ophthalmologist, Department of Surgery,Faculty of Medicine and Health Sciences, Universiti Putra Malaysia



Tarikh Input: 29/05/2019 | Kemaskini: 29/05/2019 | h_khairi


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