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Good news, bad news: sports matter but occupational and household activity really matter – sport and recreation unlikely to be a panacea for public health
  1. Charles R Ratzlaff
  1. Correspondence to Chuck Ratzlaff, Harvard Medical School Department of Radiology, Brigham and Women's Hospital, 20 Shattuck St, Room 334D, Boston, MA 02115; cratzlaf{at}

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Physical activity is incontrovertibly associated with major health benefits including decreased mortality.1 The population health challenge is how to encourage people to be physically active when technological advances generally promote the opposite behaviour. This editorial highlights novel data indicating that lifetime physical activity is influenced more by occupational and lifestyle activity than by ‘sport’ as strictly defined.

Sport – only one element of daily physical activity

Participation in organised or volitional sport and exercise programmes can contribute to daily physical activity quotas. However, our recent population-based research measuring lifetime physical activity produced an unexpected finding – sporting activity formed a small fraction of overall physical activity compared with occupational and household activity (figure 1). This was true whether sport was measured as energy expenditure or as knee and hip joint force.2

Figure 1

Lifetime energy expenditure for sport by gender (reported in metabolic equivalent (MET)–hours per week)

Historically, epidemiological studies primarily based physical activity estimates on occupation. These data were gender biased due to the male-dominated workforce. As physical activity has declined significantly in most occupations, there has been a greater emphasis in recent decades for physical activity inventories to capture sports and leisure-time activity. Despite this shift, we found that the occupation and household domains remain the most important. Using a rigorously developed and validated3 computer-guided lifetime physical activity questionnaire in a sample of 4269 Canadian adults aged 45–90 years, we found that …

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  • Funding CR is supported by Fellowships from the Canadian Institutes of Health Research and Michael Smith Foundation for Health Research. No author or related institution has received any financial benefit.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.