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Physical activity paradox: providing evidence-based guidance while closing research gaps
  1. Nico Pronk
  1. President, HealthPartners Institute, Bloomington, Minnesota, USA
  1. Correspondence to Prof Dr Nico Pronk, President, HealthPartners Institute, Bloomington, Minnesota, USA; nico.p.pronk{at}

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Physical activity is known to be good for one’s health.1 2 On the other hand, physical inactivity and sedentary behaviour are known to be harmful to health.2 3 Agreement exists about these general statements; however, emerging research points to a need to be more domain-specific as physical activity conducted during work may be harmful to health.

Most physical activity research is based on leisure-time physical activity (LTPA), that is, any form of physical activity undertaken during leisure time, such as exercise. Results support the notion that LTPA promotes cardiovascular health and may increase longevity. However, occupational physical activity (OPA), that is, physical activity undertaken during paid or voluntary work, may have opposing effects on health-related outcomes such as cardiovascular health, long-term sickness absence and mortality.4 5 As a result, a phenomenon referred to as the ‘physical activity paradox’ has emerged which refers to the apparent contradiction that LTPA tends to confer positive health outcomes, yet OPA may confer negative effects on health.4

Research is limited but corroborates these paradoxical findings.4 5 Underlying mechanisms proposed to explain the paradox include (1) limited work task autonomy, (2) heavy lifting or static postures, (3) insufficient recovery time elevating 24-hour blood pressures, (4) increased inflammation, (5) elevated 24-hour heart rates and (6) too low-intensity activity for too long duration.4 These mechanisms reflect early considerations, but additional research to clarify the scientific evidence and to close knowledge gaps is …

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  • Contributors NP is solely responsible for all aspects of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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