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The quest for better health often emphasizes the importance of regular physical activity (PA) to ward off conditions like dementia, cardiovascular disease (CVD), and cancer. Extensive research highlights a positive correlation between the benefits of PA and its frequency and intensity, suggesting that more activity is generally better. This emphasis has spurred initiatives promoting increased step counts and the use of standing desks to encourage continuous physical engagement.
However, for many individuals, physical activity at work is a mandatory aspect they can’t easily control. Recent evidence indicates that these individuals not only miss out on the benefits linked to leisure-time PA but may also face an increased risk of the very conditions PA intends to prevent.
A study in The Lancet Regional Health – Europe observed over 7,000 adults in Norway, tracking their PA patterns from age 33 to 65 and examining the risk of mild cognitive impairment (MCI) and dementia at 70 or older. Unlike previous studies relying on self-reported PA at a single time point, this research adopted a life-course approach, assessing how occupational history relates to later cognitive health.
The participants, spanning over 300 job types, engaged in physically demanding activities involving extensive use of arms and legs, such as climbing, lifting, and walking.
The study categorized participants into four PA trajectories over the 44-year span: stable low, increasing then decreasing, stable intermediate, and stable high. Findings revealed that consistently working in occupations with intermediate or high physical demands correlated with an increased risk of cognitive impairment—902 individuals diagnosed with dementia and 2407 with MCI at age 70 or older faced elevated risks.
This notion aligns with prior research, including the Copenhagen Male Study, which contrasted leisure-time and occupational PA in Danish men aged 40-59. After adjustments, those with high occupational PA had a 55% greater risk of developing dementia compared to sedentary workers.
Kirsten Nabe-Nielsen, PhD, highlighted the importance of ‘good’ physical activity, distinct from strenuous physical labor, as suggested by the World Health Organization’s guide on preventing dementia. This distinction underscores the significance of leisure-time activities over occupational exertion, reinforcing the emerging concept of the “physical activity paradox.”
Research by Andreas Holtermann and others supports this paradox, emphasizing the contrasting effects of leisure-time versus occupational PA. While leisure-time activities promote socialization and positive emotions, occupational demands, especially those with low autonomy, long hours, and high stress, are linked to adverse cognitive and cardiovascular outcomes.
Tyler Quinn, PhD, emphasized the cardiovascular risks associated with occupational PA, particularly from prolonged exertion like lifting and carrying. Stress amplifies these risks, indicating that combining physically active jobs with stress heightens the danger.
Both Skirbekk and Quinn highlighted the lack of autonomy in occupational PA, contrasting it with the flexibility of leisure-time activities that allow for breaks and recovery. They stressed the need for lifestyle changes and policy adaptations to mitigate the adverse effects of occupational PA, especially for marginalized groups facing disproportionate health risks.
Despite contrasting views on the benefits of occupational PA, ongoing research gaps necessitate a nuanced understanding of how job demands, lifestyle factors, and social determinants influence health outcomes. Addressing these gaps is crucial for tailoring effective interventions and reducing health disparities.
