Perspective: Sedentary Death Syndrome— Where to From Here?

The 2003 John Sutton Lecture and accompanying review article by Lees and Booth in this issue of the journal are aptly named “Sedentary Death Syndrome.” Physical inactivity is a risk factor for coronary artery disease, stroke, hypertension, type 2 diabetes, colon cancer, breast cancer, osteoporosis, and other “diseases of civilization.” Given the overwhelming and widely disseminated evidence (Bouchard et al., 1994; U.S. Dept. of Health and Human Services, 1996) that physical inactivity is a major risk factor for chronic disease, why are so many Canadians physically inactive? As part of a strategy to increase public awareness and compliance with active living, Lees and Booth call for more research into the molecular basis of Sedentary Death Syndrome. They argue that until a clear mechanistic link is made between physical inactivity and chronic disease, there will be continued resistance on the part of the population for adopting physically active lifestyles. This is a laudable recommendation—one that will greatly strengthen the knowledge base linking physical inactivity to specific health outcomes in a more definitive manner. While it is clear that much more mechanistic research on the issue of physical activity and health is required, we are currently faced with an epidemic of physical inactivity and an impending health care crisis. According to the 2000/01 Canadian Community Health Survey, 54% of Canadians are completely sedentary in their leisure time (expending < 1.5 kcal·kg–1·day–1), whereas only 23% are active enough to reap the health benefits of an active lifestyle (expending ≥3 kcal·kg–1·day–1) (Statistics Canada, 2002). Physical inactivity is taking an exacting toll on our health care system and accounts for more than 21,000 premature