ABSTRACT
Epidemiologic evidence supports the inverse, dose-response relationship between both physical activity and cardiorespiratory fitness and the risk of premature all-cause and disease-related mortality, in addition to the chances of developing of chronic diseases, such as cardiovascular disease (CVD), type 2 diabetes, and cancers of the breast and colon. However, there is a dearth of randomised controlled trials (RCTs) studying the effects of exercise on early mortality. The RAMIT trial failed to find a significant effect of exercise-based cardiac rehabilitation on early mortality after two years, whereas the Look Ahead lifestyle intervention (exercise plus caloric restriction) did not result in a reduction in CVD mortality rates at 9.6 years in overweight or obese patients with type 2 diabetes. However, a pooled analysis of 63 RCTs suggests that exercise-based cardiac rehabilitation reduces risk of CVD mortality and hospitalisation, and health-related quality of life, but not total mortality, risk of myocardial infarction, or revascularisation. Furthermore, current evidence demonstrates that exercise can be an effective adjunct intervention to improve and manage symptoms of major non-communicable diseases. In particular, exercise may have beneficial effects on high blood pressure, insulin sensitivity, visceral fat, long-term smoking cessation, mental health, arthritis, osteoporosis, and risk of falling.
