The future of physical activity: from sick individuals to healthy populations

Although the notion that movement can be beneficial to one’s health has been around for centuries,1 it was only in the 1950s that the first epidemiologically oriented studies on the benefits of physical activity for health were published. Through a series of publications, Morris and coworkers showed that occupational2–4 and leisure-time physical activity5 reduced the risk of coronary heart disease. In the following two decades, prospective evidence from studies such as the Harvard Alumni Health Study6 confirmed the findings by Morris and colleagues and expanded the range of health outcomes benefiting from engagement in physical activity, including hypertension,7 all-cause mortality8 and some cancer types.9,10 The growing evidence on the benefits of physical activity for health motivated the American Heart Association11 and the American College of Sports Medicine12 to produce statements on exercise testing, training and prescription in the 1970s. Although the early statements were primarily on fitness, since the late 1970s and the early 1980s, growing recognition of the distinctions between healthrelated physical activity and fitness has been observed. The shift of paradigm from individually targeted exercise science to public health-focused physical activity required the field’s terminology to be defined.

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