Damages through the Medicine of Lifestyle – Physical inactivity increases death risk by 9%!

We developed a model to illustrate the biochemical and pathological changes that follow from loss of physical activity due to severe injury. This model is meant to illustrate the pathways that lead to short and long term pathology in the body as its homeostatic mechanism is disrupted. This model is meant to help lay people understand the pathologic changes resulting from physical inactivity due to severe injury. This model provides the foundation for onset of future illnesses which are directly related to the severe injury and the underlying pathology that links them. This model is meant to be used by attorneys to educate jurors and insurance companies about the future damages that need to be considered when clients are severely injured and become physically inactive.

Long term health effects frequently follow a serious injury which leads to physical inactivity and subsequent serious illnesses. Obesity, type 2 diabetes, cardiovascular disease ( strokes and heart attacks) and mental health issues ( depression) often follow – each of these produce significant increases in premature deaths!
The NIH study of the Impact of Physical Activity on the World’s Major Non Communicable Diseases(1.) which was published in the Lancet in 2012 revealed excess deaths due to physical inactivity as:
6% from CAD (Coronary Artery Disease)
7% from Type 2 Diabetes
10% from breast cancer
10% from colon cancer
AND resulted in a 9% increase in the overall risk of premature deaths.
Significantly, they concluded that the impact of physical inactivity was quantitatively similar to the same health risks as those due to smoking or obesity.

In July 2010, researchers found that persons having poor or inadequate social relationships reduced their chance of survival by 50% (2.). THEY FOUND THAT POOR SOCIAL RELATIONSHIPS WERE EQUIVALENT TO SMOKING AND EVEN more harmful to one’s health than obesity or physical inactivity.

Researchers published an article in the May 2015 American Heart Association Journal (3.) that linked depression to stroke. People who experience long term depression doubled their risk of stroke. Moreover, this doubled stroke risk remained even if their depression was treated.

2010 WHO (World Health Organization) recommendations for physical activity:
Adults 15-64 should do at least 150 minutes of moderate intensity aerobic physical activity through the week or 75 minutes of vigorous intensity aerobic physical activity through the week or in combination.
Recommendation for Adults >64 is the same according to their ability to participate.

HOMEOSTASIS – “The dynamic constancy of the internal environment; the self-regulating biologic processes that maintain an organism’s equilibrium; the ability to maintain a constant state under various conditions of stress.” McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
The body has the ability to maintain normal operations – even in extreme conditions. However, we have to put work into keeping the body healthy in order to maintain normal operations – otherwise, problems ensue.
There are many interacting systems that work together to provide homeostasis. For this discussion, we are looking at the systems that ultimately result in death. Most deaths are due to cardiovascular disease and cancer – the major player is the inflammatory system.
The inflammatory system uses the immune system as its frontline workers. These systems work well to protect us when we have injuries such as cuts and bleeding and infections – e.g, local clotting of the blood due to pro-coagulants is often lifesaving.
Our model looks at the role of the inflammatory system and how we maintain homeostasis. We balance our inflammatory system (Coagulation/Anticoagulation is one major aspect of it ) by the maintenance that we perform on our bodies. Maintenance consists of stress management, food, exercise and a several other factors.

Our detailed Model goes on to define the chemical mediators and pathways and the pathologic changes that result from physical inactivity. These pathologic changes are the very cause of the significant increase in disease (obesity, Type 2 diabetes, stroke, heart attack and breast and colon cancers and depression) and the significantly increased risk of death that is assumed by severely injured clients who suddenly become chronically physically inactive.

Scenario – A young married mother is in a serious MVA. Previously, she lived a very healthy lifestyle with exercise, healthy eating, no smoking and she had a healthy social network of friends. She had a job.
Orthopedic injuries prevent her from returning to work and make it impossible to exercise. Because she can’t get out, she is isolated from her social network ( and the internet does not count for close personal relationships – it is too impersonal).
She then becomes depressed. Due to loss of mobility and income, she is not able to shop and select and prepare healthy food.
Her husband now has to work 60 hours per week to help recover from the loss of her income.
-> Her physical inactivity has rendered her the equivalent of an OBESE person.
-> Her lack of social relationships has turned her into the health equivalent of a SMOKER.
-> Her depression has doubled her risk of a STROKE.
-> Her physical inactivity has substantially increased her risk of obesity, Type 2 diabetes, stroke, heart attack and death.

Contact: Dr. Ron Jolda. E Mail: rjolda@pdmg.com Phone: 757-585-0321.

1. “Impact of Physical Inactivity on the World’s Major Non-Communicable Diseases”, Lancet, Lee, et al, July 21, 2012.
2. “Social Relationships and Mortality Risk: A Meta-analytic Review.” Holt-Lunstad, et al. PLoS Medicine, July 2010, Vol. 7, Issue 7.
3. “Changes in Depressive Symptoms and Incidence of First Stroke Among Middle-Aged and Older US Adults.” Journal of the American Heart Association, Glisanz, et al., May 13, 2015.