Background:Although the health benefits of regular physical activity and exercise are
well established and have been incorporated into national public health
recommendations, there is a relative lack of understanding pertaining to the
harmful effects of physical inactivity. Experimental
paradigms including complete immobilization and bed rest are not
physiologically representative of sedentary living. A useful ‘real-world’
approach to contextualize the physiology of societal downward shifts in
physical activity patterns is that of short-term daily step
reduction.Results:Step-reduction studies have largely focused on musculoskeletal and metabolic
health parameters, providing relevant disease models for metabolic syndrome,
type 2 diabetes (T2D), nonalcoholic fatty liver disease (NAFLD), sarcopenia
and osteopenia/osteoporosis. In untrained individuals, even a short-term
reduction in physical activity has a significant impact on skeletal muscle
protein and carbohydrate metabolism, causing anabolic resistance and
peripheral insulin resistance, respectively. From a metabolic perspective,
short-term inactivity-induced peripheral insulin resistance in skeletal
muscle and adipose tissue, with consequent liver triglyceride accumulation,
leads to hepatic insulin resistance and a characteristic dyslipidaemia.
Concomitantly, various inactivity-related factors contribute to a decline in
function; a reduction in cardiorespiratory fitness,
muscle mass and muscle strength.Conclusions:Physical inactivity maybe particularly deleterious in certain patient
populations, such as those at high risk of T2D or in the elderly,
considering concomitant sarcopenia or osteoporosis. The effects of
short-term physical inactivity (with step reduction) are reversible on
resumption of habitual physical activity in younger people, but less so in
older adults. Nutritional interventions and resistance training offer
potential strategies to prevent these deleterious metabolic and
musculoskeletal effects.Impact:Individuals at high risk of/with cardiometabolic disease and older adults may
be more prone to these acute periods of inactivity due to acute illness or
hospitalization. Understanding the risks is paramount to implementing
countermeasures.