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Physical activity and cardiometabolic health across an extreme lifestyle gradient

Kraft, T. S.; Wallace, I. J.; Lim, Y. A. L.; Tam, K. L.; Huat, T. B. T. A. T. B.; Tennyson, R.; Chow, S. K. W.; Fadzil, K. S. b.; Nicholas, C.; Sayed, I. b. M.; Venkataraman, V. V.; Lea, A. J.

2025-07-14 public and global health
10.1101/2025.07.11.25331394 medRxiv
Show abstract

Cardiometabolic diseases commonly rise with market-integration, industrialization, and urbanization, yet the direct role of physical activity remains debated. We collected accelerometry, health, and interview data from 1075 Orang Asli adults in Peninsular Malaysia, who currently span a wide range from rural, non-industrial to urban, industrialized lifestyles. More urban lifestyles were associated with reduced physical activity and worse cardiometabolic health. However, physical activity mediated only a small portion of urbanizations effects, suggesting independent influences. Age-related declines in activity were steeper in urban settings, indicating that non-industrial lifestyles promote activity in old age and may buffer older adults from functional decline. These results support the view that declining physical activity is an evolutionarily novel challenge contributing to poor health in modern environments. TeaserShifts toward more urban, market-integrated lifestyles are associated with lower levels of physical activity and worse cardiometabolic health, but physical activity explains only a small part of the lifestyle-health relationship.

Published in Evolution, Medicine, and Public Health (predicted rank #26) · training set

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