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This editorial refers to ‘Physical activity levels, ownership of goods promoting sedentary behaviour and risk of myocardial infarction: results of the INTERHEART study’, by C. Held et al. , doi:10.1093/eurheartj/ehr432 ‘Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise save it and preserve it.’Plato Physical fitness and physical activity have emerged as independent predictors of cardiovascular disease, whether assessed with objective exercise tests1,2 or through validated questionnaires.3Despite clear guidelines stating that adults should take physical exercise at least 30 min a day, mankind's propensity for inertia translates into a strong opposition to lifestyle modifications. However, rather than reprimanding patients for their lack of physical activity, the medical community should design an effective strategy for spreading the word that exercise is the magic trick when it comes to prevention. Indeed, the majority of people seem to be devoid of antidotes against sedentarism. Irrespective of the setting—primary or secondary prevention—physical activity remains the single most neglected therapeutic intervention worldwide.The INTERHEART case–control study involved >29 000 subjects and was instrumental in developing a worldwide strategy for cardiovascular prevention.4 In that study, factors that were strongly associated with an increased risk of acute myocardial infarction (AMI) were identified across 52 countries. More than 90% of the global risk for AMI was predicted by nine risk factors, irrespective of geographic region or ethnicity. Fortunately, these risk factors are potentially modifiable, strengthening the belief that in an ideal setting, the vast majority of heart disease can be prevented. Adjusted for other risk factors, the population-attributable risk of physical inactivity, defined as <4 h of moderate or strenuous leisure exercise per week, was 12.2%.‘Physical activity’ covers various components, as Held and colleagues address in their study.5 Two main questions were …

On cars, TVs, and other alibis to globalize sedentarism