Recent evidence suggests that we may need to rethink not only how we promote physical activity, but how we think about prevention itself. Studies by Stamatakis et al^2,3 suggest that meaningful health benefits may come not only from formal exercise, but from brief bursts of activity woven into everyday life.

The studies examined adults who reported no participation in structured exercise or sport. Using wearable devices to measure incidental physical activity, the researchers demonstrated that movement accumulated through daily living such as climbing stairs, carrying groceries, active transport, household tasks, and brisk walking was associated with striking differences in health outcomes.

As little as 3-5 minutes of vigorous incidental activity per day was associated with substantial reductions in cardiovascular disease outcomes, cancer mortality and all-cause mortality. Even short bursts of effort, often lasting only one or two minutes, appeared to matter.

Another interesting finding is that intensity matters more than you may think: one minute of vigorous incidental activity was associated with a similar level of cardiovascular risk reduction to approximately three minutes of moderate activity, or 35-50 minutes of light activity.

Public discussions about physical activity often focus on doing more. More steps, more minutes, more activity.

But this highlights that increases in effort during everyday activities can have substantial health benefits, which may be more realistic than finding large amounts of additional time. This could mean walking faster, running for the bus, choosing the stairs, picking up the pace when commuting.

While structured exercise remains one of the most effective ways to improve physical and mental health, the findings challenge the assumption that meaningful health gains are only available to people who become regular exercisers. Perhaps the public health challenge is not simply persuading everybody to exercise, but in making healthy movement a natural part of everyday life.

Prevention happens outside healthcare

Healthcare systems tend to approach prevention using clinics, appointments, programs, and interventions. We develop guidelines, create referral pathways, and prescribe exercise.

But the activities highlighted in these studies occur largely outside health services, while people are living their lives. They happen on staircases, footpaths, train platforms, in homes, workplaces and neighbourhoods in between healthcare encounters.

This shifts attention away from what clinicians do and towards the environments in which people live. Prevention depends not only on healthcare services but on transport systems, urban design, housing, employment, community infrastructure, and everyday routines.

A bout of brisk stair climbing may not feel like healthcare, but the evidence suggests it can contribute to health outcomes in meaningful ways. Perhaps the most important implication is that physical activity is not simply an individual behaviour – it is a product of systems.

Whether someone climbs stairs depends partly on the building design. Whether they walk depends partly on neighbourhood safety, connectivity and infrastructure. Whether they use active transport depends partly on public policy. Whether they leave home at all may depend on social connection, inclusion, mental health, employment, transport and community participation.

Physical activity emerges from the environments and systems we create, and how inclusive and accepting our society is. This means that promoting physical activity cannot rely solely on encouraging individual behaviour change. It also requires attention to the social, environmental and structural conditions that make movement possible.

What does this mean for people with mental health conditions?

People living with mental health conditions often face substantial barriers to participation in structured exercise because of limited access and resources. This is one reason why physical health inequities persist despite strong evidence supporting exercise-based interventions. Incidental activity may represent a broader and more accessible pathway to health improvement because it is embedded within everyday life.

Importantly, this does not eliminate inequities, but it broadens the conversation. Instead of asking whether people can access exercise programs, we begin asking whether their communities support movement, participation and active daily living.

Perhaps, then, we have been asking the wrong question. Instead of only asking how we can get more people to exercise, we should also be asking how we can create communities and systems that give everyone more opportunities to move.

Exercise remains enormously valuable, but better health does not always have to begin with a gym membership or 30-minute workout. Sometimes it can begin with small bursts of movement already woven into everyday life. The challenge for public health is to create the environmental conditions and encourage the social attitudes that promote incidental activity and community participation for everyone.

References:

1. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/physical-activity/latest-release
2. Stamatakis, E., Biswas, R. K., Koemel, N. A., et al. (2025). Dose response of incidental physical activity against cardiovascular events and mortality. Circulation, 151, 1063-1075. https://doi.org/10.1161/CIRCULATIONAHA.124.072253
3. Stamatakis, E., Ahmadi, M. N., Gill, J. M. R., et al. (2022). Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality. Nature Medicine, 28, 2521-2529. https://doi.org/10.1038/s41591-022-02100-x