The role of physical activity in an obesogenic environment for cardiovascular risk reduction across the lifespan: A Scientific Statement of the European Association of Preventive Cardiology of the ESC - Scorecard - MDSpire
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The role of physical activity in an obesogenic environment for cardiovascular risk reduction across the lifespan: A Scientific Statement of the European Association of Preventive Cardiology of the ESC
Clinical Scorecard: The Impact of Physical Activity on Cardiovascular Risk Mitigation in an Obesogenic Environment Throughout Life: A Scientific Statement from the European Association of Preventive Cardiology of the ESC
At a Glance
Category
Detail
Condition
Obesity as a major risk factor for cardiovascular diseases (CVD)
Key Mechanisms
Excess adiposity causing inflammation, insulin resistance, dyslipidaemia, hypertension, and endothelial dysfunction leading to CVD
Target Population
Children and adolescents (<18 years), adults (18–64 years), and older adults (≥65 years)
Care Setting
Public health, preventive cardiology, clinical and policy settings
Key Highlights
Obesity prevalence is rising globally, significantly increasing CVD risk by up to 50%.
Physical activity (PA) reduces CVD risk independently of obesity and is a key non-pharmacological intervention.
The built and obesogenic environment influences PA behavior and obesity, affecting implementation of PA guidelines across the lifespan.
Guideline-Based Recommendations
Diagnosis
Use BMI along with anthropometric measures (waist circumference, waist-to-hip ratio, waist-to-height ratio) or body fat assessment for obesity diagnosis.
Consider clinical obesity diagnosis based on obesity-related organ dysfunction or physical limitations, not solely BMI.
Recognize preclinical obesity with metabolic abnormalities such as hyperglycaemia combined with dyslipidaemia.
Management
Promote physical activity as a primary strategy to mitigate cardiovascular risk in obesity.
Reserve pharmacological and surgical treatments for selected cases with clinical obesity and organ dysfunction.
Implement policies to regulate commercial influences and create supportive environments for healthy behaviors.
Monitoring & Follow-up
Monitor metabolic parameters including inflammation markers, insulin resistance, lipid profiles, and blood pressure.
Assess physical activity levels and sedentary behavior across different age groups.
Evaluate environmental factors influencing physical activity adherence and obesity risk.
Risks
Obesity-related systemic inflammation and metabolic disturbances accelerate CVD progression.
Sedentary behavior and obesogenic environments undermine PA effectiveness.
Commercial interests and food industry lobbying may hinder population-level prevention efforts.
Patient & Prescribing Data
Individuals with obesity across all age groups, including those with preclinical and clinical obesity
Physical activity should be emphasized as a foundational intervention; pharmacological and surgical options are reserved for selected clinical obesity cases with organ dysfunction.
Clinical Best Practices
Incorporate comprehensive obesity assessment beyond BMI, including anthropometric and metabolic criteria.
Advocate for increased physical activity tailored to age-specific needs and environmental contexts.
Address obesogenic environmental factors through multidisciplinary collaboration involving healthcare professionals and policymakers.
Focus on prevention strategies that integrate lifestyle modification with supportive built environments.
Recognize and mitigate commercial and structural determinants that promote unhealthy dietary and activity behaviors.
