While much attention has been paid to the relationship between food consumption and health, the nutrition community long has emphasized the need for regular physical activity to be combined with sensible eating habits. Now, a study from the University of Sydney, Australia, explores the costs and impact physical inactivity has on the development of chronic conditions that are closely associated with obesity. The research underscores how nutrition and exercise are intertwined and that it may be difficult to improve public health with simplistic, one-dimensional remedies.

An example of such a simplistic solution is the city of Philadelphia’s 1.5c-per-oz tax on both sweetened and diet sodas that was passed by the city council this past June. The tax, to be levied beginning in January 2017, is expected to raise about $90 million annually. According to the office of Philadelphia mayor Jim Kenney, about 50% of the funds raised will go to pre-kindergarten education and about 50% to other city programs, schools, employee benefits and a “healthy beverages tax credit.”


Because the tax is on distributors rather than directly on consumers, it was not put on the general ballot for public vote. This approach may prove to be a model other states and municipalities may use to pass their own “junk food” taxes.

The results of such efforts toward improved health remain to be seen. In Philadelphia, the assumption appears to be a decrease in the consumption of sugary beverages and those perceived to be non-nutritive will lead to an improvement in consumer health. Yet a study published in the Journal of the American Medical Association this past June shows the rate of obesity during the past decade has risen even as consumption of caloric sweeteners during the same period has declined.

As the University of Sydney study shows, a key element to the rise of obesity may be physical inactivity among consumers. Published in The Lancet, the study provides a global estimate of the financial cost of physical inactivity by examining the direct health care costs, productivity losses and disability-adjusted life years for five major non-communicable diseases attributable to inactivity: coronary heart disease, stroke, type 2 diabetes, breast cancer and colon cancer.

Based on data from 142 countries, representing approximately 93 per cent of the world’s population, the researchers estimated that in 2013 the effect of physical inactivity on the diseases and all-cause mortality cost the world economy more than $67.5 billion.

“Physical inactivity is recognized as a global pandemic that not only leads to diseases and early deaths, but imposes a major burden to the economy,” said lead author Melody Ding, senior research Fellow from the University’s School of Public Health.

A breakdown of the costs shows $53.8 billion, or 80%, are tied to direct health care expenditures, and the balance of $13.7 billion is in indirect costs associated with productivity losses. The researchers added that type 2 diabetes was the costliest disease, accounting for $37.6 billion in direct costs.

The study also shows that the economic burden of physical inactivity is distributed unequally across regions of the world, with high-income countries bearing a larger portion of the economic burden while low- and middle-income countries experience a larger proportion of the disease burden. Poorer countries are hit hardest by disease due to less developed health and economic systems, according to the research.

The University of Sydney researchers expressed hope the study will provide useful information for policy makers as they attempt to address the rising rate of obesity around the world and alleviate the costs associated with the negative health consequences involved. Food and beverage manufacturers must hope the research will bring a broader perspective to the subject and prompt policy makers to focus on credible solutions to the issue of obesity rather than simplistic policies that are punitive and, most likely, ineffective.