[The value of physical activity for prevention of coronary heart disease]

The usefulness of exercise as a preventive measure is discussed on the basis of a review of epidemiological studies. While no preventive effect has been reliably shown for physical activity at the workplace, physical exercise during leisure time does have such an effect. The incidence of myocardial infarction can be reduced by some 50 to 60%, although the contributions of protection and selection cannot be differentiated. The present data, however, militate against the possibility that, among those actively practicing sport, a primarily positive health selection effect is operative. The optimum of physical exercise would appear to be defined by a daily calorie consumption of 300 to 400 kcal (1250-1800 kJ) per day. Within the framework of secondary prevention, physical exercise can result in a reduction in mortality rate of 20%. The possibility of exercise related incidence prompts the requirement for a thorough physical check-up of those in the relevant risk groups.