Move more, live longer: The five-minute rule

Small and realistic increases in moderate to vigorous physical activity of 5 min/day might prevent up to 6 and 10 per cent of all deaths in high-risk and general populations respectively, says a recent Lancet study. Dr Keshava R explains how to get moving and track exercise activity

In modern clinical practice, we are increasingly realising that one of the greatest threats to health is not only what people eat, but how long they remain seated. Long hours at desks, in front of screens, in cars, and on sofas have quietly made sedentary living a major risk factor for disease and early mortality.

Traditionally, we have advised patients to “exercise regularly.” However, recent large-scale, device-based studies conducted in countries such as the UK, Norway, and Sweden have given us far more precise and practical insights. The most striking finding is this: even increasing daily physical activity by just five minutes and reducing sedentary time can significantly lower the risk of early death.

It is important to distinguish between sedentary behaviour and physical activity. Sedentary behaviour involves prolonged sitting or lying down with minimal movement and little rise in heart rate, and is now seen as an independent health risk. Physical activity, in contrast, is categorised as light, moderate, or vigorous depending on how much the heart rate increases during movement.

Exercise intensity

A practical way to judge exercise intensity is by using your age-predicted maximum heart rate, calculated as 220 minus your age. For a 50-year-old, this equals 170 beats per minute. Below 65 per cent is light activity, 65–75 per cent is moderate, and above 75 per cent is vigorous. Reaching about 110 beats per minute while walking already qualifies as moderate activity, offering real health benefits and enabling personalised, measurable exercise guidance.

Device-based monitoring

What makes these studies particularly reliable is that they used device-measured physical activity.

Participants wore pedometers, accelerometers, and smartwatches that objectively recorded movement, heart rate, and sedentary time. In the past, patients would say, “I walk for 30 minutes every day,” but this was based on self-reporting. These days, wearable technology can prove how long, how quickly, how many steps, and how many hours a person spent sitting down. This has made it possible for researchers to show a clear link between decreased mortality, more movement, and less time spent sitting still.

Power of small changes

The key message from these findings is simple yet powerful:

Increasing moderate physical activity by just five minutes per day and reducing sitting time can lower mortality risk.

This suggests that being healthy does not require intense exercise at the gym. Small lifestyle adjustments, like moving around the house, taking short walks during work hours, taking the stairs rather than the elevator, or walking while talking on the phone, can have a huge impact.

Beyond cardiovascular well-being

Reduced sedentary time and regular exercise have several positive effects on general health. It strengthens bones and joints, increases muscle strength and mobility, lowers stress, anxiety, and depression, and helps regulate blood pressure and diabetes. More significantly, regardless of the intensity of the activity, cutting down on daily sitting time has positive health effects.

Doctors must move beyond saying “exercise more” and instead advise patients to sit less, move more, track their activity, and add even five extra minutes daily for better health and longevity.

Count your steps

•Less than 5,000 steps/day: sedentary
•5,000–7,500 steps: lightly active
•7,500–10,000 steps: moderately active
•More than 10,000 steps: very active
Although step counters in watches and fitness bands have certain limitations, they provide a practical and motivating benchmark.

Recommended activity

•30 minutes of moderate activity per day
•5 days a week
•150 minutes per week
For individuals with diabetes, Indian guidelines suggest around 200–210 minutes per week, which is approximately 40 minutes a day for five days. Even slow walking contributes significantly toward this goal.

(The writer is HOD & consultant - interventional cardiology at a Bengaluru hospital.)