How did physical activity levels affect heart disease deaths among San Francisco longshoremen?

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A man in athletic clothing jogs along a paved path beside a black metal fence, with trees and another person in the background. — exercise Jogging.

Research on San Francisco longshoremen demonstrated a clear link between physical activity levels and mortality from coronary heart disease. Over a 22-year observation period, workers in physically demanding roles—such as dockworkers and cargo handlers—expended at least 1,000 kilocalories more per day than those in sedentary positions like clerks and foremen.1

The study found that these sedentary workers were approximately twice as likely to die from heart disease as their more active counterparts. Notably, this increased risk was not attributed to other common factors such as smoking, obesity, high blood pressure, or the possibility that less healthy individuals were more likely to gravitate toward sedentary roles. This evidence underscores the significant protective role that consistent physical energy expenditure plays in cardiovascular health.1