The erosion of physical activity in Western societies: an economic death march

By 2030 type 2 diabetes and associated complications will be the seventh leading cause of death globally. In this context, obesity and physical inactivity have emerged as major risk factors for several chronic metabolic disorders. While exercise training exerts numerous health-related benefits in terms of the prevention and treatment of many disease states, including type 2 diabetes, it is currently under-prescribed and under-valued. We contend that unless urgent action is taken to curb the tidal wave of inactivity-related metabolic diseases, the worldwide economic burden associated with the rise in the number of diagnosed cases of type 2 diabetes will trigger the start of an economic death march for both industrial and developing nations alike. In this commentary we look ahead to 2065 and consider the impact that lifestyle interventions and associated strategies are likely to have in curbing the epidemic tide of type 2 diabetes. This is one of a series of commentaries under the banner ‘50 years forward’, giving personal opinions on future perspectives in diabetes, to celebrate the 50th anniversary of Diabetologia (1965–2015).