April 15, 2021 Keeping physically active as part of a healthy lifestyle matters for cardiovascular health, but new insights from the large Copenhagen General Population Study hint that while leisure-time exercise lowers the risk of major adverse cardiovascular events, occupational physical activity actually has the opposite effect. The findings, write Andreas Holtermann, PhD (National Research Centre for the Working Environment, Copenhagen, Denmark), and colleagues, support the view that the two types of physical activity actually interact independently on risk of MACE and all-cause mortality, supporting the notion of a “physical activity paradox.” Holtermann, in an interview with TCTMD, said that he first became aware of the paradox when he started working with labor unions more than 10 years ago. There, it was clear that people in manual-labor jobs, particularly in developed nations, did not seem to derive any benefits from working long days that involved constant walking, lifting, or higher energy expenditure and, indeed, were dying 10 to 15 years earlier than their white-collar counterparts.