We’ve all heard exercise helps you live longer. But a new study goes one step further, finding that a sedentary lifestyle is worse for your health than smoking, diabetes and heart disease.

Dr. Wael Jaber, a cardiologist at the Cleveland Clinic and Senior Author of the study, called the results “extremely surprising and said researchers must now convey the risks to the general population that “being unfit should be considered as strong of a risk factor as hypertension, diabetes, and smoking– if not stronger than all of them.”

Researchers retrospectively studied 122, 007 patients who underwent exercise treadmill testing at Cleveland Clinic between January 1, 1991 and December 31, 2014 to measure all-cause mortality relating to the benefits of exercise and fitness. Those with the lowest exercise rate accounted for 12 % of the participants.

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