An initial typology of the commercial determinants of physical activity

Abstract

Much has been written about the commercial determinants in areas such as tobacco, diet, alcohol use, fossil fuels, and gambling, but relatively little on physical activity. This paper reports the development of an initial typology that classifies major themes across physical activity areas that are subject to commercial influences. These themes comprise the creation of inactive communities, especially through fossil fuels and the promotion of screen time; the commercial sponsorship of sport and physical activity; the fitness and wellness industries; private sector funding of physical activity programmes; and commercial influences on physical activity researcher and scientific evidence. These areas are mapped against themes from the Lancet commercial determinants 2023 series, including political practices, marketing, financial practices, influences on science, and reputational actions by the commercial sector. These exist within the intersectoral nature of physical activity, as it is not one product or service. This will further the understanding of the varied commercial drivers of population levels of inactivity and initiate public health actions to counter these commercial forces.

Contribution to Health Promotion.

• Much is published on the commercial determinants of health, but this is the first to propose a comprehensive framework specifically for commercial determinants and influences on physical activity.

• Commercial for-profit influences can directly affect physical activity or use political lobbying and influence to market the idea of physical activity, sport, or healthy lifestyles as a smokescreen for unhealthy product promotion.

• These commercial influences and determinants are a subcomponent of the broader social determinants of physical activity.

• Unique features of physical activity, with actions and products across diverse domains and sectors, make the commercial influences picture more nuanced and not all health harming, unlike other areas of commercial determinants of health.

Introduction

Corporate and commercial influences are well recognized in public health, comprising private sector profit-related values and strategies that drive the marketing and use of unhealthy food and beverages, tobacco, alcohol, and gambling products among others (Friel et al. 2023), as well as the corporate practices (e.g. lobbying and scientific strategies) that seek to defend and expand commercial profits. The commercial priorities of the private sector also influence the social, physical, cultural, and informational environments more broadly through corporate business actions and engagement (e.g. public-private partnerships). There is evidence that commercial determinants are a subcomponent of social determinants of health, with commercial forces being a clear part of the complex systems that shape and influence physical activity and health (Bellew et al 2020, Maani et al. 2020, Kollapally et al. 2024). Commercial determinants also widen health inequalities, especially through their impacts in low-resource settings (De Lacy-Vawdon and Livingstone 2020, Gilmore et al. 2023).

The Lancet Commission on the commercial determinants of health (CDOH) developed a conceptual model to describe corporate strategies in relation to health (i.e. focusing not just on unhealthy products (Gilmore et al. 2023, WHO Europe 2024). The Commission identified seven commercial strategies, including the use of financial mechanisms, influencing supply chains or labour conditions, and the use of marketing and other methods to shape consumer preferences, values, and behaviours. Commonly, commercial actors use political influence and lobbying strategies to drive government policy, influence regulations, and form partnerships that purportedly have a health-related goal. Many commercial forces enhance their corporate positioning and reputation through actions described as “corporate social responsibility” activities, such as funding charities that are sometimes considered part of marketing. Further, commercial interests can influence the creation, understanding, and use of scientific evidence and influence scientific practices and publication patterns. In general, commercial determinants affect the health of all people and contribute to public health harm, particularly in the case of vulnerable or young people and when they create or widen health inequalities. The Lancet Commission noted the potential for commercial entities to have positive effects on health and society, but highlighted the evidence that some, particularly the largest multinational and transnational corporations, generally have harmful health effects (Gilmore et al. 2023). Indeed, their profits often strongly depend on these harms, as evidenced for alcohol (Bhattacharya et al. 2018), gambling (van Schalkwyck and Cassidy 2023), and ultra-processed foods (Wood et al. 2024).

Very little is written about the commercial influences on physical activity and sedentary behaviour, although these are important risk conditions leading to non-communicable disease and ill-health. A search of Scopus and Web of Science databases failed to find any mention of the ‘commercial determinants of physical activity’ (CDPA), although two brief 2025 editorials commented that physical activity has potential enemies in the corporate sector (Mclaughlin et al. 2025, Milton et al. 2025). In addition, mention had been made of commercial influences on active travel and on car production and use (Parra et al. 2018, Jochem et al 2025). Given the importance of physical activity in health promotion, the area of commercial influences (as part of social determinants) needs further explication. For this reason, we here describe the myriad ways in which commercial actors (i) negatively influence physical activity (PA), (ii) use physical activity as a desirable goal (without actually influencing it), and (iii) use physical activity as a ‘smokescreen’ to distract attention from harmful products.

Although CDPA could promote and increase physical activity in specific settings and be evidence-based, transparent and accountable, these criteria are infrequently met, and many CDPA emanate from profit-focused corporate values that drive corporate action. In many areas of commercial determinants, a clearly harmful product is being driven by commercial forces (tobacco, sugar-sweetened beverages, fast foods, alcohol, gambling). For physical activity, only some of the commercial determinants directly impact physical activity and sport behaviours as a primary goal. These commercial factors are sometimes mentioned in cross-sectional physical activity correlates research but are not described explicitly as ‘determinants’ (Bauman et al. 2002). Among CDPA actions, some directly mention physical activity change as a primary goal, others use the idea of being physically active to market their products or just market the socially desirable idea of a healthy lifestyle, whereas others ignore or deny any physical (in)activity consequences of their actions.

We propose six broad CDPA theme areas, labelled A to F in Table 1, and each is described briefly in the third column. These are influences across the movement spectrum from sedentary behaviour (sitting time) through to elite aerobic activities and sports. Physical activity is a potentially more complex situation than other commercial determinants of health, as physical activity is not a single product, and its generation or inhibition occurs across multiple sectors and agencies in society. Further, even if commercial actors restrict or prevent PA, there are many other unrestricted, free ways in which people can achieve active PA participation. Nonetheless, there are a range of commercial drivers influencing physical activity practices and pathways across settings that are worthy of public health attention. In this typology for CDPA, we started with the Lancet Commission typology of commercial determinants (Gilmore et al. 2023), but then diverged where we identified points of difference between CDPA and other commercial influences (Table 1).

Table 1.

Typology of theme areas that characterize the commercial determinants of physical activity.

CDPA theme areas	CDoH Lancet Commission strategic area	Brief examples of practices and pathways	Cross reference
A. Corporate influences creating less active society
A1. Urbanization/urban sprawl	Pol, Reg, SCW, Pow, Eq	Construction of roads and highways, building of low-density and car-dependent sprawl suburbs (commercial actors are real estate developers, with partnerships to urban planning)	A2
A2. Sustaining fossil fuel industries and transport systems	Pol, Reg, Mark, SCW, Pow, Eq	Corporate political pressure helps to maintain fossil fuel industries and support car manufacturing, displacing PA as a default behaviour	A1
B. Commercial drivers of sedentary behaviours
1. B1. Television, visual media, and online screen time	Mark, Reg	Promotion through mainstream and online media; consumption usually when sitting/sedentary; commercial actors are manufacturers and retailers of media and small screen devices which (e.g. through endless scrolling) compete with PA	E3
B2. Industries marketing sit/stand office furniture to reduce sitting time	Mark, CSR, Spo, Sci	Workplace culture requires prolonged sitting; manufacturers of standing desks and the mainstream media prematurely promoted ‘evidence’ of the benefits of sitting reduction, which stimulated standing desk sales (Buckley et al. 2015, Chau et al. 2018)	F3
C. Sport industries and sponsorship of sport and mega-events
C1. Global sport-related businesses and corporations	Pol, Pow, Mark, Reg, Fin	Massive sports-related industries that fund sport, sports merchandise and apparel, sports gambling, and infrastructure but have limited interest in physical activity levels, PA promotion, or in environments that support PA and thus become deprioritized	C2, D1, D2, E1
C2. Commercial sponsorship of mega-events and Olympics	Pow, Pol, Mark, CSR, Fin, Eq	Promise of physical activity and sport legacies in Olympic bids; sponsorship of Olympics by food/beverage industries; PA also becomes a vehicle for unhealthy product promotions and behaviours (Cotter and Mullin 2024)	C1, D1, D2
D. Commercial sponsorship directly of PA programmes
D1. General sponsorship/funding of sport programmes	Spo, Pow, Pol, Rep, CSR, Mark	Sport sector funds sports teams, competitions; commercial actors include food, beverage, and alcohol industries	C1, D2
D2. Specific sponsors children’s and adults’ PA and sport	Spo, Rep, CSR, Sci	Targeted children’s and adolescent PA and sport programmes, often funded at scale; commercial actors include food, beverage, and alcohol industries	C1, D1
D3. ‘Sportswashing’	CSR, Rep, Pol	Corporations, industries or even nations using sport to cover up other (health) harmful issues or products	C1, C2, D1, D2, F3
E. Fitness industry, gyms and wellness industry
E1. Fitness and gym industries	Fin, Rep, Mark, Eq	Proliferation of for-profit wellness programmes, fitness centres, and gyms	E2, E3
E2. Corporate wellness and fitness challenges	CSR, Rep, Mark	Corporate wellness programmes and physical activity challenges, often in workplaces that are marketed strongly but may not reach or influence inactive workers	E1
E3. Digital and social media, fitness influencers	Mark, Rep, Fin, SCW	Social media ‘fitness influencers’ marketing fitness, body image, and selling-related services and products	B1
F. Influence on science, evidence, and PA research
F1. For-profit open-access business model publishers	Sci, CSR, Mark, Reg	Commercial for-profit open-access publishers contribute to rapid increases in academic PA publications (Bauman et al. 2025)	F2, F3
F2. Corporatization of universities	Sci, Fin, Mark, Pol	Changes towards corporate values in academic institutions, associated publication pressure	F1, F3
F3. Shaping the research agenda	CSR, Pow, Sci	Co-creating PA resources with academics or direct funding of PA research that meets commercial rather than public health goals	F1, F2

Legend: CDoH strategic areas (adapted from Gilmore et al. 2023)

Pol, political, lobbying; Sci, scientific influence; Mark, marketing; SCW, supply chain/waste; LE, labour/employment; Fin, financial practices; CSR, reputation mix comprising corporate social responsibility; Rep, reputation and image; Spo, sponsorship

Additional themes: (power imbalance—Pow); (regulatory–Reg); (Equity—Eq)

Our six proposed areas of CDPA are shown in the left-hand column of Table 1. These are (i) the corporate influences around urban form and transport; (ii) the commercial drivers of sedentary behaviour and sitting time; (iii) the sport industry and mass event commercial sponsorship; (iv) direct sponsorship of PA and sport programmes; (v) commercial influences from the fitness and wellness industries; and (vi) commercial influences on physical activity science and researchers. For each area, we indicate the aspects of CDoH that are covered in each Lancet strategy area (second column) and then provide a brief illustrative case study that describes the ways in which a particular theme fits the definition of a commercial determinant of physical activity (third column). The far right-hand column shows potential links between commercial influences, suggesting they have system-wide interacting links across different dimensions of physical activity. We note that the Lancet Commission describes commercial ‘actors’ broadly to encompass both major commercial entities as well as the range of other organizations, some of whom they fund and direct, sometimes covertly. This applies to physical activity as well, with commercial entities often supported by governments and intergovernmental organizations. Academic institutions as well as non-Government organizations (NGOs) may become part of supporting this commercial system (Gilmore et al. 2023). In our physical activity and sport-related examples, we point to the activities of a wide range of commercial actors influencing CDPA, either directly (through influencing access or opportunities for PA) or indirectly, such as through corporate social responsibility-related activities.

Corporate influences contributing to a less active society

There is a plethora of evidence that the built environment is associated with physical activity (Sallis et al. 2020). Many of the drivers of urban sprawl can be viewed through a commercial determinants lens, with new housing construction being part of the for-profit business models of entrepreneurs and real estate developers. These groups use political influence and lobby governments to influence regulations around housing development and the construction of low-density housing, which is often far from facilities, infrastructure, or transport links (Kunstler 1994). This targets the least advantaged in society, creates low-walkability neighbourhoods, and encourages the primacy of private motorized vehicle traffic (Parra et al. 2018). Sprawl suburbs with lower rates of physical activity are noted in both high- and middle-income countries (Witten et al. 2012, Hino et al. 2014, An et al. 2019, Firth et al. 2022), with a generally weak government response.

A related issue is fossil fuel production, which has planetary consequences of contributing to environmental degradation, poor air quality and worsening global warming, and direct health consequences on respiratory and cardiovascular disease (Romanello et al. 2022). A commercial goal of fossil fuel consumption is to maintain motorized transport, in concert with private companies that build long-distance roads (Gray et al. 2026). The business model of the car industry is to motivate people to drive more and to market cars as a desirable product. Although motor vehicles are considered a useful product by many people, the car industry uses commercial tactics that include denial of the scale and causes of road deaths, distracting public opinion and shifting the blame from drivers to pedestrians (Oreskes and Conway 2010, Ennis 2023), using the same public relations and legal companies that helped the tobacco industry develop their tactics (Supran and Oreskes 2021, Ennis 2023). These commercial determinants directly influence physical activity through reduced opportunities for public transport and active travel, and the private sector lobbies governments to maintain fossil fuel subsidies and availability (Lantushenko and Schellhorn 2023). A lack of increase in active travel has occurred in many car-dependent countries, as the active travel infrastructure and supportive regulations are not implemented at scale (Zhang et al. 2024). The consequences are to limit efforts at increasing walkable environments and constrain the growth in public transport use.

Commercial drivers of sitting time (sedentary behaviour)

Prolonged sitting (sedentary time) has adverse health consequences, especially if paired with low levels of physical activity (Ekelund et al. 2016). The first commercial determinant is the pervasive consumption of social media and online screen usage, much of which is sedentary. Globally, an average of 6–11 hours per day is spent on screen time across adults from high- and middle-income countries alike (Harvey 2023). This followed commensurate increases in smartphone sales, which reached 1.47 billion devices per year sold globally in 2016 and a stable plateau around thereafter (Mongardini and Radzikowski 2020). Online media corporations utilize addictive algorithms to keep social media users attached to their small screen devices for as long as possible, a clear but indirect commercial influence on increasing sedentary time (Kenworthy et al. 2022). Another area of sedentary time with a more direct link to ‘sports’ participation is the global rise and popularity of E-sports, with sedentary participants and millions of sedentary observers and fans (Parshakov and Zavertiaeva 2018).

The next area is workplaces, which have changed over recent decades such that many occupations are sedentary; although inequitable, this is widespread and accepted as normative in workplace culture. However, the promotion of one solution, workplace sit-stand desks, was heavily promoted by companies that made workplace furniture, who sponsored expert meetings and developed (unachievable) sitting guidelines (Buckley et al 2015); this was promoted by the mainstream media as a new health ‘story’, well before the evidence base was established (Buckley et al. 2015, Chau et al. 2018). This comprised intensive marketing that stimulated the field, influenced community and policymaker understanding of sedentary behaviour, and used corporate social responsibility to sell relevant products under the guise of providing a solution to the problem. Further, more recent reviews have identified musculoskeletal symptoms associated with prolonged standing, further suggesting that standing desks are not the only solution to prolonged sitting (Coenen et al. 2017).

Sport industry and sport/mega-event sponsorship

There is a massive corporate investment and profit in sport, in sport-related merchandise, and in mega-events and sporting competitions (Ireland 2023). These commercial enterprises increase the perceived societal value of sport and physical activity and keep people focused on following and watching sport and mega-events. The global value of sport is usually reported as ‘commercial in confidence’ behind expensive paywalls but seems (using different methods) to total over two trillion USD annually (Anani 2024). This is comprised of funding to (i) the sport industry, (ii) sport sponsorship, (iii) sporting equipment and apparel, (iv) sports nutrition products, (v) sports gambling, and (vi) sport infrastructure. These resources fund global elite sports and competitions and invest many times more than the public sector invests in community participation (https://ec.europa.eu/eurostat/web/products-eurostat-news/-/EDN-20190923-1). However, this expenditure often has the apparent objective of linking products to sport and healthy lifestyles (especially sportswear and equipment) but has little interest or engagement with actual population levels of participation (Ireland 2023).

Sporting mega-events comprise international events and sporting competitions such as the Olympic Games and the FIFA World Cup. Unhealthy food and beverage corporations, as well as tobacco and alcohol manufacturers, are substantial sponsors of these events (Cotter and Mullin 2024), alongside sporting goods and apparel manufacturers and use them to promote their products, often to circumvent the usual advertising and marketing restrictions. For mega-sporting events, the huge infrastructure cost overruns, the unsafe working conditions for stadium workers, and their inequitable use are examples of direct commercial influence, with responsibility for harms deflected by international sporting organizations (McBride and Manno 2018, Ireland 2023, Irfan et al. 2026). The alleged ‘down’ effect of Olympic competitions has little or only transient demonstrable effect on population physical activity levels (Bauman et al. 2021) despite the inclusion of physical activity and sport legacy promises in pre-Olympic bids and altruistic exhortations to the contrary from mega-event organizers and planners. This example reflects the power relationships and political influence of organizations such as the IOC or FIFA, as well as marketing, reputation management, and financial gain by these and many other sporting organizations.

Other sports-related industries that are extremely profitable include media broadcasting rights, sports equipment manufacturing, sporting apparel and footwear brands, sports gambling, and sport infrastructure, as well as the branded merchandise from elite sports (Ireland 2023). The production processes of sports apparel and footwear often involve low-cost labour in low-income countries, with little reference to codes of conduct (Mamic 2005), which is linked to the Lancet Commission strategies of supply chain and labour force issues. This expenditure commodifies sport and is linked to the ‘positive concept of sport and active lifestyles’, but there is little evidence that it influences community participation.

Direct commercial sponsorship of community physical activity programmes

Children’s and youth sports and physical activity programmes are regular targets of commercial actors. In particular, food and beverage corporations sponsor local or regional sports programmes, teams, and events and provide sports equipment, facilities, or prizes for sponsored teams (Bragg et al. 2018, Witchalls et al. 2026). Such sponsorships embed their brands at an early age in the target market, creating brand recognition and preferences for their products. This process is known as ‘sport washing’ or ‘youth washing’ and uses the guise of corporate social responsibility to create the perception of philanthropic or community-minded actions by these commercial actors, distracting from their own harmful products (Witchalls et al. 2026). One example of distractor techniques is the contention by McDonald’s in the UK that because they sponsor local youth football (corporate social responsibility, indicating ‘community commitment’), this legitimizes their challenge to the local municipality who wanted to regulate their locations for food outlets (Borland 2025a). Industry claimed that their support of local sport and providing climbing equipment in McDonald’s stores supported active, healthy lifestyles and contributed to obesity prevention, a view supported by their solitary paid medical advisor, but a view not shared as contributing to obesity prevention by the majority of experts (Borland 2025a). This is illustrative of the broader and long history of sponsorship of sports by a range of harmful product producers, including confectionery, fast foods, and energy and sugary drinks (Borland 2025b).

Although some commercial sponsorships support local sports through ostensible partnership with municipalities, NGOs, or local clubs, the power relationships are imbalanced towards the commercial sector. Alcohol and gambling companies, as well as being highly active in schools throughout the world, use industry-developed resources that normalize drinking and gambling (van Schalkwyk et al. 2022) and also sponsor professional sports that young people watch or attend, creating brand recognition and using sport to create a positive perception of their unhealthy products or services.

The sponsorship of youth programmes may occur at scale and usually fits within the definition of the impersonal ‘commercial determinants’ that are delivered through large corporations. Community-wide programmes are supported by marketing and public relations to create brand awareness and brand saturation and to distract from unhealthy outcomes from use of the sponsor’s product. Further, these programmes are seldom evaluated independently, so their effectiveness is not clear, although there are hidden harms (such as covert promotion of harmful products to sensitize children to specific brands). Support from local community businesses also occurs for youth sport and may fit within a slightly different framework and meet community needs through local partnerships and support.

‘Sports washing’ describes the sponsorship or support of sporting events or teams to improve the reputation and image of a commercial actor (or a government agency). Industry sponsorship of sport and related events is many decades old, much of which antedated recent writings on commercial determinants (Ireland 2023). This process distracts attention from controversial issues or harmful products and focuses on the positive community perception of sport or physical activity (Grix et al. 2025). The sponsorship of elite sporting teams or high-visibility sporting events can be profitable and also incentivize the relationships between sporting or government bodies and the commercial actor. Brand marketing occurs in these events, alongside hospitality and specific promotions. In the CDPA area, it is carried out by fossil fuel manufacturers, multinational food and beverage, alcohol or gambling companies, and, in previous decades, by the tobacco industry. Examples of these sponsorships have included Formula 1 car racing, FIFA (football), the Rugby World Cup, and major league sports in the USA, and the subversion by Guinness through the sponsorship of rugby, an example of so-called surrogate marketing (Critchlow et al. 2025). Among our CDPA themes, sportswashing highlights the maintenance of commercial reputations and the perception of corporate social responsibility but can also mask labour force or human rights issues.

Fitness industry, gyms, and wellness industry

‘Fitness industries’ are a subset of the larger commercial ‘wellness industry’. These comprise for-profit exercise programmes, gyms, health and fitness centres, and related fitness providers. Fitness centres and gyms provide facilities for physical activity but usually operate on a business model to attract as many well-intentioned paying customers as possible. The industry is premised on evidence that more than half of customers will have discontinued attendance at 3–6 months, and after 12 months, few (4%–22%) will still be using the facilities (Sperandei et al 2016, Anderson et al. 2021). Other aspects of the for-profit fitness industry include marketing of home fitness equipment and promoting the use of fitness trackers and wearable smartwatches linked to fitness apps. Although the fitness and wellness industries do provide services that increase physical activity for some groups, overall they have a clear inequitable focus, targeting those who can afford their services, largely omitting older adults or those from socially disadvantaged regions, or with special physical activity programme needs (Anderson et al. 2021).

The ‘corporate wellness’ industry provides physical activity programmes and facilities in workplaces. Although some workplaces provide comprehensive physical activity programmes, many others purchase ‘packaged for profit’ programmes to workplaces. Sometimes, these are designed as ‘fitness challenges’, with websites, supportive apps, and fitness trackers. One such multinational corporation is the Global Corporate Challenge, which claims to have engaged with 250 000 workers in 65 countries (https://www.corporatewellnessmagazine.com/article/global-corporate-challenge). The Global Corporate Challenge charges workplaces for each enrolled participant. The limited independent evaluation of this programme in workplaces suggested it has negligible effects in increasing the proportion of workers meeting physical activity guidelines, as the challenge mostly attracted workers who were already physically active (Macniven et al. 2015).

Social media influencers are a major source of health information for adolescents and young adults. A sub-group of influencers focus on fitness-related messages as part of communications around beauty, wellbeing, and body image (Durau et al. 2022). For many followers, their effects are to promote positive attitudes towards the influencer and increase intention to be active rather than actual active time (Sokolova and Perez 2021). The information being disseminated may or may not have any underpinning evidence, as long as it meets the social and marketing goals of the influencer. This is a commercial determinant, as the goal of influencers is to increase their number of regular followers, which is then monetized into endorsing them and to purchase their fitness-related products (Knai and Savona 2022).

Influence on science, evidence, and physical activity research

One commercial determinant in this field is the targeting of physical activity researchers and research production by commercial interests. Academic publication has become a profitable industry characterized by aggressive marketing and increasing open access online publication. These commercial strategies have contributed to the 30-fold increase in physical activity publications within the last decade (Bauman et al. 2025). This is independent of the increase in publications through paid contributions to the thousands of ‘predatory journals’. Recent exponential increases in academic physical activity publications are driven by large for-profit publication companies (Bauman et al. 2025). This publication increase is reinforced by the corporate values being adopted by academic institutions, where publications and publication metrics are an important indicator of university success (Rawat and Meena 2014).

Another commercial action under the rubric of ‘corporate social responsibility’ is to profess a commitment to healthy lifestyle research and to develop and disseminate educational resources, often with digital components. There is little evidence for their effectiveness, as these interventions are rarely trialled before being disseminated and are unlikely to have population-wide reach. At times, commercial actors invest in funding specific ‘research’ to meet corporate goals. This results in selected research being conducted and the information environments on evidence being manipulated. Such research usually focuses on individual capacity for change, rather than interventions focusing on structural or environmental determinants of physical activity. For example, Coca-Cola funded physical activity researchers through the Global Energy Balance Network to demonstrate that physical activity could be as important as nutrition in obesity prevention (Barlow et al. 2018) and uses such activities to benefit from the health halo resulting from sports and PA partnerships. This research was in its initial stages when the corporation prematurely lobbied governments to consider physical activity for childhood obesity prevention, distracting from the harms of sugar-sweetened beverages. Another example was the Nike ‘Designed to move’ initiative, a global physical activity policy initiative in 2012, co-created with researchers, but without any subsequent support or implementation strategy—except the brand recognition and positive perspective of the company in developing it (Piggin 2015). And finally, sit-stand desk manufacturers partnered with Public Health England to convene research experts to develop expert-based sitting guidelines (Buckley et al. 2015) well before there was sufficient evidence to generate such recommendations.

Discussion and conclusions

CDPA is a new field, building on a decade of research and advocacy around other commercial determinants of health and risk factors. In this paper, we started with the accepted Lancet Commission typology of commercial determinants of health (Gilmore et al. 2023), and we broadened our approach to start to develop a typology of CDPA. Many of the established commercial determinants also influence physical activity, but there are some differences. Unlike, for example, the sugar-sweetened beverage industry (which is one category and is a health-harming product), health-enhancing physical activity occurs across multiple domains and settings. For this reason, there are varied commercial influences, some of which promise physical activity behaviour change, others indirectly influence physical activity behaviours, and others market the idea or notion of ‘being active and healthy’ as a positive concept or brand or use it as a smokescreen to obscure the harmful products produced by specific commercial actors. However, the development of a CDPA framework is not an argument to prioritize PA promotion as a solution to other commercial drivers of obesity or other public health harms, such as addressing commercial and political drivers of unhealthy diets. Instead, it is intended to place commercial determinants more visibly in view as CDPA. However, it is not intended to dissuade people from participating in health-enhancing physical activity.

Much physical activity research has previously acknowledged some factors described here as commercial determinants. For example (as described by Ennis 2023), the built environment or fossil fuels have been ‘in plain sight’ as contributors to decreased active travel or low walkable communities, and screen time is a well-recognized correlate of low physical activity and of obesity. However, the link to their commercial origins has not received specific attention. Some of these behaviours are culturally normative and societally sanctioned, such that they are not the subject of community controversy or debate. In that they are not all clearly defined ‘enemies’ of physical activity (described as such in 2025 (Mclaughlin et al. 2025)) in the way that discrete harmful products are (such as sugar-sweetened beverages, tobacco, or alcohol).

This paper describes an initial typology for CDPA in six thematic areas consistent with previous commercial determinants (Gilmore et al. 2023). This adds to the social determinants framework for physical activity, albeit with some differences from other commercial determinants. Some factors directly influence physical activity or sedentary time, and others have backstage and indirect effects (van den Akker et al. 2024), with large fossil fuel corporations or car manufacturers likely to be indifferent to physical activity outcomes. Some commercial influences, particularly through sponsorships, market the positive image of sport or physical activity for reputational benefit or to distract from their engagement in unrelated health-harming products. Other commercial actors use the potential of physical activity to drive corporate profits but are not really concerned with widescale physical activity or sport outcomes. These include gyms, the wellness and fitness industries, corporate wellness programmes, and fitness social influences. Sports apparel and footwear manufacturers are also concerned with image and fashion creation, rather than expecting purchasers to become more active.

Some commercial forces influence the research that is conducted and influence researchers through driving the number of academic publications in physical activity; the latter is synergistic with corporate pressures from academic institutions to increase publications. In addition, there are commercial actors that fund specific, targeted research with agendas that meet commercial interests, irrespective of the scientific quality of evidence, or even fostering the potential for misinformation.

Finally, these commercial influences are interrelated (Table 1, far right column). As part of a systems approach, commercial actors can influence different domains across the physical activity system. This suggests further investigation is needed to characterize the systems interactions between physical activity and commercial determinants (Knai et al. 2018, Bellew et al. 2020). The commercial influences that target physical activity behaviour focus on individual change, targeting more affluent individuals participating in programmes or enrolling in gyms, and do not focus on the upstream considerations of equity or the structural environmental or social determinants of physical activity.

The initial typology here is open to development as additional commercial influences on physical activity are recognized. It provides an initial typology which can guide the development of research and policy strategies and initiate counter-marketing efforts to expose and attenuate these commercial influences. Some work is already identifying the research needed to understand the commercial influences on active travel (Jochem et al. 2025, Shaw et al. 2026). There may be additions to the physical activity themes described here, and this evolution is useful if it better delineates commercial influences on the spectrum of movement.

The classification of types of CDPA presented here categorizes commercial practices to inform policymakers, sports clubs, and the general community. Next, changes to regulations are needed to influence fossil fuel production, reduce urban sprawl production, and reduce unfettered access to addictive small screen entertainment. Strategies are required to influence sport and physical activity sponsorship, to expose the commercial drivers of mega-events and Olympic Games, to restrict the use of physical activity or sport sponsorship as a distractor from other unhealthy products, and to seek alternative funding sources. More effective, and more transparent management of conflicts of interest in all these areas of influence is also a priority, acknowledging that simple disclosure of conflicts of interest is not enough in itself.

The counterfactual argument is compelling; if all of the commercial investment and sponsorship had targeted evidence-based programmes with high population reach, then one would expect that increases in the rates of sport and physical activity participation would be detected by routine population surveys. This is not evident, as a recent global review identified that many countries are not going to achieve the World Health Organization 2030 targets for physical activity and have shown little change over the past three decades (Strain et al. 2024).

However, commercial influences could be a positive force for increasing physical activity. For example, fitness centres could be influenced to target older adults or inactive groups, and wearable technologies could be made more widely available. Pharmaceutical companies or health insurance companies could evaluate whether their existing lifestyle programmes really reach all those with chronic disease and directly influence their physical activity. Sponsorship of community sport could be assessed in relation to increasing population levels of participation in sport or physical activity and in relation to its indirect harms. But these potential solutions require increased community awareness of the commercial influences on physical activity and the need to redress harms and maximize the potential for physical activity gains.

This initial classification of CDPA requires further investigation across the commercial influences on physical activity that we have described. Further investigation will further clarify the potential benefits of some commercial agents on physical activity and sport and uncover areas where the commercial influence is deleterious and under-recognized. In the middle, there are commercial forces whose actions are indifferent to physical activity, with their motives and effects on physical activity identified and public health strategies considered to address them. Perhaps most importantly, we acknowledge that this initial analysis does not consider higher-order systemic influences that influence PA, though this is largely due to the fact that they have been under-researched in this field, with the exception of a few well-known examples. This paper should therefore be seen as a starting point for more in-depth analyses of the wider systems which create and enable the pathways to PA-related harms and to identify entry points for creating sustainable environments that support PA.

Author contributions

Adrian Bauman (Conceptualization, Data curation, Writing—original draft, Writing—review & editing), and Mark Petticrew (Conceptualization, Methodology, Writing—original draft, Writing—review & editing)

Conflicts of interest

None declared.

Funding

No funding was sought or used to conceptualize or write this paper.

Data availability

Not applicable