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Growing evidence suggests that although leisure time physical activity (LTPA) (ie, performed for sports and recreation) leads to positive cardiovascular disease (CVD) outcomes, occupational physical activity (OPA) (ie, activity occurring at work) may not decrease the risk of CVD morbidity and mortality. The potentially contradictory health effects of LTPA and OPA are referred to as the physical activity health paradox.1 OPA and LTPA occur in different contexts and settings that may differentially contribute to cardiometabolic health risk. LTPA typically consists of a wider range of body movements performed at levels that are sufficiently intense to improve cardiorespiratory fitness and metabolism, is performed voluntarily, and often occurs over shorter durations with adequate recovery time in between episodes. On the other hand, OPA typically includes static loading, lifting heavy objects, repetitive or painful body movements and postures, long durations (>8 hours) with low control, and inadequate periods of recovery in between episodes, which may attenuate health benefits or possibly increase health risks.