The “Futile Labour” Paradox: occupational physical activity fails to offset diabetes burden and is associated with microvascular stress signals in rural older adults

In labour-dependent rural older adults, heavy occupational labour may not confer metabolic benefit at the population level and is independently associated with a microvascular stress-related signal. This "Futile Labour Paradox" challenges the assumption that physical activity is uniformly beneficial in later life and underscores the need to distinguish occupational labour from discretionary exercise.