Heart health: How small changes in daily activity can offset sitting

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Researchers say sitting for prolonged periods is detrimental to heart health. DZ FILM/Stocksy
  • Researchers report that any activity is more beneficial to heart health than sitting, including sleeping.
  • Experts say daily activity can help with blood pressure, glucose levels, and muscle strength.
  • They say that even taking 5-minute walking breaks during the workday can be beneficial.

Baseball great Satchel Paige famously said “Don’t look back. Something might be gaining on you.”

In other words: keep moving.

That’s the theme of a new study that states any activity — even sleeping — is better for the heart than sitting.

Supported by the British Heart Foundation and published today in the European Heart Journal, the study’s authors say their research is the first to assess how different movement patterns throughout the 24-hour day are linked to heart health.

The researchers say it’s the first evidence to emerge from the international Prospective Physical Activity, Sitting and Sleep (ProPASS) consortium.

Cardiovascular disease — all diseases of the heart and circulation — is the number one cause of mortality globally, the researchers point out. In 2021, it was responsible for one in three deaths (18 million) worldwide, with coronary heart disease the single biggest killer.

In their study, University College London scientists analyzed data from six studies, encompassing 15,246 people from five countries, to see how movement across the day is associated with heart health.

Each participant wore a device on their thigh measuring their activity throughout the 24-hour day and had their heart health measured.

Heart health was measured using six outcomes: body-mass index (BMI), waist circumference, HDL cholesterol, HDL-to-total cholesterol ratio, triglycerides, and HbA1c.

The study identified behaviors making up a typical 24-hour day, with time spent doing moderate-vigorous activity providing the most benefit to heart health, followed by light activity, standing, and sleeping. All were compared with the adverse impact of sedentary behavior.

The team modeled what would happen if an individual changed various amounts of one behavior for another each day for a week to estimate the effect on heart health for each scenario. They reported that when replacing sedentary behavior, as little as 5 minutes of moderate-vigorous activity had a noticeable effect on heart health.

The researchers said for a 54-year-old woman with an average body mass index of 26.5, a 30-minute change translated into a 0.64 decrease in BMI, which is a difference of 2.4%.

Replacing 30 minutes of daily sitting or lying time with moderate or vigorous exercise could also translate into a 2.5 cm (2.7%) decrease in waist circumference or a 1.33 mmol/mol (3.6%) decrease in glycated haemoglobin.

“The big takeaway from our research is that while small changes to how you move can have a positive effect on heart health, intensity of movement matters,” Jo Blodgett, PhD, the study’s lead author and a researchers at the UCL Surgery & Interventional Science and the Institute of Sport, Exercise & Health, said in a statement.

Blodgett added that the most beneficial change the team observed was replacing sitting with moderate to vigorous activity, which could be a run, a brisk walk, or stair climbing.

“Basically any activity that raises your heart rate and makes you breathe faster, even for a minute or two,” she said.

Although the authors said the findings can’t infer causality between movement behaviors and cardiovascular outcomes, this research does contribute to a growing body of evidence linking moderate to vigorous physical activity over 24 hours with improved body fat metrics.

They also said more long-term studies will be crucial to better understanding the associations between movement and cardiovascular outcomes.

Researchers said that although time spent doing vigorous activity was the quickest way to improve heart health, there are ways for people of all abilities to benefit. It’s just that the lower the intensity of the activity, the longer the time is required to start having a tangible benefit.

They said using a standing desk for a few hours a day instead of a sitting desk, for example, is a change over a relatively large amount of time but is also one that could be integrated into a working routine fairly easily.

The least active subjects were also found to gain the greatest benefit from becoming more active.

“A key novelty of the ProPASS consortium is the use of wearable devices that better differentiate between types of physical activity and posture, allowing us to estimate the health effects of even subtle variations with greater precision,” Emmanuel Stamatakis, PhD, the joint senior author of the study and a professor the Charles Perkins Centre and Faculty of Medicine and Health at the University of Sydney, said in a statement.

Dr. Cheng-Han Chen, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in California, told Medical News Today there are many simple ways to add more steps to one’s day.

“Take scheduled breaks throughout the day to take a short five-minute walk, either around the house or around the office; taking the stairs instead of the elevator, parking farther from the store and walking, and walking more briskly when shopping,” he advised.

Chen said using stairs has multiple positive effects.

“Walking upstairs is harder exercise than walking on level ground. That’s because not only are you moving your body, you’re moving it against gravity, and you’re essentially pushing yourself up and out,” he said. “You are also building your muscles in your lower body, strengthening your core, and your lower back.”

“Climbing stairs is more difficult, you’re doing more exercise, and more exercise is better for you and your heart. We think that climbing stairs actually gives you three times as much exercise as the same amount of time walking on the ground,” Chen noted.

Dr. Yu-Ming Ni, a cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California, told Medical News Today that more activity leads to better blood pressure control. That, in turn, puts less strain on the heart over time and can prevent the development of heart failure or a heart attack.

“Muscles are also an important consumer of blood sugar and physical activity improves blood sugar levels and can reduce the risk for diabetes,” Ni said. “Since diabetes is a major risk factor for heart attacks and strokes, any effort to prevent diabetes will ultimately lead to less risk of heart disease.”

Ni noted that the study shows even small improvements in physical activity can impacts blood sugar and blood pressure.

“Remember that small changes done over years can have a lasting impact on health,” Ni said. “It may not seem like much to walk 5 minutes every hour of desk work, but this can add up over the work day. In an 8-hour work day, this amounts to 40 minutes of physical activity. Add in a 15-minute walk during your lunch break and you suddenly have almost an hour of additional physical activity each work day.”

Dr. J. Wes Ulm, a medical researcher and bioinformatics expert who works as an analyst for the National Institutes of Health, told Medical News Today the research “at first glance may not appear to point to much in the way of groundbreaking recommendations,” it’s signifcant. Especially for people in the United States.

“The U.S., unfortunately, has borne the brunt of a slow-burn health crisis particularly over the past decade, with a trend of steadily declining life expectancy that markedly accelerated during the COVID-19 pandemic but — unlike most of the rest of the world — has failed to right itself,” he said.

Ulm said the United States now has one of the lowest life expectancies for any developed nation, along with worse outcome measures for a variety of other core public health metrics.

He added that more movement helps, especially with chronic disease.

“The prevalence and severity of such chronic illnesses, in turn, are profoundly exacerbated by physical inactivity, obesity, and poor diet, the first (and by implication the second) of which is specifically addressed by the research reported in this study,” Ulm said.

Dr. Bradley Serwer is a cardiologist and chief medical officer at VitalSolution, a company that offers cardiovascular and anesthesiology services to hospitals nationwide.

Serwer told Medical News Today that the study’s findings reaffirms why we see so much technology tracking movement.

“We have seen many updates and advancements over the years. Smart watches which track movement, steps, flights of stairs, heart rate, heart rate variability, etc. have been a valuable tool. Not only do they track your statistics, they also can serve as a reminder when you are sedentary for too long,” he said.

Serwer added that standing desks have become popular to promote constant movement.

“Exercise throughout the workday can help decrease professional burnout, can improve mood and help with mental clarity,” he said. “My tips for long term success include finding a physical activity that you enjoy that you will stick to. Find an exercise partner to help motivate you. Record your workout either on a smart watch or an old fashion written log. These tips will help motivate and encourage you to continue with permanent lifestyle changes.”

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