Exploring the link between daily patterns of movement and heart health.
Replacing sitting with as little as a few minutes of moderate exercise a day tangibly improves heart health, according to new research from the University of Sydney and UCL.
Published in the European Heart Journal and supported by the British Heart Foundation (BHF) and National Health and Medical Research Council (NHMRC), the study is the first to assess how different movement patterns throughout the 24-hour day are linked to heart health.
It is also the first evidence to emerge from the Prospective Physical Activity, Sitting and Sleep (ProPASS) consortium, led by the University of Sydney’s Charles Perkins Centre, which aims to generate knowledge to inform future guidelines and policies.
Global Impact of Cardiovascular Disease
Cardiovascular disease, encompassing all heart and circulation diseases, is the leading cause of death worldwide. In 2021, it accounted for one in three deaths (20.5 million), with coronary heart disease being the most significant contributor. The global prevalence of cardiovascular disease has doubled since 1997 and is expected to continue rising.
The study involved analyzing data from 15,246 participants across five countries, using wearable devices to track daily movement and assess heart health through six common indicators. The research established a hierarchy of daily behaviors, with moderate to vigorous activity having the most positive impact on heart health. Light activity, standing, and sleeping also contribute positively, in contrast to the detrimental effects of sedentary behavior.
“What is important to highlight about these findings is that replacing static or sedentary postures with movement is likely to improve heart health only if it becomes a long-term habit.”
– Professor Emmanuel Stamatakis
Study Findings and Implications
The team then 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. When replacing sedentary behavior, as little as five minutes of moderate to vigorous activity had a noticeable effect on heart health.
For a 54-year-old woman with an average BMI of 26.5, for example, a 30-minute change translated into a 0.64 decrease in BMI, which is a difference of 2.4 percent. Replacing 30 minutes of daily sitting time with moderate or vigorous physical activity could also translate into a 2.5 cm (2.7 percent) decrease in waist circumference or a 1.33 mmol/mol (3.6 percent) decrease in glycated hemoglobin – a measure of blood sugar levels used to indicate diabetes.
Accessibility and Integration of Movement Into Daily Life
Dr. Jo Blodgett, first author of the study from UCL’s Institute of Sport, Exercise & Health, said: “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. The most beneficial change we 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.”
Professor Emmanuel Stamatakis, ProPASS consortium founder and joint senior author of the study from University of Sydney’s Charles Perkins Centre, added: “What is important to highlight about these findings is that replacing static or sedentary postures with movement is likely to improve heart health only if it becomes a long-term habit.”
The researchers pointed out that although time spent doing vigorous activity was the quickest way to improve heart health, people of all abilities could benefit – but the lower the intensity of the activity, the longer the time required to start seeing a tangible benefit.
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 as it does not require any time commitment.
Those who are least active were also found to gain the greatest benefit from switching from sedentary behaviors to more active ones.
Professor Stamatakis said the wearables field was presenting exciting opportunities for health research.
Wearable Technology and Future Research
“A key novelty of this study and the ProPASS consortium more broadly 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.”
Though the findings cannot infer causality between movement behaviors and cardiovascular outcomes, they contribute to a growing body of evidence linking moderate to vigorous physical activity over 24 hours with improved body fat metrics. Further long-term studies will be crucial to better understanding the associations between movement and cardiovascular outcomes.
Personalized Activity Recommendations and Public Health Implications
Professor Mark Hamer, joint senior author of the study from UCL’s Institute of Sport, Exercise & Health, said: “Though it may come as no surprise that becoming more active is beneficial for heart health, what’s new in this study is considering a range of behaviors across the whole 24-hour day. This approach will allow us to ultimately provide personalized recommendations to get people more active in ways that are appropriate for them.”
James Leiper, Associate Medical Director at the British Heart Foundation, said: “We already know that exercise can have real benefits for your cardiovascular health and this encouraging research shows that small adjustments to your daily routine could lower your chances of having a heart attack or stroke. This study shows that replacing even a few minutes of sitting with a few minutes of moderate activity can improve your BMI, cholesterol, and waist size, and have many more physical benefits.
“Getting active isn’t always easy, and it’s important to make changes that you can stick to in the long-term and that you enjoy – anything that gets your heart rate up can help. Incorporating ‘activity snacks’ such as walking while taking phone calls, or setting an alarm to get up and do some star jumps every hour is a great way to start building activity into your day, to get you in the habit of living a healthy, active lifestyle.”
Reference: “Device-measured physical activity and cardiometabolic health: the Prospective Physical Activity, Sitting, and Sleep (ProPASS) consortium” by Joanna M Blodgett, Matthew N Ahmadi, Andrew J Atkin, Sebastien Chastin, Hsiu-Wen Chan, Kristin Suorsa, Esmee A Bakker, Pasan Hettiarcachchi, Peter J Johansson, Lauren B Sherar, Vegar Rangul, Richard M Pulsford, Gita Mishra, Thijs M H Eijsvogels, Sari Stenholm, Alun D Hughes, Armando M Teixeira-Pinto, Ulf Ekelund, I Min Lee, Andreas Holtermann, Annemarie Koster, Emmanuel Stamatakis, Mark Hamer, ProPASS Collaboration, Nidhi Gupta, Coen Stehouwer, Hans Savelberg, Bastiaan de Galan, Carla van de Kallen and Dick H J Thijssen, 10 November 2023, European Heart Journal.