Research on Physical Activity and Cardiovascular Risk

Latest Research Shows That Three Minutes of Moderate Activity Daily Can Reduce Cardiovascular Events and Mortality Risk

Cardiovascular diseases (CVD) are the leading cause of death worldwide. Most clinical and public health guidelines have traditionally been based on the heart-protective properties of structured exercise. For example, most of the evidence in the World Health Organization (WHO) 2020 Guidelines on Physical Activity and Sedentary Behavior comes from self-reported measures that primarily record recreational exercise during leisure time.

For many adults, regularly engaging in structured (leisure-time) exercise may be unappealing or difficult to achieve, and participation rates are generally low. Moreover, dropout rates in exercise-based cardiac rehabilitation programs tend to be high. Incidental physical activity (IPA) that occurs as part of daily life, such as commuting, working, household chores, or other domestic activities, may offer a feasible advantage in the primary and secondary prevention of cardiovascular disease as it overcomes several barriers to structured exercise, including lack of time and motivation, high costs, difficulty accessing facilities, and lack of confidence in one’s own physical abilities or skills.

Recently, researchers at the University of Sydney published a study titled "Dose Response of Incidental Physical Activity Against Cardiovascular Events and Mortality" in the journal Circulation.

The study suggests that for older adults, just three minutes of moderate incidental physical activity (such as doing household chores or walking while shopping) per day may reduce the risk of cardiovascular events (such as heart attacks) and the risk of death from such events.

Few middle-aged and older adults regularly engage in exercise during leisure time. Incidental physical activity (IPA) refers to unplanned physical activity that naturally occurs as part of daily life, such as doing household chores, walking while shopping, climbing stairs, carrying items, or brief walks. These activities do not require dedicated time or space but are integrated into daily tasks.

In this new study, the research team assessed the relationship between incidental physical activity (IPA) and its varying intensities with major adverse cardiovascular events (MACE) and mortality, and estimated the "health equivalence" of light and moderate IPA relative to one minute of vigorous incidental physical activity (VIPA).

The research team used a prospective cohort study design to analyze data from 24,139 non-exercising participants (56.2% female) from the UK Biobank Accelerometer Sub-study between 2013-2015, with an average age of 61.9 ± 7.6 years. IPA energy expenditure and the daily duration of VIPA, moderate incidental physical activity (MIPA), and light incidental physical activity (LIPA) were calculated using a validated machine learning-based intensity classifier. Major adverse cardiovascular events (MACE) included incident stroke, myocardial infarction, and heart failure; cardiovascular disease death; cardiovascular disease mortality rate; and all-cause mortality.

The analysis covered 22,107 participants (MACE), 22,174 participants (cardiovascular disease mortality rate), and 24,139 participants (all-cause mortality), with 908/223/1071 events recorded during the 7.9-year follow-up period. Incidental physical activity (IPA) showed an L-shaped association, reaching a minimum around 35 to 38 kJ/kg·day, with corresponding risk ratios for MACE, cardiovascular disease mortality, and all-cause mortality of 0.49, 0.33, and 0.31, respectively.

Both MIPA and VIPA were associated with lower cardiovascular disease mortality risks. VIPA reached its minimum risk with about 14 minutes per day, and MIPA reached its minimum with 34-50 minutes per day. The median VIPA (4.6 min/day) and median MIPA (23.8 min/day) durations were associated with cardiovascular disease mortality risk ratios of 0.62 and 0.50, respectively. LIPA showed a subtle inverse gradient, with cardiovascular mortality being statistically significant only at levels > 130 minutes per day.

The study also showed that one minute of VIPA is equivalent to 2.8-3.4 minutes of MIPA and 34.7-48.5 minutes of LIPA in terms of cardiovascular disease risk reduction.

Overall, the study indicates that any level of VIPA and MIPA is associated with a dose-response relationship to reduced cardiovascular disease risk, while LIPA has a weaker association with all outcomes. One minute of VIPA or approximately 3.0-3.5 minutes of MIPA are related to similar levels of cardiovascular disease risk reduction. These findings highlight the potential value of incidental physical activity for cardiovascular health, especially for individuals who find it difficult to engage in regular exercise.

The research team suggests that people can reduce their risk of cardiovascular disease as they age by engaging in daily incidental activities, such as cooking for themselves instead of dining out, or doing household chores like cleaning rooms.

Reference

Emmanuel Stamatakis and Raaj K. Biswas and Nicholas A. Koemel and Angelo Sabag and Richard Pulsford and Andrew J. Atkin and Afroditi Stathi and Sonia Cheng and Cecilie Thøgersen-Ntoumani and Joanna M. Blodgett and Adrian Bauman and Carlos Celis-Morales and Mark Hamer and Jason M.R. Gill and Matthew N. Ahmadi. Dose Response of Incidental Physical Activity Against Cardiovascular Events and Mortality. doi:10.1161/CIRCULATIONAHA.124.072253. https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.124.072253