Even Sleeping Is Better for Your Heart Than Sitting

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.

Cardiovascular disease, which refers to all diseases of the heart and circulation, is the number one cause of mortality globally. In 2021, it was responsible for one in three deaths (20.5M), with coronary heart disease alone the single biggest killer. Since 1997, the number of people living with cardiovascular disease across the world has doubled and is projected to rise further.

In this study, researchers analysed data from six studies encompassing 15,246 people from five countries, to see how movement behaviour across the day is associated with heart health as measured by six common indicators. Each participant used a wearable device on their thigh to measure their activity throughout the 24-hour day and had their heart health measured.

The researchers identified a hierarchy of behaviours that make up a typical 24-hour day, with time spent doing moderate to vigorous activity providing the most benefit to heart health, followed by light activity, standing and sleeping - compared with the adverse impact of sedentary behaviour.

"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

The team then modelled what would happen if an individual changed various amounts of one behaviour for another each day for a week, to estimate the effect on heart health. When replacing sedentary behaviour, 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 haemoglobin – a measure of blood sugar levels used to indicate diabetes.

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.”

Professor Stamatakis said the wearables field was presenting exciting opportunities for health 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 behaviours 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.

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 behaviours across the whole 24-hour day. This approach will allow us to ultimately provide personalised 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, 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: Blodgett JM, Ahmadi MN, Atkin AJ, et al. Device-measured physical activity and cardiometabolic health: the Prospective Physical Activity, Sitting, and Sleep (ProPASS) consortium. European Heart Journal. 2023:ehad717. doi: 10.1093/eurheartj/ehad717

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