The study, supported by the British Heart Foundation (BHF) and published in European Heart Journal, is the first to assess how different patterns of movement over the course of 24 hours relate to heart health. It is the first evidence to emerge from the international Prospective Physical Activity, Sitting and Sleep (ProPASS) consortium.
Cardiovascular disease, which refers to all diseases of the heart and circulatory system, is the number one cause of death worldwide. In 2021, it was responsible for one in three deaths (20.5 million), with coronary heart disease alone the biggest killer. Since 1997, the number of people living with cardiovascular disease worldwide has doubled and is projected to increase further.
In this study, researchers at UCL analyzed data from six studies, involving 15,246 people from five countries, to see how movement behavior during the day was related to heart health, as measured by six common indicators*. Each participant wore a wearable device on their thigh to measure their activity over the course of 24 hours and measured their heart health.
The researchers identified a hierarchy of behaviors that make up a typical 24-hour period, with time spent in moderate-to-vigorous activity providing the most heart-healthy benefits, followed by light activity, standing, and sleep compared to the negative effects of sedentary behavior .
The team modeled what would happen if a person swapped various amounts of one behavior for another every day for a week, in order to estimate the effect on heart health for each scenario. When replacing sedentary behavior, just 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 BMI reduction of 0.64, which is a difference of 2.4%. Replacing 30 minutes of daily sitting or lying down with moderate or vigorous exercise could also translate into a reduction in waist circumference of 2.5 cm (2.7%) or a reduction in glycated hemoglobin of 1.33 mmol/mol (3, 6%).
Dr Jo Blodgett, first author of the study from UCL Surgery & Interventional Science and the Institute of Sport, Exercise & Health, said: “The big takeaway from our research is that while small changes to the way you move can have a positive effect in the heart, health, intensity of movement are important. The most beneficial change we noticed was replacing sitting with moderate to vigorous activity — which could be running, brisk walking, or stair climbing — basically any activity that gets your heart rate up and makes you breathe faster, even and for a minute or two.’
The researchers pointed out that although time spent in vigorous activity was the fastest way to improve heart health, there are ways to benefit people of all abilities — it’s just that the lower the intensity of the activity, the more time needed to start having tangible benefits. Using a standing desk for a few hours a day instead of a sitting desk, for example, is a change over a relatively long period of time, but it’s also one that could be incorporated into a work routine fairly easily, as it doesn’t require any time commitment .
Those who are less active were also found to derive the greatest benefit from changing from sedentary to more active behaviour.
Professor Emmanuel Stamatakis, joint senior author of the study from the Charles Perkins Center and the University of Sydney’s School of Medicine and Health, said: “A key innovation of the ProPASS consortium is the use of wearable devices that better differentiate between types of physical activity and posture , allowing us to more precisely estimate the health effects of even subtle variations.”
Although the findings cannot infer causality between exercise behaviors and cardiovascular outcomes, they contribute to a growing body of evidence linking 24-hour moderate-to-vigorous physical activity with improved measures of body fat. Further long-term studies will be crucial to better understand the associations between exercise and cardiovascular outcomes.
Professor Mark Hamer, joint senior author of the study from UCL Surgery & Interventional Science and the Institute of Sport, Exercise & Health, said: “Although it is no surprise that being more active is beneficial for heart health , what’s new in this The study examines a range of behaviors throughout the 24-hour period. This approach will ultimately allow us to provide personalized recommendations to get people more active in ways that are right 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 reduce your chances for heart attack or stroke This study shows that replacing even a few minutes of sitting with a few minutes of moderate activity can improve BMI, cholesterol, waist size and many other physical benefits.
“Getting active isn’t always easy, and it’s important to make changes you can stick with long-term and enjoy — anything that gets your heart rate up can help. Incorporating ‘activity snacks’ like walking Taking phone calls or setting an alarm to get up and do a few star jumps every hour is a great way to start incorporating activity into your day, getting you into the habit of living a healthy, active lifestyle.”
This research was funded by the British Heart Foundation.
*Studies were part of the Prospective Physical Activity, Sitting and Sleep (ProPASS) consortium. Heart health was measured using six outcomes: body mass index (BMI), waist circumference, HDL cholesterol, ratio of HDL to total cholesterol, triglycerides and HbA1c.