Spring Into Wellness: Learn How Physical Activity Limits Heart Risks for Women

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Published April 13, 2021

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“All Americans should strive to achieve at least 150 minutes per week of moderate intensity activity, which is equivalent to walking about 30 minutes daily at a brisk but comfortable pace.”

Does sitting increase a woman’s chance for heart failure? A November 2020 story featuring University at Buffalo researcher Michael J. LaMonte, PhD, MPH, Research Associate Professor, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, explained that the answer is yes. However, the headline-making study also helps us better understand the path to good health.

Here, LaMonte shares the study findings, and explains why physical activity and other healthy lifestyle choices are so important to better health outcomes.

What is the link between sitting and heart failure?

As part of the Women’s Health Initiative study, we followed a group of 80,982 postmenopausal women, who at enrollment were aged 50-79 years, had no history of heart failure, and who completed a questionnaire pertaining to the amount of daily inactive time. Participants were followed, on average, for nine years, during which time we identified new cases of acute hospitalized heart failure. The women participating in this study were enrolled at 40 clinical centers across the United States, including at UB.

Women who spent more than 9.5 hours per day in sitting or lying down activities while awake had a 42% higher risk of developing heart failure. This result was seen after accounting for differences in several factors related to inactive time and heart failure, including age, race-ethnicity, and menopausal hormone therapy use.

When we further accounted for heart attacks occurring prior to heart failure hospitalization — heart attack is a major cause of heart failure that also can result in more time inactive — the significantly increased risk of heart failure continued to be seen with prolonged sitting and lying time. Even among women who reported recreational physical activity levels that meet current guidelines, heart failure risk was elevated in the women who also reported more than 9.5 hours per day in sitting and lying activity. This latter finding points to the need to not only promote more physical activity for heart failure prevention, but to also promote interruption of inactive time throughout the day.

If a woman exercises regularly, heart failure from too much sitting and lying down is still a danger, correct?

Yes. This was a novel finding of our study, as I mention above. Even women whose usual physical activity levels would achieve current guideline recommendations, if they also had prolonged daily inactive time (greater 9.5 hours per day), their risk of heart failure was still significantly elevated.

Beyond advice from their doctor, how do adults know whether they need to be more active?

Being aware of national guideline recommendations for physical activity among adults is just as important as knowing values for blood pressure, cholesterol levels, or weight status that are clinically significant. All Americans should strive to achieve at least 150 minutes per week of moderate intensity activity, which is equivalent to walking about 30 minutes daily at a brisk but comfortable pace.

That said, our finding showed that women who met this recommendation still had excess heart failure risk if they sat for long periods of time throughout the day. We now know that interrupting prolonged sitting with standing breaks or very brief bouts of movement is probably needed to reduce the adverse effects of sedentary behavior in addition to purposeful physical activity.

What do you recommend for women who in their work or home life need to be seated for lengthy periods of time?

Periodic standing breaks, with or without movement, and brief bouts of activity — walking in place, walking across the room and back — appear to be helpful ways to interrupt sitting time. These “breaks” get the heart pumping and the blood flowing, and engage our brains and nervous system in such a way to help things keep running correctly, so to speak, when faced with long periods of inactivity.

What are some healthy lifestyle choices, habits, or activities that can help mitigate these issues?

Healthy lifestyle generally is common sense, with five simple rules of thumb:

  1. DON’T SMOKE!
  2. Sit less, move more. (Take a walk!)
  3. Eat sensibly.
  4. Limit alcohol intake.
  5. Take care of your stress and mental wellness.

Lastly, do you think there needs to be more discussion and public outreach about the dangers of too much sitting and lying down — not just for women but for everyone?

Yes! The current Physical Activity Guidelines for Americans, which is a revision from the initial 2008 recommendations, now places considerable emphasis on both being physically active and less sedentary. But, as with most public health guidelines and initiatives, it takes a while for the message to resonate within the population and for sustained change to be undertaken. With patience and determination, we will get there!

5 healthy lifestyle choices.