Study Finds a "Hierarchy" of Physical Activities Healthier Than Sitting — Sleeping is One

Moderate-vigorous activity and even lighter intensity, like sleeping, benefit the heart.

Beautiful young woman sleeps in a comfortable bed. Sunbeam of dawn on her face.
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Sitting isn’t good for you. That’s abundantly clear from studies linking prolonged sedentary behavior — from working at a desk to Netflix binging on the couch — with a wide range of medical conditions from Type 2 diabetes to heart disease and even premature death.

But studies also show if you’ve racked up too many hours glued to one place, all is not lost. For instance, engaging in exercise “snacks” (aka micro-burts of physical activity) for a least five minutes every 30 minutes or so does your metabolism, heart, and mind good.

Now, according to a study published last week in the European Heart Journal, any sort of physical activity, including sleeping, is better than being flat on your tuchus. Examining data from six studies encompassing over 15,000 people across five countries, the researchers looked at which kinds of movement within a typical 24-hour day conferred the most heart health benefits. Unsurprisingly, moderate-vigorous physical activity came out on top, followed by light activity, which included standing and sleeping.

“The big takeaway from our research is that while small changes to how you move can have a positive effect on heart health, the intensity of movement matters,” Jo Blodgett, the study’s first author and a research fellow in the University College London’s Institute of Sport, Exercise and Health, said in a press release.

“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.”

Replacing sitting with exercise or sleep

All participants, both men and women hailing from the Netherlands, Denmark, Finland, the UK, and Australia, had a wearable device strapped to their thigh to measure their physical activity throughout the day. They also had six common indicators of heart health measured: body-mass index (BMI), waist circumference, high-density lipoprotein (HDL or “good”) cholesterol, the ratio between their total and good cholesterol, triglycerides (a common type of fat in the body), and hemoglobin A1c (a test that measures your average blood sugar over the past three months; higher values are strongly associated with increased risk of heart disease).

Once the researchers identified a sort of hierarchy of movement based on these indicators, they modeled what would happen to your heart health if you switched up your activity for a week.

For instance, if you replaced 30 minutes of sitting with moderate to vigorous physical activity, you could see a 0.63 decrease in BMI. (It’s important to note that BMI is a contentious measurement of health.) Even swapping sitting for five minutes of this sort of activity had a noticeable effect on heart health.

Light activity appeared to have benefits, but the downside is that you would have to do more of it for longer to see any benefits. Yet, how this applies to sleep as a light activity is a bit more nuanced. On average, study participants were getting 7.7 hours of shut-eye a night. If you’re getting any more than that — bear in mind, the recommended hours of sleep for an adult is seven to nine hours — the benefits aren’t going to be as significant as the ones from physical activity.

However, there may be benefits to hitting the snooze button if you’re sleep-deprived. Studies have found that poor sleep is bad for the heart. Sleep disorders such as insomnia, apnea, and narcolepsy have been linked to a higher risk of cardiovascular diseases. The researchers say they aren’t entirely sure of the benefits of getting more sleep versus exercising in sleep-deprived folks, but they hypothesize that “prioritizing sleep over physical activity” should probably be a focus.

These findings come at a time when heart disease, especially in the US, is on the rise. According to the American Heart Association, cardiovascular disease-related deaths jumped during the first year of the pandemic, from 874,613 in 2019 to 928,741 in 2020.

“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,” Mark Hamer, one of the study’s co-authors and clinical professor in sport and exercise medicine at UCL, said in the press release. “This approach will allow us to ultimately provide personalized recommendations to get people more active in ways that are appropriate for them.”

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