Exercise Doesn’t Need to Be Intense to Yield Benefit

Among older women, regular light physical activity was associated with lower incidence of cardiovascular disease (CVD) and coronary heart disease (CHD), a prospective cohort study found.

Among the women in the highest versus lowest quartile of light physical activity in minutes per day, risk of incident CVD events was lower by 22% and risk of CHD was reduced 42% (both P<0.001 and reflecting adjustment for numerous potential confounders), reported Andrea LaCroix, PhD, MPH, of the University of California in San Diego, and colleagues in JAMA Network Open.

Each 1-hour/day increment in light activity was associated with a 14% lower risk of CHD (P=0.05 for trend) and 8% lower risk of CVD (P=0.03 for trend) after adjustment for moderate-to-vigorous activity participants engaged in, the researchers indicated.

Light physical activity was defined as energy expenditure of less than 3 metabolic equivalent tasks (METs). Participants in the so-called OPACH study, part of the Women’s Health Initiative, wore accelerometers to measure activity during waking hours.

Some prior investigations found a dose-response relationship between physical activity and cardiovascular benefit that extended to low levels of moderate physical activity. But those studies did not directly address CVD/CHD prevention with light activity, noted Gregory Heath, DHSc, MPH, of the University of Tennessee in Chattanooga, in an accompanying editorial, although other benefits have been noted.

He noted that the current study supports the 2018 Physical Activity Guidelines, which asserted that light activity is beneficial in terms of CVD and CHD.

The present investigation “should serve as a clarion call to physicians, other health care professionals, health care systems, and public health agencies to embrace, communicate, and promote the 2018 Physical Activity Guidelines to all patients and constituents,” Heath wrote.

“To temporize such action is to jeopardize the future health and well-being of older women, leaving most with the consequences of sedentarism and inadequate levels of physical activity with associated premature death and deficits in physical and mental functioning,” he continued.

Paul Thompson, MD, of Hartford Hospital in Connecticut, said the study findings weren’t a great surprise — most investigations have demonstrated that nearly any physical activity lowers CVD events — but he noted its design made the findings more credible than has been the case in other research.

“This study used accelerometers, which is probably the best way to measure physical activity because it is not dependent on self-report, and showed benefit in older women. So, there is some addition to our knowledge, but frankly not much,” he told MedPage Today.

Based on these findings even quite low levels of physical activity are beneficial, Thompson emphasized. “The idea that almost anything reduces its risk is helpful, but that is where most of the data have been going or suggesting for a long time now.”

The researchers evaluated 5,861 women with a mean age of 78.5 years. Mean follow-up was 3.5 years, during which participants had 570 cardiovascular disease events and 143 coronary heart disease events. The cohort was 17.6% Hispanic, 48.8% white, and 33.5% black.

“Large, pragmatic randomized trials are needed to test whether increasing light physical activity among older women reduces cardiovascular risk,” LaCroix and colleagues concluded.