It’s the dog days of summer. This summer feels particularly hot and sultry, so you may not be motivated to exercise regularly. You don’t have to entirely skip the couch and the streaming binge-a-thon calling your name; just be sure to fit in some time to move – your Heart will thank you. Pay tribute to your Heart and move, as studies have proven sedentary behavior and physical inactivity are significant independent risk factors for heart disease, and heart disease is a killer.

We highlight it loudly and often, cardiovascular disease is the number one cause of death in the U.S. and globally. According to the AHA’s 2022 Heart Disease and Stroke Statistics Update, approximately 121.5 million people in the U.S. have high blood pressure, 100 million have obesity, more than 28 million people have Type 2 diabetes, and only 1 in 4 adults reported achieving the physical activity and exercise recommended in the U.S. Department of Health and Human Services Physical Activity Guidelines for Americans, 2nd edition. Various research studies over the past two decades indicate more than 80% of all cardiovascular events may be prevented by a healthy lifestyle and management of known cardiovascular risk factors. Incorporating more movement into your daily activities, with a heavy emphasis on activity, is a huge first step.

Just Don’t Sit Around

Sedentary behavior is a known risk factor for heart disease, and a review article published in the American Journal of Lifestyle Medicine has shown that sitting is an independent risk factor for cardiovascular disease. Sedentary behavior is a distinct concept from physical inactivity. It is defined as “any waking behavior characterized by an energy expenditure ≤1.5 metabolic equivalents [of task] (METs), while in a sitting, reclining or lying posture. Sedentary activities include our favorites, such as watching T.V., listening to music, reading and writing, knitting and sewing, playing video or computer games, and riding in a car.

Sedentary behavior has been identified as an independent risk factor for heart disease due to several reasons:

• Reduced Physical Activity: When we engage in sedentary behavior, we tend to be inactive and spend minimal energy. Regular physical activity is crucial for maintaining cardiovascular health. Sitting for long periods reduces overall physical activity, negatively impacting heart health.

• Decreased Blood Flow and Muscle Activity: Sitting for extended periods can reduce blood flow and muscle activity. Muscles play a significant role in glucose and lipid metabolism. When muscles are inactive, they utilize less glucose and fatty acids, which can lead to elevated blood sugar levels and triglycerides. This increase in blood glucose and lipids can contribute to the development of cardiovascular risk factors such as insulin resistance, high blood pressure, and dyslipidemia.

• Impaired Blood Vessel Function: Prolonged sitting can impair the function of the endothelium, which is the inner lining of blood vessels. When sitting, blood flow becomes slower and less forceful, which can affect the ability of blood vessels to dilate and constrict properly. Impaired endothelial function is associated with the development of atherosclerosis, the buildup of plaque in the arteries, which can lead to heart disease.

• Increased Inflammation: Sedentary behavior is linked to chronic low-grade inflammation in the body. This inflammation can contribute to the development and progression of atherosclerosis. Inflammatory processes within the blood vessels can damage the arterial walls and promote the formation of plaques, increasing the risk of heart disease.

• Weight Gain and Obesity: Sedentary behavior is often associated with weight gain and obesity. Excess body weight and obesity are significant risk factors for heart disease, as they contribute to other cardiovascular risk factors such as high blood pressure, high cholesterol levels, and insulin resistance.

Sedentary Behavior vs. Physical Inactivity

Sedentary behavior and physical inactivity are related but distinct concepts:

• Sedentary Behavior: Sedentary behavior refers to activities involving sitting or reclining with low energy expenditure. As mentioned, it includes activities such as sitting at a desk, watching television, using a computer, or driving a car. Sedentary behavior is characterized by prolonged periods of sitting or minimal movement.

• Physical Inactivity: Conversely, physical inactivity refers to not engaging in moderate to vigorous physical activity. It refers to a lack of exercise or inadequate participation in activities that raise the heart rate and require increased energy expenditure. Physical inactivity encompasses a broader range of behaviors beyond just sitting; adults are classified as inactive if they did not report any sessions of light to moderate or vigorous leisure-time physical activity of at least 10 minutes a day. Physical inactivity has also been defined as expending less than 1.5 kcal or 1500 calories daily in leisure physical activities, equivalent to walking a little over 1.3 miles or approximately 3000 steps.

In simpler terms, sedentary behavior focuses explicitly on the time spent sitting or reclining. At the same time, physical inactivity is a broader concept that encompasses a lack of participation in any form of physical activity, regardless of whether it involves sitting or not.

While it’s interesting to understand the distinctions between the terms, both sedentary behavior and physical inactivity are associated with negative health outcomes, and it is important to reduce sedentary behavior and increase physical activity levels to promote overall health and well-being.

Heart Risk:  Physical inactivity > Smoking

So on the spectrum of sedentary behavior being the worst and being physically inactive only ranking slightly better, being physically inactive at the lowest level puts you at higher risk than smoking.  What?!? We all know that a sedentary lifestyle or being unfit has some risks, but a study by the Cleveland Clinic showed it was worse than the risk factors of smoking, hypertension, or diabetes, which one would normally categorize as stronger than physical inactivity. What made this Cleveland Clinic study so unique was that researchers weren’t relying on patient’s self-reporting their exercise, rather participants were tested on a treadmill to objectively figure out the real measure of what they can do and their actual fitness level. Now we know, you live longer! It’s all about getting up and really moving. 

Get the Kids Moving Too

Think it’s just the adults who are subscribing to an inactive lifestyle? Think again. According to the AHA’s 2022 Heart Disease and Stroke Statistics, the prevalence of high school students who engaged in ≥60 minutes of physical activity on at least 5 days of the week was 44.1% and was lower with each successive grade (from 9th [49.1%]–12th [40.0%] grades). Beyond identifying increased physical activity has been associated with an increased life expectancy and decreased risk of cardiovascular disease, it has been proven that physical activity also produces overall physical, psychological and social benefits. Inactive children are likely to become inactive adults. Not only does an active child reduce the risk of developing heart disease, studies show children also do better academically if they get enough physical activity. Seize the moment and initiate some of your favorite childhood games like playing catch, organizing a game of tag or capture the flag, jumping rope or on rainy days, stream a workout like kickboxing, yoga or dance to your kid’s favorite tunes.

Moving and the Overall Health Long Game

An umbrella review of 24 systematic reviews of adults ≥60 years of age concluded that those who are physically active are at a reduced risk of cardiovascular disease mortality (25%–40% risk reduction), all-cause mortality (22%–35%), breast cancer (12%–17%), prostate cancer (9%–10%), and depression (17%–31%) while experiencing better quality of life, healthier aging trajectories, and improved cognitive functioning. Set a physical activity target of at least 150 minutes (2.5 hours) of heart-pumping physical activity per week, and embark upon a lifelong journey to heart health.