Heart-Smart Exercise Advice for the Sedentary

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Physical inactivity is an important risk factor for a heart attack. The American Heart Association recommends at least 30 minutes of moderate-intensity exercise (for example, brisk walking) five days a week). Exercise not only reduces your risk of a heart attack, but also helps control body weight, lower blood pressure, reduce the risk of diabetes, and improve triglyceride levels. But what should you do if you’ve led a sedentary lifestyle for years?

Two studies in JAMA Network Open in 2019 offer hope to people who start exercising later in life and to those who are unable to do moderate-intensity or vigorous exercise. The first study suggests that if you are middle-aged and have been sedentary most of your life, it’s not too late to gain substantial health benefits by becoming physically active.

Researchers analyzed data from 315,000 participants in the NIH-AARP Diet and Health Study, who were ages 50 to 71 when they enrolled and filled out detailed questionnaires about their diet, health, and physical activity, past and present. Over the next 14 years, those who had reported participating in moderate to vigorous physical activity, starting in their teens or 20s, were about one-third less likely to die (notably from cardiovascular disease but also cancer) than those who were consistently inactive over the decades. But those who started to become physically active between the ages of 40 and 61 also had a one-third lower mortality rate. The researchers controlled for factors such as age, race, smoking, body weight, and diet.

Low-intensity physical activity, such as slow walking and light housework, may be enough to reduce the risk of heart attacks and coronary deaths among older women, according to the second study, which included about 5,800 women, age 63 and older (average age, 78) at the start.

Participants initially wore a device that measured their physical activity for four to seven days, and were then followed for an average of 3.5 years. After controlling for many factors—including overall health, weight, physical function, and moderate to vigorous physical activity—the researchers found that women who did the most light activity (averaging six hours a day) were about one-third less likely to have a heart attack or die from coronary causes than those who did the least (averaging three hours a day). The more daily light activity they did, the greater the coronary benefit. Previous research has found similar benefits among older men.

If you’re not currently active, your doctor can help you plan reasonable starting goals, bearing in mind your general health.