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Lead Researcher Discusses Kaiser Permanente Study on Sedentary Behavior and Heart Failure

January 21, 2014

Deborah Rohm Young, PhDThis week, the journal Circulation: Heart Failure published a Kaiser Permanente study that showed sedentary behavior and lack of physical activity is linked to heart failure in men. Deborah Rohm Young, PhD, a research scientist with the Kaiser Permanente Department of Research & Evaluation, is the lead author of this study. We caught up with her to learn more about the study and its implications.

Can you summarize what your research reveals?

In this study, we followed 82,000 California men aged 45 years and older for 10 years. The focus was on their activity levels and heart failure, which is a cardiovascular disease that occurs when the heart is unable to maintain a proper blood flow.

What we found is that high sedentary time and low physical activity are both associated with developing heart failure. The odds of developing heart failure were greater for low physical activity than sedentary time, but they both seemed to have an independent effect on developing heart failure.

What do you consider the most interesting findings of this study?

It is interesting that both low activity and high sedentary time were associated with developing heart failure. Another interesting finding from our work was that when we separated out the people who had coronary heart disease from the people who didn’t, the relative risk of developing heart failure with low physical activity and high sedentary time was constant. It didn’t matter if you had prevalent heart disease or not, the impact of not being active was the same.

And when we looked at people who had chronic diseases such as coronary heart disease or hypertension, we found that being more active and less sedentary conferred benefits. So I would say that even if you have these chronic conditions, you can still be active. It’s still safe as long as you get the OK from your health care provider. These are important behaviors for reducing risk of heart failure.

Should people who work at a desk eight hours a day be concerned?

That’s the hard thing — our society is based upon a lot of sitting. The message is when you can walk instead of stand, walk. When you can stand instead of sit, stand.

But the answer isn’t to get everyone standing desks, because there also can be problems with too much standing. What can help is changing it up and allowing for more movement.

The question we asked in the study was “Outside of work, how much time do you spend sitting?” It was really the men doing a lot of sitting outside of their work. We did not analyze their sitting at work.

Most people do sit all day long at work. If you’re one of those, it’s a call to action: When you get home don’t sit in front of TV on top of that. If people can walk, they should walk. If they can putter around the house, they should putter rather than doing nothing.

What led you to study this topic?

Although the effects of being too sedentary are emerging, we weren’t aware of it previously being looked at in terms of heart failure as an outcome. Most of the work with physical activity and cardiovascular disease has been done with coronary heart disease and much less on heart failure. While heart failure is often a result of having coronary heart disease, that is not always the case.

And so this issue still needed to be explored. There were only a couple studies in the literature that looked at physical activity and heart failure and those have been done in predominately white populations. We were fortunate to be able to study the question within our diverse, more generalizable populations of Northern and Southern California Kaiser Permanente membership.

This study followed only men. Would you expect to see the same results among women?

We would. There are no specific biological differences as to why it would be different. We do know that women are less likely to develop heart failure than men, but we would expect the impact of low physical activity and high sedentary time would be the same for both.

How do you hope these findings will be translated into action?

I think the No. 1 message is regular physical activity. That message needs to continue to be emphasized. The national guidelines are for 150 minutes of moderate physical activity a week and our data demonstrates that being more active is better than being less active.

This provides another reason why people should be physically active. This study shows there’s a reduced risk of heart failure. Physicians should be counseling their at-risk patients to become more physically active.

While it’s too early to draw hard conclusions about sitting or sedentary behavior, the evidence is emerging that too much sitting or being sedentary is not good for you. And we do believe the impact of being sedentary is independent of the amount of physical activity a person does. Given the number of health benefits from being physically active, people should find ways to put physical activity into their lives and spend less time sitting.