Relationship between physical activity paradox and cardiovascular disease risk factors

 Investigators examined the impact of the physical activity paradox in the contributing factors for cardiovascular disease in a new article published in the Public Library of Science (PLOS) ONE publication (CVD).

Physical activity during free time has been found to lower the risk of cardiovascular disease and death. Workplace physical activity, on the other hand, is likely to increase the risk of all-cause and CVD-related mortality, particularly among men. Furthermore, there is scepticism about the relationship between occupational physical activity and major cardiovascular events, ischemic heart disease (IHD), and CVD risk factors.

The physical activity health paradox refers to the conflicting link between physical exercise during work and leisure and CVD susceptibility factors.

The current physical activity standards are mostly based on statistics on leisure-time physical activities. Nonetheless, a significant portion of the public at large, especially those from poorer backgrounds, engages in the majority of their daily physical exercise at work. As a result, examining the negative health effects of workplace physical exercise is crucial.

About the Study

The researchers used compositional data analysis to examine the mechanism behind the connections of high-intensity physical activity (HIPA), strolling, and sedentary behaviour during work and leisure with CVD risk factors in an adult general population sample (CoDA). Systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and waist circumference were all identified as CVD risk factors.  The researchers examined data from the Copenhagen City Heart Study (CCHS) fifth evaluation, which was collected from October 2011 to February 2015.

For a week, study participants wore accelerometers in their iliac crest and right thigh and had their WC, LDL-C, and SBP measured. The accelerometer data was analysed with the Acti4 software to assess daily physical activity and inactive behaviour types. Redistributing time between 1) HIPA: the total of rowing, ascending stairs, cycling, and sprinting, and 2) walking into work and leisure categories yielded the correlation measure.

Results

The final trial sample included 652 patients from CCHS research, with a median accelerometer wear length of six days at 23.8 hours per day, according to the findings. During leisure, increased walk or HIPA and less sedentary activity were linked to lower SBP, whereas they were linked to higher SBP at work. Furthermore, the magnitude of the predicted SBP fluctuations had significant differences between the two domains.

Both in work and leisure sectors, greater HIPA and less sedentary behaviour were connected to lower LDL-C and smaller WC, albeit with minor estimates during work. Regardless of domain, the results revealed that more walking and much less sedentary activity were linked to higher LDL-C and greater WC. Furthermore, the predicted variance in WC was not proportional due to the temporal reallocations.

When diuretics, cholesterol-lowering drugs, or antihypertensives were added in the sensitivity analyses, results identical to the main trial were found for the WC, LDL-C, and SBP outcomes. The predicted change in SBP for time redistributions amongst walking and sedentary behaviour demonstrated the same trend when the evaluations were limited to 146 people administering these three drugs, but they were larger than the main assessments. The predicted variations in SBP considering time reallocations among HIPA and sedentary behaviour followed the opposite pattern as the primary study.

LDL-C and WC, on the other hand, showed opposing trends. WC in the leisure walk and sedentary behaviour reallocations, as well as the HIPA and inactive behaviour reallocations at work; and LDL-C in the leisure walk and sedentary behaviour reallocations, as well as the HIPA and inactive behaviour reallocations at work.

Conclusions

More HIPA or strolling and less inactive activities seemed to be linked to a decreased SBP during leisure, but it looked to be linked to a higher SBP at work, as per the study findings. There were no substantial differences in LDL-C and WC among domains. These findings highlight the importance of taking into account the physical activity-health paradox, at least for specific CVD risk factors. Furthermore, the authors stated that workplace physical activity standards should take into account the detrimental health effects of physical activity.

According to the researchers, more research using prospective data and broader study groups is needed to better understand the health impacts of walking and other types of physical activity in both work and leisure. Future research could benefit from combining device-based assessments with evidence from job-exposure matrices, previous job titles, questionnaire data, or regularly collected administrative data to improve exposure assessment and reduce misclassification.

According to the authors, a thorough understanding of how existing research may be used to increase public physical activity levels and what to suggest to demographic groups with elevated levels of workplace physical activity regarding their free time physical activity is critical.