Leisure Time Physical Activity but not Occupational Physical Activity Benefits Cardiovascular Health

by | Apr 27, 2021 | 2021, Cardiovascular Health, Fitness and Exercise

Written by Joyce Smith, BS. This study found that higher leisure time physical activity was associated with reduced major adverse cardiovascular events (MACE) and all-cause mortality risk, while higher occupational physical activity was associated with increased risk, independent of each other.

woman stretchingScientific evidence has shown us that the potential health effect of physical activity depends on the circumstances in which it is performed. Leisure time physical activity such as sports, recreation, and aerobics are associated with reduced cardiovascular disease and all-cause mortality 1-3, whereas low occupational physical activity does not always support better health and even men with high occupational physical activity may have an increased risk of death 4. A recent 2018 study by Holtermann et al describes how leisure time physical activity improves cardiorespiratory and metabolic health, while occupational physical activity with fatigue, elevated 24-hour blood pressure and heart rate does not 5.

The contrasting health outcomes between leisure time physical activity and occupational physical activity is called the “physical activity paradox” 6. Evidence shows that people who participate in leisure time physical activity have decreased systemic inflammation and high-sensitivity C-reactive protein, whereas those who do hard physical labor have elevated levels 7. A brisk 30-minute walk will raise heart rate and improve cardiorespiratory fitness, while occupational work activity often fails to sufficiently increase heart rate to improve fitness. However, work that involves heavy lifting or standing for long periods of time will sustain increased blood pressure and 24-hour heart rate without sufficient recovery time, both of which are risk factors for heart disease and mortality. This is a sharp contrast to the improved cardiorespiratory fitness seen during leisure time physical activity which requires short bursts of intense physical activity that raises blood pressure only briefly and allows for adequate recovery time 8. Unfortunately, physical activity guidelines do not differentiate between work and leisure time 1,2.

In their current research (2021) Holtermann and colleagues explore further the health implications of leisure time physical activity versus occupational physical activity and hypothesize that leisure time physical activity reduces cardiovascular disease risk and death while occupational physical activity increases risk 9. They compared the risk of major adverse cardiovascular events (MACE) and death from all causes for both types of physical activity. The study included 104,046 women and men, aged 20–100 years, from the Copenhagen General Population Study who were recruited from 2003–2014. Participants completed questionnaires about their leisure time physical activities and occupational physical activities. Each activity was then categorized as low, moderate, high, or very high.

A median follow-up of 10 years, revealed that out of the 104,046 participants, there were 9.5% (9,846) deaths from all causes and 7.6% (7,913) from MACE, which included fatal and nonfatal myocardial infarctions, fatal and non-fatal strokes, and other coronary deaths. After adjusting for age, sex, lifestyle, health, and education, the team found that leisure time physical activity was associated with a 40% reduced risk for death and a 15% reduced risk for MACE while occupational physical activity was associated with a 27% increased risk for death and a 35% increased risk for MACE. The results imply that the risk of cardiovascular disease and all-cause mortality increases with higher occupational physical activity and with lower leisure time physical activity, independent of the levels of each other.

This study is observational only and cannot prove causation. Both physical and occupational activities were self-assessed and subject to potential bias recall and misclassification. In addition, study participation rate was a low 43%. Since the study data was based on Denmark’s working conditions that involved both high and low income areas, study results may not generalize to other countries; thus future studies are needed that specifically target low-income and less privileged populations of more diverse socioeconomic and racial/ethnic backgrounds.

Source: Holtermann, Andreas, et al. “The physical activity paradox in cardiovascular disease and all-cause mortality: the contemporary Copenhagen General Population Study with 104 046 adults.” European Heart Journal 42.15 (2021): 1499-1511.

© The Author(s) 2021. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/)

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Posted April 27, 2021.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

References:

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