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Major life events have a negative impact heart health

Being physically active is one of the best ways to promote a healthy heart. Moderate- and vigorous-intensity exercise strengthens the heart muscle, improving its ability to pump oxygen-rich blood throughout the body. The American Heart Association recommends that adults participate in at least 150 minutes per week of moderate-intensity aerobic activity, or 75 minutes per week of vigorous aerobic activity, or a combination of both. 

However, according to statistics from the U.S. Centers for Disease Control and Prevention, only 1 in 5 teens (20%) and about 1 in 4 adults (24%) in the U.S. routinely achieve the recommended levels. In addition, a new American Heart Association Scientific Statement suggests that even these low levels of physical activity decrease significantly during major life events or transitions. 

In the statement, entitled “Supporting Physical Activity in Patients and Populations During Life Events and Transitions,” the scientific writing group confirms that sedentary behavior is a cardiovascular disease risk. The study focuses on the need to understand how life changes affect physical activity levels and what can be done to help people maintain good heart health through times of transition. 

“Certain life events and transitions may mark the beginning and end of different phases of a person’s life, and these life changes may lead to periods of less physical activity and more sedentary lifestyle behaviors. Physical activity is an important heart-healthy behavior and too much sitting and inactivity is not good for you,” said Dr. Abbi D. Lane-Cordova. 

“This is a particularly important topic right now because, in addition to life’s other major events, the COVID-19 pandemic is another disruption of everyone’s daily routines and activity levels.”

The writing group considered data on 17 different potential life events or transitions, and found evidence of decreased activity levels during the following nine events:

  • Beginning a new school (elementary, middle, high school or college) – each a distinct life event;
  • a first job or career change;
  • a marriage or civil union;
  • pregnancy;
  • parenting;
  • retirement; or
  • moving into a long-term care facility.

These changes had disproportionate effects on the physical activity levels of certain groups within the population: individuals with lower levels of education; those who lived alone during the initial COVID-19 lockdown; those with no access to safe outdoor space for exercise; and women during pregnancy and parenthood.

Factors affecting the physical activity levels of youth (<18 years) were analyzed on the basis of individual, social, environmental and policy contributors. At the individual level, activity amongst youth was most affected by factors such as gender, age, time spent outside, body image, motor coordination, physical activity preferences and involvement in school sports.

At the interpersonal level, youth were influenced by their weight and physical activity levels, and by their parents’ education level. Environmental influencers for youth included neighborhood crime rates, perception of safety, proximity and access to school programs, and recreational facilities. 

Similar analysis of the physical activity levels for adults (18+ years) found individual influencers included: perceived health benefits of exercise; history of and intention to exercise; confidence in achieving goals; enjoyment; and lower stress levels.

Social and cultural norms affected adults both negatively and positively, while environmental influencers included proximity and access to recreation facilities and greenspaces, transportation, neighborhood walkability and convenience.

The authors of the statement suggest that future efforts should be made to identify socio-ecological factors that would support routine exercise for all people, especially those going through life transitions. Examples of these factors include safer streets for pedestrians and cyclists, rails-to-trails programs and park upgrades. 

The statement also suggests that healthcare professionals have an important role to play in discussing the benefits of physical activity with their patients. They could ask a few questions as part of the routine collection of vital statistics during a health visit, or they could recommend behavioral counseling to patients. 

The writing group also suggests that simple, commercially available wearable technology such as pedometers or accelerometers can be used to monitor physical activity levels and changes. Simple, practical measures like adding 1,000 steps per day to increase daily physical activity levels can result in increased health benefits. 

“It’s important to maintain or improve physical activity when major life events happen, which is often a time when exercise is most needed,” said Dr. Lane-Cordova. “There are so many ways people can do this. They could plan family activities that involve exercise, use free videos or websites to exercise at home or take standing breaks while at work. The most important things are to be aware of the positive health and cardiovascular impact of physical activity and make the effort to get moving.”

The writing group said it is crucial “to look beyond the health care setting and engage organizations, communities, workplaces, faith-based communities and assisted living facilities to promote physical activity.” The statement provides a list of resources for individuals and health care professionals, many of which are free and online. Finally, the statement highlights the need to develop and test interventions that specifically target life events and transitions linked to declines in physical activity levels.

The research is published today in the AHA’s flagship journal Circulation.

By Alison Bosman, Staff Writer

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