Sophia Antipolis, April 9, 2021: The first major study showing that leisure physical activity and professional physical activity have opposite and independent links to cardiovascular disease risk and longevity was published today in European Heart Journal, Journal of the European Society of Cardiology (ESC).1
“We adjusted for multiple factors in our analysis, indicating that the links were not explained by lifestyle, health conditions, or socioeconomic status,” said study author Professor Andreas Holtermann of the National Research Center for the Working Environment, Copenhagen, Denmark.
The World Health Organization (WHO) recommends physical activity during recreation and work to improve health.2 Previous studies have suggested that occupational activity is associated with an increased risk of heart disease and mortality, but is too small to fully explain whether this is due to manual labor or because employees had unhealthy lifestyles or low socioeconomic status (e.g., low level of education).
This study included 104,046 women and men aged 20–100 years from the General Population Study in Copenhagen with baseline measurements in 2003–2014. Participants completed questionnaires on leisure and employment activities and were categorized as low, moderate, high, or very high activities for each.
During a median follow-up of 10 years, 9,846 (9.5%) deaths from all causes and 7,913 (7.6%) major adverse cardiovascular events were reported (MACE, defined as fatal and nonfatal myocardial infarction, fatal and nonfatal stroke, and other coronary deaths).
Compared with low physical activity in leisure time, after adjusting for age, gender, lifestyle, health and education, moderate, high and very high activity were associated with 26%, 41% and 40% reduced risk of death. In contrast, compared to low work activity, high and very high activity were associated with a 13% and 27% increased risk of death, respectively.
Similarly, after adjustment, compared to low leisure activities, moderate, high, and very high levels of leisure activities were associated with 14%, 23%, and 15% reduced risks of MACE, respectively. Compared to low employment, high and very high levels are associated with an increased risk of MACE by 15% and 35%, respectively.
Professor Holtermann said: “Many people with physical jobs believe that physical activity at work keeps them fit and healthy, so they can relax when they get home. Unfortunately, our results suggest that this is not the case. And while these workers could benefit from physical activity in their spare time, after walking 10,000 steps while cleaning or standing for seven hours in a production line, people feel tired so it’s an obstacle. “
Although the study did not investigate the reasons for opposing associations for professional and leisure physical activity, Professor Holtermann said: “A brisk 30-minute walk will benefit your health by raising your heart rate and improving cardiorespiratory fitness, while work activity often does not increase your heart rate enough to improve fitness. In addition, work that involves lifting a few hours a day raises blood pressure for many hours, which is associated with the risk of heart disease, while short bursts of intense physical activity in free time only briefly raise blood pressure. “
Professor Holtermann’s vision is to reorganize professional activity to mimic the beneficial aspects of free exercise. Several approaches are piloted, such as rotation between workstations on the production line, so that employees work a “healthy mix” of sitting, standing, and lifting during the shift. In another study, kindergarten workers play games together with children, instead of watching them, so that they both speed up their heart rate and increase their fitness. “We are trying to change tasks, give time to recover or increase the heart rate so that it has benefits for fitness and health,” he said.
Professor Holtermann concluded: “Societies need adults with enough health and fitness to work longer as the retirement age increases. We need to find ways to make active work good for health. “