Going for a brisk walk after a long day at work may be better for your heart than getting all of your exercise on the job.
New research suggests that while current health guidelines indicate that leisure-time activity and physical activity at work are created equally when it comes to heart health benefits, this may not be the case after all.
Leisure-time exercise -- whether it be taking a walk, jogging or hopping on your Peloton bike after a hard day's work -- can improve heart health, but only getting your exercise on the job seems to increase heart risks.
This is what's known as the "physical activity paradox," said study author Andreas Holtermann, a professor at the National Research Centre for the Working Environment in Copenhagen, Denmark.
"Leisure physical activity leads to fitness, improved health and well-being, but work physical activity leads to fatigue, no fitness gain, and elevated heart rate and blood pressure over the day without sufficient rest," Holtermann said.
For the study, researchers asked close to 104,000 people (aged 20 to 100 years) from the Copenhagen General Population Study to rate their leisure-time and employment physical activity as low, moderate, high or very high.
There were more than 7,900 major cardiovascular events, such as heart attacks and strokes, and about 9,850 deaths overall during an average of 10 years of follow-up. The more leisure-time physical activity a person reported, the lower their risk of dying or experiencing a heart attack, stroke or other cardiovascular event.
By contrast, folks who said they got most of their physical activity on the job were more likely to die or sustain a cardiovascular event than those people who reported less manual labor. The findings held even after the researchers controlled for other factors that affect heart and stroke risks, such as weight, alcohol intake, smoking status, cholesterol and blood pressure levels.
Something has to change, Holtermann said.
"Work ought to be organized, so the worker not become too fatigued or exhausted, with sufficient time/ability for recovery, so they have energy to do the health-promoting activities at leisure," he said. "The worker ought to take responsibility for…improving physical activity during leisure, as well as getting sufficient recovery to recuperate from work."
In an editorial accompanying the new study, Martin Halle and Melanie Heitkamp, of the Technical University of Munich in Germany, also called for change. "Companies should offer breaks and recovery time during work, sufficient recreational breaks and complementary exercise training for their employees, especially for workers in heavy manual jobs," they wrote.
The research was published April 9 in the European Heart Journal.
Two American cardiologists agreed that leisure-time physical activity is important for promoting heart health and that occupational activity can be deleterious.
"In general, leisure-time physical activity, which is often of the endurance type, promotes cardiovascular health and reduces the risk of suffering a fatal heart attack," said Dr. Evan Appelbaum, director of Men's Health Boston. He was not involved in the new study.
"Occupational physical activity, typically more resistance-type, lacks adequate rest and recovery and may not reduce risk, and may increase risk of heart attack," Appelbaum said.
Repeat bouts of high-intensity burst exercises such as those that may be part of manual labor can cause a very rapid rise in heart rate. "The latter may act as a trigger for heart-treated events or promote higher levels of inflammation/injury that could promote heart disease over time," Appelbaum added.
If the only exercise you get is at work, it's not enough to boost heart health, said Dr. Guy Mintz. He directs cardiovascular health at Northwell Health's Sandra Atlas Bass Heart Hospital in Manhasset, N.Y.
"Patients engage in physical activity during time away from work, and any physical activity at work is a bonus, not a replacement, for good aerobic activity," Mintz said. "The findings serve as a wake-up call to companies to promote regular cardiovascular activities in the workday. This can range from yoga, to floor exercise like Tai Chi, to step competitions, etc., to gyms on site."
More people are working from home due to the COVID-19 pandemic, and that could be a good thing, Mintz noted.
"There is a great opportunity to build in effective leisure-time activities into the workday to promote cardiovascular health and a happier and healthier workforce," he said. "I recommend that all my patients engage in 40 minutes of continuous aerobic activity, like walking, at least four times a week, and there is no excuse not to achieve this goal while working from home."
Learn how much exercise you need for a healthy heart at the American Heart Association.
SOURCES: Andreas Holtermann, PhD, professor, National Research Centre for the Working Environment, Copenhagen, Denmark; Evan Appelbaum, MD, director, Men's Health Boston, Chestnut Hill, Mass.; Guy Mintz, MD, director, Northwell Health's Sandra Atlas Bass Heart Hospital, Manhasset, N.Y.; European Heart Journal, April 9, 2021