Both sitting too much - sometimes called sitting disease - and exercising too little may increase the chance of heart failure, a new study suggests.
The risk of heart failure was more than double for men who sat for at least five hours a day outside of work and didn't exercise very much compared with men who were physically active and sat for less than two hours a day, says the study's lead author, Deborah Rohm Young, a senior scientist at Kaiser Permanente in Pasadena, Calif. Heart failure is when the heart muscle isn't pumping blood adequately, but it doesn't mean the heart stops beating.
The risk was lowest for men who exercised the most and sat for fewer than two hours a day, she says. "This adds to the evidence that too much sitting is bad for you."
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Research has linked too much sitting to increased risk of type 2 diabetes and death from cancer, heart disease and stroke. It may affect mood and creativity. One study showed that if most people spent fewer than three hours a day sitting, it would add two years to the average life expectancy in this country.
Government statistics show almost half of people report sitting more than six hours a day, and 65% say they spend more than two hours a day watching TV.
"If you've been sitting for an hour, you've been sitting too long," says James Levine, co-director of Obesity Solutions at Mayo Clinic in Phoenix and Arizona State University. He did some of the first research on sitting disease but was not involved in this study. "My gut feeling is you should be up for 10 minutes of every hour."
For the latest study, researchers with Kaiser Permanente followed more than 82,000 men, ages 45 to 69, for up to 10 years. The group was racially diverse. Men reported their physical activity levels and the amount of time they spent sitting outside of work.
Findings in the American Heart Association's journal, Circulation: Heart Failure:
• Men who sat five or more hours a day, outside of work, were 34% more likely to develop heart failure than men who spent two hours or less sitting. This was true no matter how much they exercised.
• Men who were the least physically active were 52% more likely to develop heart failure than men who were the most active, regardless of how much time they spent sitting.
• Even men with hypertension and coronary artery disease who exercised regularly and sat less had lower levels of heart failure, Young says.
"We only studied men, but the findings could probably be generalized to women," she says.
Although the researchers didn't quantify exactly how much physical activity the men did, federal data show that only about 21% of adults in the USA say they meet the government's recommendations for aerobic and muscle-strengthening exercise.
Those guidelines advise adults to get at least 2½ hours of moderate-intensity physical activity each week, such as brisk walking, or 1¼ hours of a vigorous-intensity activity, such as jogging or swimming laps, or a combination of the two types. And adults should do muscle-strengthening activities at a moderate- or high-intensity level two or more days a week, the guidelines say.
About 1 in 5 Americans older than 40 will eventually develop heart failure, also called congestive heart failure, says Clyde Yancy, a spokesman for the American Heart Association and chief of cardiology at Northwestern University Feinberg School of Medicine in Chicago.
The symptoms of heart failure include fatigue and shortness of breath. Myriad problems may cause heart failure, but the major ones include high blood pressure, heart attacks, different forms of heart valve disease and specific heart-muscle diseases also known as cardiomyopathies, Yancy says.
People with heart failure often have an impaired quality of life and don't feel very well, Yancy says. Exercise not only prevents heart failure, it also provides "therapeutic benefits" for people with heart failure. Doctors often recommend moderate physical activity, like walking, to patients, he says.
Among the reasons exercise is beneficial: It helps promote weight loss, lower blood pressure and improve circulation, Yancy says. "All of those variables allow the heart to work more efficiently." On the other hand, being sedentary can cause your weight to go up, raise blood pressure and hurt your circulation, he says.
Many people spend nine or more hours a day in their seats, especially those who work long hours at a desk job, travel frequently or watch a lot of TV. Data show that getting up intermittently throughout the day might reduce the ill effects of prolonged sitting, Levine says.
"You have to break up sitting time, because we were designed to move. The natural amount of movement that our bodies need is far greater than what we are currently doing," he says.
"Standing at your desk instead of sitting accounts for a trivial increase in caloric expenditure, but someone who works at a standing desk may move around more during the day."