May 12, 2021 – Not all exercises are created equal and the exercises you do in your spare time are better for your heart health than exercises at work. Exercise in the workplace can actually damage heart health, according to a study published in April.
The difference between recreational and workplace exercise is a phenomenon sometimes referred to as the “exercise paradox,” senior study author Andreas Holtermann, PhD, of the National Research Center for the Work Environment in Copenhagen, Denmark, told WebMD.
“Our results suggest that doctors, patients, and managers should be aware that a manual job that requires physical activity may not improve workers’ fitness and health, while health-enhancing recreational physical activities should be encouraged,” he said.
Does the exercise guideline apply to everyone?
According to the World Health Organization and the United States Department of Health and Human Services, physical activity is essential to maintaining and improving health. However, these guidelines do not distinguish between leisure and work activity. However, some research has shown that physical activity required at work may not provide the same benefits and may even increase heart risk.
These earlier studies were not robust enough to draw firm conclusions. In addition, “a large part of the evidence available for physical activity and health comes primarily from physical leisure activities among highly educated employees,” says Holtermann. The question is whether they apply to on-the-job exercises in other groups.
To examine the differences between manual labor and leisure, Holtermann and his team used data from 104,046 adults (between 20 and 100 years of age) who participated in the general population study in Copenhagen from 2003 to 2014, covering the greater Copenhagen area, the high and low income regions belonged.
Participants reported their leisure and professional physical activity, population size, lifestyle, medical information, and living conditions themselves. They also had a physical exam that included height, weight, resting blood pressure, and heart rate. The participants were then observed for an average of 10 years.
Quantity vs. quality
During the follow-up period, there were 9,846 deaths from all causes (9.5% of participants) and 7,913 major cardiac events such as fatal or non-fatal heart attacks or strokes (7.6% of participants).
High levels of recreational activity were associated with a lower risk of cardiac events and a lower risk of death. However, many physical activities at work were associated with a higher risk of heart attacks and strokes and a higher risk of death.
Holtermann says the results may seem “surprising” in light of the World Health Organization’s recommendation that “all steps count towards better health”.
However, he has “extensive experience” in measuring the physical activity requirements of workers and “extensive experience discussing this issue with employees and managers, unions, workplaces and policy makers”.
For people who work in these environments, “it is nothing new that the health effects of physical activity at work are different.” But many consider the guidelines to be for more educated employees than for them, he says.
He pointed out other differences between work and leisure exercise.
“I think the most important difference is the massive dose difference – often 6 to 8 hours of physical activity at work for several consecutive days, compared to 30 to 60 minutes of leisure time some days a week,” he says.
Controversial results
An accompanying editorial by Dr. Martin Halle and Dr. Melanie Heitkamp, both from the Technical University of Munich, questions the study results.
“Findings from numerous populations and continents have shown generally and consistently that regular physical activity has positive effects on cardiovascular health and premature mortality, a scientific finding that has been largely implemented in the guidelines of the WHO [World Health Organization] as well as the European Society of Cardiology, ”they write.
The editorial suggests some possible explanations for the “physical activity paradox” found in the current study. Recreational exercises can often be more aerobic, while professional exercises can involve “repetitive resistance exercises with brief seizures and often inadequate recovery time”.
In addition, “heavy manual labor workers may speculate particularly psychological factors (e.g. night shifts and environmental stressors such as noise or air pollution),” they speculate.
Interpret with caution
Genevieve Dunton, PhD, a professor in the Departments of Preventive Medicine and Psychology at the University of Southern California, also had reservations about the study’s impact and said the results should “be interpreted with caution.”
While there “certainly is a plausible argument that physical activity at work has fewer cardiovascular benefits than leisure time activity … the data may not support the claim that physical activity alone affects cardiovascular health,” she says.
The study leaves out two factors that “could explain the observed association” and were not taken into account by the researchers: emotional reactions during physical activity and general psychological stress.
“Individuals can experience more positive emotional responses … in their leisure time compared to professional physical activity, which can result in more mental health benefits and a lower risk of cardiovascular events / mortality,” she says.
She also says that those who do manual labor are more mentally stressed than those who have the time and resources to exercise.
Without considering this emotional stress, “we need to be very careful in suggesting that professional physical activity increases the risk of cardiovascular events and death,” says Dunton.
Triple burden
Commenting on the study for WebMD, Andrew Freeman, MD, co-chair of the American College of Cardiology’s Nutrition and Lifestyle Working Group, said, “Physical activity – including exercise at work – is generally helpful,” Engaging physical activity is good for the heart , Mind and body, and that is probably the most important point this study captures. “
Movement in the workplace is often stressful and also comes with work-related responsibilities. “Exercising for a certain period of time – that’s for me – and being outdoors in nature, where lots of people run or jog, is good for cardiovascular health,” he says.
Holtermann agrees, noting that physical activity at work is controlled by work production, while leisure time activities are tailored to personal needs, motivation, and context.
“The people with the unhealthy manual labor are also the ones with fewer resources and opportunities, which is a triple burden that can play an important role in explaining the socio-economic gap in health,” he says.
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Andreas Holtermann, PhD, National Research Center for the Work Environment, Copenhagen, Denmark.
World Health Organization: “WHO Guidelines on Physical Activity and Inactivity.”
Andrew Freeman, MD, co-chair of the Diet and Lifestyle Working Group at the American College of Cardiology.
Genevieve Dunton, PhD, Professor, Department of Preventive Medicine and Psychology, University of Southern California.
JAMA: The Physical Activity Guidelines for Americans.
European Heart Journal: “The paradox for physical activity in cardiovascular diseases and all-cause mortality: the current general population study in Copenhagen with 104 046 adults.” “Prevention of cardiovascular diseases: applies to professional work” every step counts ” ? “
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