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Apr 04, 2018

Exercise, Not Weight Loss, Boosts Survival in Patients with Heart Disease

Study finds even low levels of physical activity reduce risk of death in patients with heart disease.

Exercise trumps weight loss in patients with heart disease, based on a recent study that links exercise, not weight loss, to increased survival for heart patients.

Published in the Journal of the American College of Cardiology, this study looked at the long-term effects of exercise and body weight in patients with heart disease. Both factors are strongly linked to cardiovascular health, as guidelines recommend regular physical activity and a healthy weight to promote better health. However, less is known about the long-term impact of changes in exercise or weight in patients living with heart disease.

To learn more, researchers analyzed data from the Nord-Trondelag Health study, which tracked the health of Norwegian adults for three decades. The study included a total of 3,307 patients with heart disease, a third of whom were women.

Participants completed health exams in 1985, 1996 and 2007 to track their health, weight, and physical activity. Researchers then used national death records to track survival rates among participants through 2014.

Throughout the 30–year study, there were a total of 1,493 deaths among participants. After analysis, researchers found that weight loss and physical activity had different impacts on survival.

The good news is that even small levels of physical activity had a significant protective effect on participants. Adults who maintained low levels of activity had 19% lower risk of death than those with no regular activity. Those who met or exceeded current physical activity guidelines had even greater benefits, with a 36% lower risk of death than inactive adults.

The association between changes in weight and mortality risk, however, was surprising. While weight gain usually has a negative impact on health, researchers found no association between weight gain and mortality risk. Researchers also found that weight loss—mainly in adults who were at a normal weight at the start of the study—was associated with increased mortality risk. This association is part of what experts call the "obesity paradox," where being overweight appears to have a protective effect on health.

However, experts urge caution when interpreting results, as the study did not explore reasons for changes in weight. There are many factors that could impact the association between weight and mortality risk, and this study design could not account for them all.

The key finding, according to authors, is the importance of a healthy lifestyle—including exercise—for patients with heart disease. While weight is an important when it comes to heart health, it’s not the only factor that affects outcomes. And as findings show, even small amounts of exercise can boost survival, regardless of weight.

Questions for You to Consider

  • What is a heart-healthy diet?

  • A heart-healthy diet is full of fruits, vegetables, beans and whole grains and includes low-fat dairy, fish and nuts as part of a balanced diet. It’s important to limit intake of added sugars, salt (sodium) and bad fats (saturated and trans fats).

  • How much exercise do I need?
  • Regular physical activity is important for both children and adults. According to the 2008 Physical Activity Guidelines for Americans:

    • Children and adolescents should get 60 minutes or more of physical activity daily.
    • Optimum exercise levels for adults includes:
      • 150 minutes of moderate-intensity or 75 minutes of vigorous exercise (or a combination of the two) each week.
      • Activity spread across the week with periods of aerobic exercise of at least 10 minutes at a time.
      • Muscle strengthening activities 2 or more days a week.

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