Even light physical activity can mitigate ‘ticking time bomb’ of cardiac health, study finds

16th May 2024

A lack of physical activity in children as they grow into adulthood causes significant heart damage that could put them at an increased risk of myocardial infarction and stroke in later life, a new study has found.

Researchers found that increased sedentary time in adolescence increases heart mass, leading to long-term impacts on the heart’s structure and function.

The findings, published in the European Journal of Preventive Cardiology, show that encouraging even light physical activity in children can positively impact their future cardiac health and reduce the risk of premature heart damage.

The preliminary results of this study were presented at the European Society of Cardiology Congress in August 2023.

Increasing levels of physical activity are known to improve cardiometabolic and vascular health among young people. This has led to the recommendation that children under 18 undertake an average of 60 minutes of moderate-to-vigorous-intensity physical activity daily.

However, there is limited research showing how sedentary time and physical activity affect changes in heart structure and function over time in children.

To address this issue, researchers from the Universities of Exeter, Bristol and Eastern Finland analysed data from 1,682 children and young people who are part of the University of Bristol’s Children of the 90s cohort.

Activity levels were measured using accelerometer devices at ages 11, 15 and 24, including time spent sedentary or engaged in light-intensity physical activity or moderate-to-vigorous-intensity physical activity.

The researchers examined changes to their cardiac structural and functional properties during growth until young adulthood through echocardiography measurements at ages 17 and 24.

Blood samples were also measured for markers of cardiovascular risk including low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, glucose, insulin, and high-sensitivity C-reactive protein. Blood pressure, heart rate, smoking status, socio-economic status, family history of cardiovascular disease, and dual-energy X-ray absorptiometry measured fat mass and lean mass were accounted for in the analyses.

At age 11, the children spent an average of six hours per day in sedentary activities, which increased to nine hours per day by young adulthood. The researchers found this significant increase in sedentary time contributed 40% of the total increase in heart mass seen in participants from ages 17 to 24.

The results were similar in children and adolescents with either normal weight or overweight and obesity, and in children with either normal blood pressure or high blood pressure.

However, the increase in cardiac mass was reduced on average by almost half (49%) over the seven-year observation period due to light physical activity. This involved participation in activities such as walking, cycling, playing in the playground and gardening for at least three hours per day, combined with decreasing sedentary time.

In comparison, for each additional minute of moderate-to-vigorous physical activity during childhood, the researchers found a 5% increase in cardiac mass out of the total expected increase occurring between adolescence and young adulthood.

They say their findings show that sedentary time contributes eight times more to increased cardiac mass than moderate-to-vigorous physical activity, the latter of which is associated with physiological increase.

The researchers suggest that childhood sedentariness causes increased body fat, inflammation, blood pressure, lipid levels, arterial stiffness and subsequent cardiac enlargement, which leads to poor cardiac health later in life.

Professor Andrew Agbaje, professor (associate) of clinical epidemiology and child health at the Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, said: ‘Childhood sedentariness is a ticking time bomb, and tackling the problem should be a public health priority. Light physical activity is the only effective antidote against sedentariness and it’s fairly easy to accumulate three to four hours a day.’

Professor Agbaje added: ‘There should be a political will at local, national and global levels to promote light physical activity. We need to act now because the economic and health cost of sedentariness may become unbearable. Public health experts, health policymakers, paediatricians and parents should encourage kids to participate in daily light physical activity straight away.’

A version of this article was originally published by our sister publication Nursing in Practice.

EU-funded project to reduce cardiac damage from breast cancer therapy set to launch clinical trial

30th August 2023

Women receiving breast cancer therapy across six clinical centres in Europe will be enrolled in a study to determine whether behavioural and psychological interventions can reduce the cardiac damage from anti-cancer therapies.

The innovative CARDIOCARE project, which was launched in 2021 by a consortium of European partners including the European Society of Cardiology (ESC), aims to radically change the management of older women with breast cancer by harnessing the expertise of a multidisciplinary team to improve the monitoring, treatment and care these patients receive.

It is already known that breast cancer survivors have an estimated 32% higher risk of cardiovascular disease.

Now, a clinical trial evaluating the impact of behavioural and psychological interventions on quality of life, physical and mental wellbeing, and the cardiotoxic effects of breast cancer treatment will be conducted in 750 patients with breast cancer.

As part of the trial, all patients will receive the CARDIOCARE mobile app, which includes psychological and behavioural elements called ePsycHeart and eHealtHeart. Participants will be randomly allocated to receive both ePsycHeart and eHealtHeart – the intervention group – or to receive ePsycHeart only.

ePsycHeart monitors quality of life, mobility and mental health using a wearable chest band heart rate sensor, smartwatch and questionnaires. eHealtHeart encourages patients to adopt behaviours such as physical activity, healthy diet, games to improve memory and changing the home environment to reduce the risk of falls.

A further aim of the trial is the early identification of women with breast cancer who are at the greatest risk of cardiac damage from anti-cancer treatments. The trial will utilise cutting-edge technologies, such as next generation sequencing, to pinpoint changes in gut microbe species that signal damage of the heart and blood vessels before symptoms occur. In addition, artificial intelligence will be used to analyse images of the heart to predict the likelihood of heart damage.

Professor Dimitrios Fotiadis, project coordinator and professor of biomedical engineering at the University of Ioannina in Greece, said: ‘Cardiovascular disease is a devastating complication of anti-cancer treatment that affects physical and mental health. CARDIOCARE will provide women over the age of 65 with breast cancer the tools to improve their physical health and to psychologically adapt to the disease.

‘CARDIOCARE is on track to improve the physical and mental health of older women with breast cancer by detecting the cardiovascular side effects of anti-cancer treatment early and providing digital tools to help patients improve their mental and physical wellbeing.‘