- Cardiovascular-kidney-metabolic (CKM) syndrome includes heart and kidney disease, diabetes and obesity.
- New study suggests light exercise may reduce the risk of dying from CKM.
- Light physical activity includes gardening, cooking, shopping and light housework.
You’re probably aware of several risk factors for cardiovascular disease, including a sedentary lifestyle, poor diet, stress and high blood pressure. In 2023, the American Heart Association added another risk factor for cardiovascular disease (CVD): kidney disease.
Chronic kidney disease is a condition that prevents the kidneys from functioning properly. Because there is a bidirectional relationship between the heart and kidneys, when one is not functioning properly, it will negatively affect the other.
To add to this, various aspects of CVD, kidney disease, type 2 diabetes and obesity overlap. This led the American Heart Association to define the overlap as cardiovascular-kidney-metabolic syndrome (CKM). CKM occurs in five stages: 0, 1, 2, 3 and 4, with stages 3 and 4 being advanced stages of the disease. Almost 90% of Americans have at least one component of CKM, according to the American Heart Association.
According to a recent study in the Journal of the American Heart Association, physical activity is recommended for slowing the progression of cardiovascular-kidney-metabolic syndrome. But most research has focused on moderate-to-vigorous physical activity, which can be difficult to perform for those with advanced CKM. These researchers sought to determine if light-intensity physical activity reduced the mortality rate for individuals in stages 2, 3 and 4 of CKM. Here’s what they found.
How Was This Study Conducted?
Researchers drew data on 7,246 adults who had participated in the National Health and Nutritional Examination Survey (NHANES) from 2003 to 2006. The average age of participants was 48, and just over half of them were female. None of the participants were pregnant at the time of the study, and all participants had valid accelerometer data, which recorded most of their physical activity (anything performed in water, like swimming, was not recorded since the accelerometers were not waterproof).
Based on medical data, participants were categorized according to their cardiovascular-kidney-metabolic syndrome stage. Stage 0 corresponded to normal weight, blood pressure, lipids, glycemic measures and kidney function—basically meaning that they did not have CKM.
Stage 1 was characterized by body mass index ≥25, excess waist circumference or prediabetes. Stage 2 included those with diabetes, high blood pressure, metabolic syndrome, high triglycerides or moderate-to-high risk chronic kidney disease. Stage 3 included everything in stage 2 and also encompassed very high-risk chronic kidney disease or a 10-year predicted risk of developing cardiovascular disease of ≥20% according to the Predicting Risk of Cardiovascular Disease Events calculator. Stage 4 includes all of the above, plus cardiovascular disease.
What Did This Study Find?
After collecting data and running statistical analyses, researchers found that light physical activity was significantly associated with lower mortality in cardiovascular-kidney-metabolic syndrome stages 2 to 4. Each one-hour increase in light physical activity was associated with a 14% to 20% lower relative risk of mortality.
Like all studies, this one has limitations, including the fact that water activities were not recorded. NHANES also includes self-reported data, which always leaves room for bias and misreporting.
How Does This Apply to Real Life?
According to the AHA, one in three adults has three or more risk factors for cardiovascular disease, metabolic disorders or kidney disease. But many risk factors can be prevented or managed with lifestyle changes, including physical activity. This study suggests that even light physical activity can be advantageous in mid-to-late stages of cardiovascular-kidney-metabolic syndrome.
Because most guidelines focus on moderate-to-vigorous physical activity, defining light physical activity is a bit more difficult. If you use target heart rates, moderate-to-vigorous physical activity falls between 50% and 85% of maximum heart rate (MHR). Light activities raise your heart rate less than 50% of your MHR.
Some examples of light-intensity activities include simple calisthenics, some types of yoga, Tai Chi, stretching, slow dancing, grocery shopping, light housework, cooking and gardening.
This study is a good example of showing that all physical activity counts and accumulates benefits—at least to a point. Engaging in only light-intensity physical activities is better than sitting all day and getting no activity. But light-intensity activities won’t improve your fitness status much. That requires engaging in higher-intensity activities and getting your heart rate up (and being consistent with it).
To increase your light physical activity, be intentional about looking for ways to move more throughout the day, and get creative with it. For example, staying well-hydrated will ensure you need to get up and use the bathroom more often. And since you have to get up, you may as well do some walking lunges to the bathroom and push-ups against the bathroom sink.
Physical activity is one pillar for preventing CKM. A heart-healthy diet, like the Mediterranean diet, also goes a long way. Getting seven to nine hours of quality sleep and addressing any sleep disorders, like sleep apnea, is also important, as is taking steps to reduce your stress levels. Altogether, these behaviors can help reduce blood pressure and cholesterol levels, stabilize blood sugar and aid in healthy weight management—all areas that influence disease risk.
Our Expert Take
This study suggests that for each hour increase in light physical activity, the risk of dying decreases 14% to 20% in those with stage 3 and 4 CKM. Light physical activity involves simply moving more throughout your day and engaging in activities like light housework, cooking and shopping. To improve your fitness level in addition to reducing disease risk, experts recommend you engage in 75 to 150 minutes of moderate-to-vigorous physical activity each week.
