Exercise helps the heart, but can manual labor hurt?


May 12, 2021: The whole exercise is not created equal and the exercise which you get during free time is better for heart health than exercise. In fact, physical at work exercise may be detrimental to heart health, according to a study published in April.

The difference between leisure time and workplace exercise is a phenomenon that is sometimes called the “paradox of physical activity,” the study’s lead author, Andreas, explains to WebMD Holtermann, PhD from the National Research Center for the Workplace in Copenhagen (Denmark).

“Our findings suggest that physicians, patients and managers should be aware that having manual labor that requires physical activity cannot improve the fitness and health of workers, while physical activity should be promoted. leisure that improves health, ”he said. he says.

Do exercise guidelines apply to everyone?

According to the World Health Organization and the U.S. Department of Health and Human Services, physical activity is essential to maintaining and improving health, but these guidelines do not distinguish between physical activity in free time and in work time. . But some research has suggested that the physical activity needed at work may not provide the same benefits and may even increase heart risk.

These previous studies were not solid enough to offer definitive conclusions. In addition, “much of the existing evidence on physical activity and health comes primarily from physical activity in leisure among white-collar populations with higher education,” says Holtermann. The question is whether they apply to employment in other groups.

To find out the differences between manual labor and leisure exercise, Holtermann and his team used data from 104,046 adults (aged 20 to 100) who participated in the Copenhagen General Population Study from 2003 to 2014. Participants came from a larger area of ​​Copenhagen, which included high- and low-income regions.

Participants were informed about their physical activity, demographics, lifestyle, medical information, and leisure and physical living conditions. They also did a physical exam that included height, weight, rest blood pressure, i heart rate. Participants were followed for an average of ten 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 blows (7.6% of participants).

High levels of leisure activity were associated with a lower risk of cardiac events and a lower risk of death. But a lot of physical activity at work was related to more chances of heart attacks and strokes and a higher risk of death.

Holtermann says the findings may seem “surprising,” in light of the World Health Organization’s recommendation that “every step is important to improving health.”

However, he has had “many years of experience” measuring physical activity demands on manual workers and has “a long experience in discussing this issue with employees and managers, unions, jobs and policymakers.” .

For people working in these environments, “it’s nothing new that the health effects of physical activity at work are different.” But many do not “consider the guidelines to be appropriate for them, but for white-collar workers with higher education,” he says.

He noted other differences between exercise in working time and leisure.

“I think the main important difference is the big dose difference: often 6 to 8 hours of physical activity at work for several consecutive days, compared to 30 to 60 minutes of leisure a few days a week,” he says. .

Controversial conclusions

An editorial accompanying Martin Halle, MD, and Melanie Heitkamp, ​​PhD, from the Technical University of Munich in Germany, questions the results of the study.

Evidence from numerous populations and continents has shown widely and consistently that regular physical activity has beneficial effects on cardiovascular health and premature mortality, a scientific finding that has been widely applied to WHO guidelines. [World Health Organization] as well as the European Society of Cardiology, ”they write.

However, the publisher suggests some possible explanations for the “physical activity paradox” found in the current study. Exercise in leisure can often be more aerobic, while occupational exercise can involve “repetitive endurance exercise in short episodes and often insufficient recovery time.”

In addition, they “speculate,” workers in heavy manual labor may be especially exposed to psychological factors (e.g., night shifts and environmental stressors such as noise or air pollution).

Interpret with caution

Genevieve Dunton, Ph.D., a professor in the departments of Preventive Medicine and Psychology at the University of Southern California, also had reservations about the implications of the study, saying the results “should be interpreted with caution.”

While there is “certainly a plausible argument that occupational physical activity provides fewer cardiovascular benefits than physical activity in leisure time … the data may not support it until it states that occupational physical activity for itself is detrimental to cardiovascular health, ”he says.

The study omits two factors that could “explain the observed association” and that the researchers did not take into account: emotional responses during physical activity and general psychological stress.

“People may experience more positive emotional responses … during leisure time compared to occupational physical activity, which could lead to more mental health benefits and a lower risk of cardiovascular events / mortality,” he says .

In addition, he says, those who work with manual labor have more psychological stress than those who have time and resources to exercise at leisure.

Regardless of this emotional stress, “we need to be very tempting when it comes to claiming that occupational physical activity increases the risk of cardiovascular events and death,” Dunton says.

Triple load

Commenting on the WebMD study, Andrew Freeman, MD, co-chair of the American College of Cardiology’s nutrition and lifestyle working group, says that while physical activity (including exercise at work) ) is helpful, “dedicated physical activity is good for the heart, mind, and body, and this is probably the most important point that this study captures.”

Exercise in the workplace is often stressful and is also associated with work-related responsibilities. “Exercising for a dedicated period,‘ that’s for me, ’and especially being outdoors in nature, where a lot of people walk or jog, is good for cardiovascular health,” he says.

Holtermann agrees in pointing out that physical activity at work is controlled by work production, while recreational exercise is tailored to personal needs, motivation, and context, he says.

“People who have unhealthy manual labor are also those with fewer resources and possibilities, which is a triple burden that can play an important role in explaining the socioeconomic gap in health,” he says.

WebMD Health News


Andreas Holtermann, PhD, National Research Center for the Workplace, Copenhagen, Denmark.

World Health Organization: “WHO Guidelines on Physical Activity and Sedentary Behavior”.

Andrew Freeman, MD, co-chair of the Nutrition and Lifestyle Working Group, American College of Cardiology.

Genevieve Dunton, PhD, Professor, Departments of Preventive Medicine and Psychology, University of Southern California.

JAMA: “Physical Activity Guidelines for Americans.”

European Heart Journal: “The paradox of physical activity in cardiovascular disease and all-cause mortality: the contemporary study on the general population of Copenhagen with 104,046 adults”, “The prevention of cardiovascular disease: it applies” all steps “for professional work?”

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