Study: Adhering to guidelines within the 24-Hour Movement Paradigm can help lower your mortality risk

The importance of exercise and physical activity has been instilled in us since we were children. Sit less, move more.

Currently, the U.S. Department of Health and Human Services recommends adults aim for at least 150 minutes of moderate-intensity aerobic physical activity, or 75 minutes of vigorous-intensity aerobic physical activity, per week.

There is an issue with this, though. The time we do consciously carve out of our schedules for exercising actually accounts for a very small increment of our 24-hour day.

“Exercise makes up only about 2% of your entire day,” said Dr. Benjamin D. Boudreaux, FACSM, clinical assistant professor of exercise science. “It seems almost naïve to think that this tiny 2% is going to offset everything else we do during the day.”

Boudreaux’s new study “Achieving Guidelines within a 24-Hour Movement Paradigm and Risk of Mortality in US Adults” suggests that we can get a more accurate picture of someone’s overall health by knowing how much physical activity and sedentary behavior (or how often you sit during the day) they engage in and the amount of sleep they get throughout the day.

“Many studies tend to look at sleep, sedentary time or physical activity alone individually and how each relates to your health, but interestingly, we have a limited understanding about how examining all three behaviors simultaneously is associated with our overall health,” he said.

Boudreaux and his colleagues worked with participants enrolled in the 2005 and 2010 National Health Interview Survey, looking at publicly available self-reported data of more than 41,000 people. Each person self-reported their daily amount of moderate-to-vigorous physical activity, sitting time (both in and outside of work) as well as amount of time spent sleeping.

The goal was to examine if meeting the 24-hour guidelines (physical activity: ≥150 min/wk of moderate, ≥75 min/wk of vigorous, or equivalent of both; sedentary time: <8 h/d for non-working adults; <4 h/d for working adults; total sleep duration: 7-9h/d) are associated with mortality, both from all causes and specifically from cardiovascular disease.

“What we found is pretty striking,” Boudreaux said. “There is a clear dose-response relationship — the more guidelines you meet, the more you do, the lower your risk. For those who met all three, we found a 37% reduced risk of all-cause mortality and a 47% reduced risk of cardiovascular mortality.”

So, there is this notion that, yes, we know exercise and sleep are important, he added, but these results tell us they are even more crucial than we thought.

The study results did highlight a problem, though: Only 22% of people met all three of the 24-hour movement guidelines.

In fact, according to the study’s data, about 20% of people aren’t as active as they should be, one-third don’t get an adequate amount of sleep, and most people sit for about 12-14 hours each day.

Boudreaux and his colleagues also ran a hypothetical model, asking, “If everyone met all three guidelines, how many deaths could be prevented?”

“We found that 16.8% of total deaths and 38.7% of cardiovascular deaths could potentially be prevented,” he said.

This is among the first studies to quantify those three combined behaviors simultaneously for mortality. In future studies, this data could extend to other outcomes, including hypertension, diabetes, cancer, Alzheimer’s and dementia, Boudreaux added.

The study’s findings emphasize the significance of sitting less, moving more throughout the day and regularly getting adequate sleep. Making healthy choices throughout the day, like parking farther away to get in more steps, using breaks to take a walk or limiting screen time before bed, can make all the difference in the long run.

“It isn’t enough to say, ‘Exercise is important. It’s great for our health.’ We shouldn’t check that box and ignore what we do for the remaining 98% of your day,” Boudreaux said. “The more you do, the more you benefit.”