Summary: New research shows that replacing sedentary time with moderate to vigorous activity across the day leads to meaningful improvements in heart health markers compared with remaining sedentary.
The study analyzed wearable-device data from more than 15,000 people and mapped how different daily movement patterns relate to cardiovascular risk factors. The findings reveal a clear hierarchy of behaviors: time spent in moderate-to-vigorous activity offers the greatest benefits, followed by light activity, standing and sleep, while prolonged sedentary time is linked with poorer heart-health indicators. Even small shifts — for example, substituting short periods of sitting with more active behaviors — produced measurable improvements.
These results support personalized strategies to increase daily activity and reduce sedentary time in order to protect cardiovascular health.
Key Facts:
- The researchers used thigh-worn wearable devices to capture 24-hour movement and posture data in participants from five countries.
- Replacing 30 minutes of sitting with moderate activity was associated with measurable reductions in BMI and waist circumference.
- The study highlights the potential for individualized activity recommendations to improve heart health for people with different capabilities and lifestyles.
Source: UCL
This study, funded by the British Heart Foundation (BHF) and published in the European Heart Journal, is the first to use data from the international Prospective Physical Activity, Sitting and Sleep (ProPASS) consortium to evaluate how movement across a full 24-hour day links to cardiovascular health.
Cardiovascular disease — which includes all conditions affecting the heart and blood vessels — remains the leading cause of death worldwide. In 2021, cardiovascular conditions accounted for roughly one in three deaths globally. The prevalence of cardiovascular disease has risen substantially in recent decades and is expected to continue increasing.
For this analysis, UCL researchers combined data from six cohort studies, totaling 15,246 participants across five countries. Each participant wore a device on their thigh that distinguished sitting, standing, light activity and moderate-to-vigorous activity throughout the day, while routine clinical measurements provided common heart-health indicators.
The team ranked daily behaviors by their association with heart-health measures. Time spent in moderate-to-vigorous activity had the strongest positive links, followed by light activity and standing. Sleep also showed favorable associations compared with sedentary time, which was consistently linked to less healthy profiles.
To estimate potential effects of behavior change, researchers modelled scenarios where an individual swapped minutes of one behavior for another over a week. Even small substitutions produced notable changes: replacing just five minutes of sedentary time per day with moderate-to-vigorous activity showed detectable improvements in several heart-health metrics.
As an illustrative example, for a 54-year-old woman with an average BMI of 26.5, replacing 30 minutes of daily sitting with moderate-to-vigorous activity corresponded to a 0.64 decrease in BMI (about 2.4%). The same 30-minute swap was associated with an approximate 2.5 cm (2.7%) reduction in waist circumference and a 1.33 mmol/mol (3.6%) decrease in glycated haemoglobin4.
Dr Jo Blodgett, the study’s first author from UCL Surgery & Interventional Science and the Institute of Sport, Exercise & Health, said: “The key message is that small changes in how you move during the day can improve heart health, but movement intensity matters. Replacing sitting with moderate-to-vigorous activity — such as brisk walking, running or stair climbing — delivers the greatest benefits, even when done in short bursts.”
The researchers emphasise that while vigorous activity produces the fastest improvements, people at all fitness levels can gain benefits. Lower-intensity activities and postural changes require more time to yield measurable advantages, but they are practical to incorporate into everyday life. For example, using a standing desk for part of the workday is a low-barrier change that reduces sedentary time without demanding extra exercise sessions.
Those who are currently least active tended to experience the largest gains when they shifted from sedentary behaviors to more active ones.
Professor Emmanuel Stamatakis, joint senior author from the Charles Perkins Centre and the Faculty of Medicine and Health at the University of Sydney, noted: “A strength of the ProPASS approach is using wearable sensors that clearly distinguish posture and activity intensity, allowing us to estimate the health effects of subtle differences in daily movement with greater precision.”
While this observational analysis cannot prove causation between movement patterns and long-term cardiovascular outcomes, it adds to growing evidence that moderate-to-vigorous physical activity across the day is linked with better body-composition and metabolic markers. Longer-term and interventional studies will be important to confirm causal pathways and refine recommendations.
Professor Mark Hamer, joint senior author from UCL Surgery & Interventional Science and the Institute of Sport, Exercise & Health, said: “This study advances our understanding by evaluating a full day of behaviours rather than focusing on single activities. That perspective will help develop personalised, achievable activity recommendations tailored to people’s preferences and circumstances.”
James Leiper, Associate Medical Director at the British Heart Foundation, added: “We already know exercise benefits cardiovascular health. This research shows that small, manageable changes — even a few minutes of moderate activity instead of sitting — can improve BMI, cholesterol and waist size. Building short ‘activity snacks’ into daily routines, like walking during phone calls or getting up for brief movement breaks, is an effective way to make activity habitual and protective for heart health.”
Funding: This research was funded by the British Heart Foundation.
About this cardiovascular disease research news
Author: Matt Midgley
Source: UCL
Contact: Matt Midgley – UCL
Image: The image is credited to Neuroscience News
Original Research: The findings will appear in European Heart Journal