How to exercise and sleep your way to perfect health (over 24 hours)

Scientists have pinpointed the ideal wellbeing regimen. From duration of exercise to length of sleep, here’s what they recommend you do.

How to exercise and sleep your way to perfect health (over 24 hours)

Where would we be without activity trackers? Even those of us who are the most technologically reluctant are usually aware of at least our daily step count and, for the data driven, the wrist-worn wearable has become a means of documenting everything from sleep to heart rate. Increasingly we rely on them for motivation, the stats providing us with a sense of guilt and accomplishment often in equal measure, prompting us to be more active when we don’t feel like it. In scientific studies, fitness monitoring is providing more meaningful insights into how we move (or don’t) as researchers drill down through data in a way that could change activity guidelines for maintaining and improving health.

Mark Hamer, a professor in sport and exercise medicine at University College London (UCL), says activity trackers have advanced understanding of movement patterns and health in unexpected ways. “Fifteen years ago the only means we had of assessing activity levels was with questionnaires that were problematic and unreliable,” he says. “With wearable trackers we can accurately capture the nuances of daily activity, not just structured sports and exercise, which comprise a relatively tiny part of the daily pie.”

It is this everyday activity that makes a difference to health. “These devices record and track any increases in vigorous activity, such as digging in the garden, which we had previously overlooked in research but which have such an important impact for the majority of people,” Hamer says. “We now know from wearable data that repeated short bouts of high-effort incidental activity can help to prevent chronic disease outcomes.”

Results of scientific tracking studies can also give us a clearer idea of what is needed to avoid ill health - not always as daunting as you might imagine. In a recent study, published in the journal Diabetologia, Dr Christian Brackenridge, a researcher at Swinburne University of Technology, led an international team looking at the movement and activity patterns of 2,000 adults to determine the perfect daily balance of sitting, standing and physical activity for optimum health.

Brackenridge asked participants to wear the scientific-grade thigh-worn trackers that are often used in studies because they produce more accurate results and, he says, “are less likely to be biased by idle wrist movements”. They are not commercially available and for everyday use a Fitbit or Apple Watch is fine.

Fitness monitoring is providing more meaningful insights into how we move.

Brackenridge then monitored all movement over 24 hours and assessed results against cardiometabolic health markers such as waist circumference, BMI, blood glucose and cholesterol levels. Collectively, these markers are considered risk factors for both cardiovascular diseases, such as strokes and heart attacks, and metabolic diseases, including obesity and type 2 diabetes. Based on the top five to ten people with the lowest cardiometabolic risk factors, he and his team were able to come up with what he says is an “ideal balance of behaviours and physical activity” to ward off these risks and stay healthy.

Encouragingly, his results showed that getting more sleep - up to eight hours and 20 minutes was considered healthy - and not necessarily breaking a sweat got results. In particular, the benefits of interrupting sitting time with light activity - that’s pottering around the house, walking from room to room - were pronounced. “It’s the action of breaking up prolonged sitting down with regular light activity that is beneficial,” Brackenridge says. “We found that doing this around meal times seems to have a very positive outcome on metabolic health for people with type 2 diabetes.”

Other experts are now specialising in activity-data tracking. Emmanuel Stamatakis, professor of physical activity, lifestyle and population health at the University of Sydney, has published more than 400 peer-reviewed papers, many of them using wearable device data that he says takes information about movement and wellbeing to a new level. His latest papers, including a review of six studies involving 15,253 people conducted with an international team including Hamer and published in the European Heart Journal, have shown that everything from five daily minutes of stair climbing to at least 2.6 hours a day standing up can dramatically improve health.

All this is welcome news for more reluctant exercisers who find the prospect of 150 minutes a week of moderate-intensity activity or 75 minutes of vigorous exercise almost insurmountable. “A lot of people hate gyms and hate structured exercise so just don’t do it,” Stamatakis says. “We need to give people more activity options that are both achievable and beneficial for those who fall well short of targets.”

The key thing is to make these small changes daily habits. “It’s no good adopting these things once or twice a week,” Stamatakis says. “If they are going to work, you need to add some of them every day.” Still, specific amounts of these incidental exercises are not intended to be a prescription but a guide.

“Not all these habits will be achievable for everyone within every 24 hours,” Brackenridge says. “But they are things we can work towards adding to our lifestyles and which will boost our health in a holistic way.” The more of these scientifically sound activity changes you can implement every day, the better for your waistline, health and longevity.

---

1. Try to get between 7 hours and 8 hours 20 minutes of sleep a night

About seven hours of sleep is often recommended for peak health, but in Brackenridge’s study participants with the healthiest cardiometabolic profile allowed themselves eight hours and 20 minutes a night.

Consistently getting too much or too little sleep is associated with a higher risk of ill health. Results of a study at UCL, published in PLOS Medicine, that analysed the impact of sleep duration on the health of more than 7,000 men and women aged 50 to 70 found that getting five hours of sleep or less at age 50 meant people were 40 per cent more likely to be diagnosed with two or more chronic diseases over 25 years, compared with those who slept up to seven hours a night. Healthy people who slept for longer than nine hours at 50 seemed to experience no adverse health outcomes, but in people who had any chronic underlying health issue, longer than nine hours was associated with about a 35 per cent increased risk of developing another illness.

2. Sit for less than six hours a day

The less time we spend sitting and lying down (when not sleeping) the better, but Brackenridge found that “sitting longer than six hours was associated with less optimal cardiovascular and metabolic health outcomes”. Stamatakis says that risks of high blood pressure, cholesterol and other cardiometabolic risk factors become considerable if you sit for ten hours daily but reach concerningly high levels if you sit for 12.1 hours in every 24-hour cycle.

“If you do sit for a lot of the time, the benefits of breaking it up with movement are huge,” Stamatakis says. “Accumulate 90 minutes a day of walking or three to eight minutes a day of stair-climbing and you can eliminate many of the adverse outcomes of long sitting.”

The less time we spend sitting and lying down the better.

3. Aim for 4.4 minutes of Vilpa

Vigorous intermittent lifestyle physical activity (Vilpa) is considered the non-exerciser’s version of high-intensity interval training (HIIT), involving bursts of huffing and puffing that last 10-60 seconds.

“We are not talking a structured form of exercise, such as interval training, but daily activity that imitates some of the physiological effects of that kind of workout,” Stamatakis says. “It shouldn’t feel like a chore and should be something you find easy to slot into your day.” He gives examples such as playing high-energy games with the kids, running for the bus or climbing up and down stairs or hitting maximum walking pace two or three times for 20-30 seconds on a ten-minute stroll to the shops.

In a Nature study involving 25,241 UK non-exercisers, Stamatakis showed that just three to four daily bouts of high-effort activity during daily tasks led to big reductions in the risk of premature death. “This kind of activity has an even more dramatic effect on health than we realised,” he says. “We showed 60-second bouts of Vilpa for a total of 4.4 minutes a day to be associated with a 26-30 per cent reduction in cancer and all-cause early mortality as well as a 32-34 per cent lower risk of death from heart disease.”

4. Accumulate a total of 64 minutes of walking

We all know that walking is good for us, but how many steps do we really need to do to stay healthy? In another of his tracking studies published in March, Stamatakis highlighted a daily total of 64 minutes of walking steps as a level that enhanced the overall health of his participants.

“We do not mean you have to go out for an hour-long hike each day,” he says. “All of the walking activity accumulated by participants was incidental, the kind you clock up in everyday activity.” In steps, this equates to 6,000-8,000 a day, but he says that anything above a baseline 2,200 steps a day is associated with a lower risk of death. The lowest early mortality risk comes with people who clocked up 9,000-10,500 steps a day.

5. Stand for at least 2.6 hours

Sit less, stand more is a maxim we should all apply to life. Brackenridge found the optimum amount of time on your feet to be five hours and ten minutes, but anything more than 2.6 hours of standing a day is associated with better health outcomes. “The important thing is to replace excess sitting with any other activity, including standing,” Stamatakis says. “The more you can do that every day, the more you will benefit.”

6. Run (even if it’s just for a couple of minutes)

Running - even for a bus or chasing kids around the park - can have a potent effect on wellbeing if you do it daily. In his recent ProPass paper, Stamatakis reported that “any amount of regular running is associated with better cardiometabolic health”. You don’t need to “go for a run” or schedule a weekly 5km to make a difference. “Your best bet is to run for one or two minutes and build up the number of times you do that in a day,” he says.

Running can have a potent effect on wellbeing if you do it daily.

7. Spend five minutes climbing the stairs

Marching up and down stairs has been associated with improved blood sugar and cholesterol levels as well as helping to lower blood pressure. “For someone who doesn’t consider themselves an exerciser, stair walking is tremendously effective,” Stamatakis says. “Going up and down a few flights with effort during the day for a total of five minutes is a good target.”

THE TIMES