Health Risks of an Inactive Lifestyle

What is an inactive lifestyle?

Being a couch potato. Not exercising. A sedentary or inactive lifestyle. These all mean the same thing: a lifestyle with a lot of sitting and lying down, with very little or no exercise.

People are spending more time doing sedentary activities. During our leisure time, we are often sitting while using a computer or other device, watching TV, or playing video games. Many of our jobs have become more sedentary, with long days sitting at a desk or while commuting. And the way most of us get around involves sitting - in cars, on buses, and on trains.

When you have an inactive lifestyle:

• You burn fewer calories. This makes you more likely to gain weight
• You may lose muscle strength and endurance, because you are not using your muscles as much
• Your bones may get weaker and lose some mineral content
• Your metabolism may be affected, and your body may have more trouble breaking down fats and sugars
• Your immune system may not work as well
• You may have poorer blood circulation
• Your body may have more inflammation
• You may develop a hormonal imbalance

Having an inactive lifestyle can increase your risk of developing chronic (long-term) diseases. This is sometimes referred to as "sitting disease". By not getting regular exercise, you raise your risk of:

• Obesity
• Heart diseases, including coronary artery disease and heart attack
• High blood pressure
• High cholesterol
• Stroke
• Metabolic syndrome
• Type 2 diabetes
• Certain cancers, including colon, breast, and uterine cancers
• Osteoporosis and falls
• Increased feelings of depression and anxiety

Having a sedentary lifestyle can also raise your risk of premature death. And the more sedentary you are, the higher your health risks are.

If you have been inactive, you may need to start slowly. Your health care provider can help you choose the best type or amount of activity for you based on your fitness level and health. You can keep adding more exercise gradually. The more you can do, the better. But try not to feel overwhelmed and do what you can. Getting some exercise is always better than getting none. Eventually, your goal can be to get the recommended amount of exercise for your age and health.

There are many ways to get exercise; it is important to find the types that are best for you. You can also try to add activity to your life in smaller ways, such as at home and at work.

There are some ways you can be active around your house:

• Housework, gardening, and yard work are all physical work. To increase the intensity, you could try doing them at a more vigorous pace.
• Keep moving while you watch TV. Lift hand weights, do some gentle yoga stretches, or pedal an exercise bike.
• Work out at home with a workout video (on your TV or on the internet).
• Go for a walk in your neighborhood. It can be more fun if you walk your dog, walk your kids to school, or walk with a friend.
• Stand up when talking on the phone.
• Get some exercise equipment for your home. Treadmills and elliptical trainers are great, but not everyone has the money or space for one. Less expensive equipment such as yoga balls, exercise mats, stretch bands, and hand weights can help you get a workout at home too.

Most of us sit when we are working, often in front of a computer. It can be challenging to fit physical activity into your busy workday, but here are some tips to help you get moving:

• Get up from your chair and move around at least once an hour
• Park at the back of the parking lot
• Stand when you are talking on the phone or during a video conference
• Find out whether your company can get you a stand-up or treadmill desk
• Take the stairs instead of the elevator
• Use your break or part of your lunchtime to walk around the building
• Stand up and walk to a colleague's office instead of sending an email
• Have "walking" or standing meetings with co-workers instead of sitting in a conference room

The good news is that it's never too late to change your exercise habits. You can start slowly and find ways to fit more physical activity into your life. Regular exercise has many benefits and may help prevent or control many diseases.

Healthy Living

What is healthy living?

Healthy living means taking care of your body and mind by making choices that support your overall wellbeing. Many things affect your health. Some you can't control, like your genetic makeup or your age. But there are many daily habits you can change to help you feel your best.

Creating new healthy habits takes time, but small, steady changes are easier to maintain and can become part of your everyday routine.

Healthy living can help you feel better, boost your energy, and lower your risk for serious health problems such as heart disease, cancer, and stroke.

You don't have to change everything at once. Start with a few steps to build a foundation for a healthier lifestyle. These can include:

• Get the screening tests recommended for you, including those specific to women's health and men's health
• Stay up to date on vaccines to protect yourself from disease
• Maintain a healthy weight that's right for you
• Eat a variety of healthy foods, and limit calories, added sugar, and saturated fat
• Be physically active, even small amounts of exercise can be helpful
• Keep your blood pressure and cholesterol in a healthy range
• Don't smoke, or take steps to quit if you do
• Protect your skin from too much sun
• Limit alcohol, or choose not to drink at all
• Get enough sleep each night to help your body and mind recharge
• Manage stress and work on improving your mental health, such as by practicing meditation, relaxation techniques, or gratitude
• Protect yourself from sexually transmitted infections (STIs)
• Visit your health care provider regularly for checkups
• See your dentist and eye care specialist for routine care
• Stay connected with friends, family, or community groups, and do activities you enjoy

Healthy living is a lifelong journey. Over time, small steps can add up to big health benefits.

Healthy Sleep

What is sleep?

While you are sleeping your brain and body functions are still active. Sleep is a natural process that helps your body restore energy, supports learning and memory, and keeps you healthy.

During sleep, your brain cycles through different stages of non-rapid eye movement (non-REM) sleep and rapid eye movement (REM) sleep. Non-REM sleep has three stages that range from light to deep sleep, while REM sleep is when most dreaming occurs. During each stage, your brain waves, breathing, heart rate, and body temperature change throughout the night. Certain phases of sleep help you:

• Feel rested and energetic the next day.
• Learn new information, get insight, and form memories.
• Give your heart and blood vessels a rest.
• Release growth hormone, which helps children grow and assists in muscle repair and tissue healing for everyone.
• Release sex hormones, which contribute to puberty and fertility.
• Maintain a healthy balance of hormones that control hunger and fullness.
• Strengthen your immune system by producing cytokines (hormones that help the body fight infection).

You need all the stages to get a healthy sleep.

The amount of sleep you need depends on your age, lifestyle, health, and sleep patterns. The general recommendations for sleep are:

• Babies (4-12 months): 12-16 hours a day (including naps)
• Children (1-2 years): 11-14 hours a day (including naps)
• Children (3-5 years): 10-13 hours a day (including naps)
• Children (6-12 years): 9-12 hours a day
• Teens (13-18 years): 8-10 hours a day
• Adults (18 years and older): 7-9 hours a day

During puberty, teenagers' biological clocks shift. They tend to fall asleep later and wake up later, which can conflict with the early school start times. This is one reason many teenagers don't get enough sleep.

Some people think adults need less sleep as they age, but there is no evidence to support this. However, older adults often get less sleep or spend less time in the deep, restful stages of sleep. They also wake up more easily.

It's not just the number of hours of sleep you get that matters. The quality of the sleep you get is also important. People whose sleep is frequently interrupted might not get enough of certain stages of sleep. If you are wondering whether you are getting enough sleep, including quality sleep, ask yourself:

• Do I have trouble getting up in the morning?
• Do I have trouble focusing during the day?
• Do I doze off during the day?

If you answered yes to any of these questions, you may need to improve your sleep habits.

Sleep is important for overall health. When you don't get enough sleep (sleep deprivation), it does more than just make you feel tired. It can impair your ability to think clearly, react quickly, and form memories. This increases your risk of making mistakes, taking risks, or getting into accidents.

Sleep deprivation can also affect your mood, leading to:

• Irritability
• Problems with relationships, especially for children and teenagers
• Depression
• Anxiety

It can also affect your physical health. Not getting enough sleep, or getting poor-quality sleep, increases your risk of:

• High blood pressure
• Heart disease
• Stroke
• Kidney disease
• Obesity
• Type 2 diabetes

Not getting enough sleep can also lower your levels of hormones that help children grow and help the body build muscle, repair tissue, and fight infections.

Sleep deprivation also magnifies the effect of alcohol. A tired person who drinks too much alcohol will be more impaired than a well-rested person who drinks the same amount.

You can take steps to improve your sleep habits. First, make sure that you allow yourself enough time for sleep. Getting enough sleep each night may help you feel happier and more productive during the day.

To improve your sleep habits, it also may help to:

• Go to bed and wake up at the same time every day.
• Avoid caffeine, especially in the afternoon and evening.
• Avoid nicotine.
• Exercise regularly, but not too close to bedtime.
• Avoid alcoholic drinks before bed.
• Avoid large meals and drinks late at night.
• Don't take a nap after 3 p.m.
• Relax before bed by taking a bath, reading or listening to calm music.
• Keep your bedroom cool, dark, and quiet.
• Get rid of distractions such as TVs, computers, and phones.
• Get enough sunlight exposure during the day.
• If you can't fall asleep for 20 minutes, get up and do something relaxing.
• See a health care provider if you have continued trouble sleeping. You may have a sleep disorder, such as insomnia or sleep apnea. In some cases, your provider may suggest trying a sleep study or other treatments.

If you are a shift worker, getting good sleep can be more challenging. You may also want to:

• Take naps and extend your total sleep time
• Keep the lights bright at work
• Limit shift changes to help your body adjust
• Limit caffeine to the first part of your shift
• Remove sound and light distractions in your bedroom during daytime sleep (for example, use light-blocking curtains or earplugs)

Heart Disease in Women

What is heart disease?

Heart disease is a general term that includes many types of heart problems. It's also called cardiovascular disease, which means heart and blood vessel disease.

Coronary artery disease (also called coronary heart disease) is the most common type of heart disease in both men and women. It happens slowly over time when a sticky substance called plaque builds up in the arteries that supply your heart muscle with blood. The plaque narrows or blocks blood flow to the heart muscle and can lead to:

• Angina - chest pain from lack of blood flow
• Heart attacks - when part of the heart muscle dies from loss of blood flow
• Heart failure - when your heart can't pump enough blood to meet your body's needs
• Arrhythmia - a problem with the rate or rhythm of your heartbeat

In the United States, heart disease is the number one cause of death in women. But women are often not diagnosed with heart disease as quickly as men are. That's because:

• Women are more likely than men to have "silent" heart disease, meaning that they don't have symptoms.
• Health care providers may not recognize heart disease in women because women's symptoms may be different from men's symptoms.
• Women are more likely than men to have certain types of heart disease that can be harder to diagnose.

A delay in diagnosis may mean a delay in medical care that could help prevent serious problems, such as a heart attack. That's why it's important to learn about your risk for heart disease, the symptoms in women, and how to keep your heart healthy.

Women can get any type of heart disease. Like men, the most common type of heart disease among women is coronary artery disease. But there are certain types of heart disease which are less common, but affect women more often than men:

• Coronary microvascular disease - Chest pain from spasms (sudden tightening) in the smallest arteries of the heart that pinch off blood flow. It typically happens during rest or routine activities. This serious condition increases your risk of having a heart attack or other heart diseases. This type may be harder to diagnose since blockages in smaller arteries can be harder to see on imaging tests.
• Broken heart syndrome - Strong chest pain or other signs that look like a heart attack. It's caused by the stress of powerful emotions, such as deep grief, anger, or surprise. It can happen even if you're healthy. It mostly affects women after menopause and usually doesn't cause any lasting damage.
• Variant angina - A rare type of strong chest pain from spasms in the heart arteries. The pain usually happens in a pattern during sleep. Variant angina rarely causes a heart attack.

Your risk for developing heart disease increases with:

• Menopause. Women can develop heart disease at any age, but your risk increases after your periods stop, usually by age 55. Before menopause, your body makes more estrogen (a female hormone) which helps protect against heart disease. That's why women generally develop coronary artery disease 10 years later than men. During and after menopause, estrogen levels drop and your risk for heart diseases goes up. If your periods stop before age 40, your risk will be higher than other women your age.
• Family history of heart disease. Your risk for heart disease may be higher if your:
  • Mother or sister had heart disease before age 65.
  • Father or brother had heart disease before age 55.
• Problems during pregnancy, such as high blood pressure, gestational diabetes, anemia, and high blood pressure.
• Use of hormonal birth control (pills, patches, or vaginal rings with estrogen and progesterone).
• Endometriosis.
• Polycystic ovary syndrome.
• Inflammatory and autoimmune diseases.
• Metabolic syndrome.
• Mental health issues, such as stress, anxiety, or depression.
• Health risks from a lack physical activity.
• Obesity or being overweight.
• Diabetes.
• Low HDL cholesterol levels.
• Mild to moderate high blood pressure.
• Smoking.

If you have one or more risks for heart disease, ask your health care provider for help understanding your risk level. Ask if you need any heart tests to help catch heart disease early.

When women have symptoms of heart disease, they may include:

• Pain or discomfort in the chest that may be dull and heavy or sharp
• Pain in the neck, jaw, throat, upper belly, or back
• Nausea or vomiting
• Unusual fatigue
• Shortness of breath (feeling like you can't get enough air) during physical activity

Women who have coronary artery disease are more likely than men to have chest pain when resting or doing daily activities, rather than during exercise. They're also more likely than men to feel chest pain from mental stress.

Symptoms of a heart attack in women may also be different than in men. Chest pain is the most common symptom for both sexes. It may feel like crushing or squeezing. But women are somewhat less likely than men to have chest pain.

During a heart attack, women may feel:

• Pressure or tightness in the chest
• Pain in the upper back, arms, neck, jaw or throat
• Dizziness
• Unusual fatigue
• Indigestion, heartburn, nausea, or vomiting
• Stomach pain
• Shortness of breath

Heart attacks usually don't look like the sudden, dramatic events we see in the movies. The symptoms may be mild or strong. They may start slowly. They can stop and then come back.

You can help lower your risk by:

• Learning how to prevent heart disease and making heart-healthy habits part of your daily life.
• Asking your provider about your personal risk for heart disease and the best way to manage your heart health.

Remember, women can have heart disease without symptoms. But if you pay attention to your risk for heart disease, you can take action to prevent problems or keep them from getting worse.

NIH: National Heart, Lung, and Blood Institute

Heart Failure

What is heart failure?

Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.

Heart failure can affect one or both sides of your heart:

• With right-sided heart failure, your heart is too weak to pump enough blood to your lungs to get oxygen.
• With left-sided heart failure, your heart can't pump enough oxygen-rich blood out to your body. This happens when the left side of your heart becomes either:
  • Too weak to pump enough blood.
  • Too thick or stiff to relax and fill with enough blood.

Left-sided heart failure is more common than right-sided heart failure.

Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.

Conditions that can cause heart failure include:

• Arrhythmia (a problem with the rate or rhythm of your heartbeat)
• Cardiomyopathy
• Congenital heart defects or other types of heart diseases that you are born with
• Coronary artery disease
• Endocarditis
• Heart attack
• Heart valve diseases
• High blood pressure
• A blood clot in your lung
• Diabetes
• Certain severe lung diseases, such as COPD (chronic obstructive pulmonary disease)
• Obesity

Over time, left-sided heart failure can lead to right-sided heart failure.

Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if:

• You're 65 years old or older. Aging can weaken and stiffen your heart muscle.
• Your family health history includes relatives who have or have had heart failure.
• You have changes in your genes that affect your heart tissue.
• You have habits that can harm your heart, including:
  • Smoking
  • Eating foods high in fat, cholesterol, and sodium (salt)
  • Having an inactive lifestyle
  • Alcohol use disorder (AUD)
  • Illegal drug use
• You have other medical conditions that can affect your heart, including:
  • Any heart or blood vessel conditions, including high blood pressure
  • Serious lung diseases
  • Infection, such as HIV or COVID-19
  • Obesity
  • Diabetes
  • Sleep apnea
  • Chronic kidney disease
  • Anemia
  • Thyroid disease
  • Iron overload disease
  • Cancer treatments that can harm your heart, such as radiation and chemotherapy
• You are African American. African Americans are more likely to develop heart failure and have more serious cases at younger ages than people of other races. Factors such as stigma, discrimination, income, education, and geographic region can also affect their risk of heart failure.

The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.

Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling (edema) and other problems.

Symptoms of heart failure may include:

• Feeling short of breath (like you can't get enough air) when you do things like climbing stairs. This may be one of the first symptoms you notice.
• Fatigue or weakness even after rest.
• Coughing.
• Swelling and weight gain from fluid in your ankles, lower legs, or abdomen (belly).
• Difficulty sleeping when lying flat.
• Nausea and loss of appetite.
• Swelling in the veins of your neck.
• Needing to urinate (pee) often.

At first you may have no symptoms or mild symptoms. As the disease gets worse, your symptoms will usually bother you more.

Fluid buildup and reduced blood flow to your organs can lead to serious problems, including:

• Breathing problems from fluid in and around your lungs (also called congestive heart failure)
• Kidney or liver damage, including cirrhosis
• Malnutrition if fluid buildup makes eating uncomfortable or if your stomach doesn't get enough blood flow to digest food properly
• Other heart conditions, such as irregular heartbeat and sudden cardiac arrest
• Pulmonary hypertension

To find out if you have heart failure, your health care provider will

• Ask about your medical history, including your symptoms
• Ask about your family health history, including relatives who have had heart failure
• Do a physical exam
• Likely run heart tests and blood tests, including a brain natriuretic peptide (BNP) test

In some cases, your provider may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

Your treatment will depend on the type of heart failure you have and how serious it is. There's no cure for heart failure. But treatment can help you live longer with fewer symptoms.

Even with treatment, heart failure usually gets worse over time, so you'll likely need treatment for the rest of your life.

Most treatment plans include:

• Taking medicine
• Eating less sodium and drinking less liquid to control fluid buildup
• Making other changes, such as quitting smoking, managing stress, and getting as much physical activity as your provider recommends
• Treating any conditions that may make heart failure worse

You may need heart surgery if:

• You have a congenital heart defect or damage to your heart that can be fixed.
• The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
  • An implantable cardioverter defibrillator.
  • A biventricular pacemaker (cardiac resynchronization therapy).
  • A mechanical heart pump (a ventricular assist device (VAD) or a total artificial heart).
• Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.

As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.

You may be able to prevent or delay heart failure if you:

• Work with your provider to manage any health conditions that increase your risk of developing heart failure
• Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute