Small Movements, Big Benefits for People With CKM Syndrome

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Staying active doesn’t have to mean intense workouts to improve health, especially for people living with cardiovascular-kidney-metabolic (CKM) syndrome. A large study published in the Journal of the American Heart Association found that light physical activity, such as casual walking, household chores, or standing and moving throughout the day, was linked to a lower risk of death, particularly for people with more advanced stages of CKM syndrome.

“There’s growing evidence that lighter activity like walking or gardening can be beneficial for heart health,” said study investigator Michael Fang, Ph.D., M.H.S., assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore. “However, studies have not examined the long-term benefits for those with heart disease or those at high risk for heart disease.”

Investigators analyzed data from more than 7,200 U.S. adults (mean age of 48 years, 52% women) who participated in the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2006. Participants wore activity monitors that objectively measured how much time they spent moving each day. The team then followed participants for nearly 15 years to see how physical activity levels related to long-term survival.

CKM syndrome includes a range of conditions affecting the heart, kidneys and metabolism, such as obesity, diabetes, high blood pressure, kidney disease and cardiovascular disease. Participants were grouped into CKM stages based on disease severity (stage 0-4), from early risk factors to advanced cardiovascular disease.

“Light physical activity is something you can do without losing your breath,” explained lead investigator Joseph Sartini, B.S.E., a Ph.D. candidate in biostatistics at Johns Hopkins Bloomberg School of Public Health. “Common examples are yoga, casual walking, stretching and household chores.”

Across all stages, most daily movement came from light activity, not vigorous exercise. In fact, light activity made up more than 90% of all active time, and nearly all activity (98.5%) among people with advanced CKM syndrome. Importantly, people in higher CKM stages tended to spend less time moving overall.

The study found that for people with moderate to advanced CKM syndrome (stages 2-4), each additional hour of light physical activity per day was associated with a 14% to 20% lower risk of death, even after accounting for age, sex, race and whether they met weekly exercise recommendations. The greatest benefit was seen in people with the most advanced disease, meaning small increases in movement led to meaningful improvements in survival.

For example, increasing active time by just 30 minutes to one hour per day was linked to a larger absolute reduction in mortality risk for people with advanced CKM syndrome than for those at earlier stages.

These findings suggest that replacing sedentary time with light movement, rather than focusing only on structured exercise, can have real health benefits, especially for people who may not be able to engage in vigorous activity. For patients with CKM syndrome, moving more throughout the day may be one of the most achievable and effective ways to protect long-term health.

“Light physical activity is an overlooked treatment tool that can help improve heart health for people with CKM syndrome,” said Sartini. “For those in later CKM syndrome stages, the potential health benefits of light activity are substantial.”