Light daily movement linked to longer life in cardiometabolic disease

By Dr. Liji Thomas, MDReviewed by Benedette Cuffari, M.Sc.Jan 14 2026

Even small increases in everyday movement may translate into meaningful survival benefits for people living with advanced heart, kidney, and metabolic disease.

Study: Light Physical Activity and All‐Cause Mortality in US Adults Across Cardiovascular‐Kidney‐Metabolic Syndrome Stages. Image Credit: Ljupco Smokovski / Shutterstock.com

A recent study published in the Journal of the American Heart Association examines the association between light physical activity and all-cause mortality in people with cardiovascular-kidney-metabolic (CKM) syndrome.

What is CKM syndrome?

CKM syndrome is a complex medical condition that affects individuals with multiple chronic diseases, including cardiovascular disease, kidney disease, type 2 diabetes, and obesity, all of which arise from or are worsened by similar risk factors. Patients with CKM syndrome are at a greater risk for heart attacks, strokes, kidney failure, and other complications of type 2 diabetes and obesity.

Clinical interventions used to manage CKM syndrome can include moderate-to-vigorous levels of physical activity (MVPA). However, the feasibility of this recommendation may be limited among most patients with more advanced (stage three or four) CKM syndrome.

Study design and population

The current study included 7,246 people aged 20 years and older who completed the 2003-2006 National Health and Nutritional Examination Survey (NHANES). CKM syndrome was stratified by standard data based on prior studies, including body mass index (BMI), waist circumference, prediabetes or diabetes, triglyceride levels, metabolic syndrome, cardiovascular disease, and chronic kidney disease.

CKM stage zero was characterized by normal weight, normal blood pressure, lipid levels, glucose levels, and kidney function. Comparatively, stage one patients had a BMI exceeding the upper limit for obesity, an abnormally high waist circumference, or prediabetes. Because mortality rates were low in these groups, stages zero and one were combined for analysis.

The most severe stages included patients with very high-risk chronic kidney disease or a predicted 10-year risk of 20 % or higher of developing cardiovascular disease, based on the Predicting Risk of Cardiovascular Disease Events calculator. These criteria defined stage three CKM syndrome, whereas the presence of overt cardiovascular disease characterized stage four CKM syndrome.

All study participants were able to walk and wore uniaxial, non-waterproof accelerometers. Various analytics, including kernel density plots, Cox regression, and spline-based models, were used to estimate the association between light physical activity and mortality risk according to CKM stage. Models were adjusted for age, sex, race or ethnicity, and whether participants met recommended MVPA guidelines.

Light physical activity linked to lower mortality

Patients with stages zero and one CKM syndrome reported the highest median light physical activity, with the lowest physical activity levels recorded among the most advanced CKM stage patients. Across all stages, approximately 94 % of the individual’s active time was spent on light PA, with 98.5 % or more observed in patients with stages three and four CKM syndrome.

The median follow-up period was 14.4 years. Mortality rates increased markedly with CKM severity, from 3.3 deaths per 1,000 person-years in stages zero and one to 10.5 in stage two, 74.9 in stage three, and 70.7 in stage four. After adjusting for other factors, mortality rates were lower among people with stages two, three, and four CKM who engaged in light physical activity. With each additional hour of light physical activity, the relative risk of mortality dropped by approximately 14 % to 20 %.

The drop in mortality with increased light physical activity was steepest among patients with stage four CKM. More specifically, the risk of mortality was about 4.2 % less as light physical activity levels rose from 1.5 to two hours a day, as compared to about 2.2 % less among those with stage two CKM syndrome.

Previous short-term controlled trials based on cardiac rehabilitation involving exercise suggested lower mortality from cardiovascular causes in people with pre-existing coronary heart disease. However, this form of intensive exercise is rare in the American population with more severe CKM syndrome. Thus, the researchers of the current study focused on more clinically relevant light physical activity to determine its potential association with reduced mortality.

Light PA was associated with lower risk of all-cause mortality for individuals with CKM stages 2 and above, with absolute benefit increasing with CKM stage.

The study findings demonstrate the importance of effective public health messaging that emphasizes the beneficial role of light physical activity and encourages its adoption as a replacement for sedentary time. The authors note that, because this was an observational study, residual confounding cannot be ruled out, and the findings should be interpreted as associations rather than causal effects.