January 10, 2026 10:16 am (IST)
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Exercise
Study finds walking can benefit people CKM syndrome. Photo: Unsplash

Light-intensity activities, such as walking, yoga, or household chores, are associated with a lower risk of death among individuals with cardiovascular-kidney-metabolic (CKM) syndrome, according to new research published today in the Journal of the American Heart Association, an open-access, peer-reviewed journal.

CKM syndrome affects nearly 90% of U.S. adults, encompassing conditions such as high blood pressure, abnormal cholesterol and lipids, elevated blood glucose, excess weight, and reduced kidney function. When combined, these factors significantly increase the risk of heart attack, stroke, and heart failure compared to any single factor alone. CKM stages range from 0 to 4, with higher numbers indicating greater risk for cardiovascular events.

The study suggests that light physical activity, the most common level of daily activity, may offer meaningful health benefits, particularly for individuals at CKM stage 2 and above. While moderate- to vigorous-intensity exercise is recommended in general guidelines, authors note it may not be feasible for adults with advanced CKM syndrome.

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

Study Design

Researchers analyzed data from the 2003–2006 National Health and Nutrition Examination Survey (NHANES), which collected health and physical activity information from about 7,200 adults. The survey included physical exams, blood samples, and up to seven days of activity measured via accelerometers, devices that track movement levels.

Using these readings, the team classified participants’ activity as light, moderate, or vigorous.

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

CKM stages were determined based on participants’ health data:

Stage 0: Normal weight, blood pressure, lipids, blood sugar, and kidney function

Stage 1: Excess weight and/or pre-diabetes

Stage 2: Multiple CKM components and/or moderate-to-high-risk kidney disease

Stage 3: Very high-risk kidney disease, high cardiovascular risk, or subclinical cardiovascular disease

Stage 4: Multiple CKM components or chronic kidney disease combined with prior heart attack, stroke, atrial fibrillation, or peripheral artery disease

Key Findings

Lower mortality risk: Light physical activity was significantly linked to reduced risk of death in CKM stages 2–4.

Dose-response effect: Adding one extra hour of light activity per day corresponded to a 14–20% lower risk of death over 14 years.

Greater benefit at higher CKM stages: Increasing activity from 90 minutes to 2 hours daily resulted in a 2.2% risk reduction for stage 2, compared to 4.2% for stage 4.

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

Expert Commentary

Bethany Barone Gibbs, Ph.D., FAHA, an American Heart Association volunteer and professor at West Virginia University, highlighted the study’s importance by saying: “We know less about the health impacts of light-intensity activities compared to more intense physical activity. Light activities promote energy expenditure, movement, and circulation — all physiological processes linked to better health — but research here is limited.”

Study Limitations

The researchers noted that the study is observational, meaning it identifies associations rather than proving causation. Individuals with advanced illness may have had higher baseline risk of death and engaged in less light-intensity activity, potentially influencing the results.

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