High blood pressure, or hypertension, is a common health issue affecting millions of people worldwide, and can lower both the quality and length of life. Finding ways to lower the risks for those with hypertension is very important—which is why researchers wanted to determine if live microbes could be beneficial for those dealing with high blood pressure.
Including certain live microorganisms in your diet through foods or supplements—like probiotics—has been shown to be a promising way to and improve heart health. Fermented foods like kefir, kimchi and some yogurts can be good sources of live microbes. In this study, the researchers looked at how both dietary live microbes and sedentary behavior can affect people with hypertension. Let’s unpack what they found.
How Was This Study Conducted?
To investigate the association between dietary microbes intake and sedentary behavior with mortality risk in adults with high blood pressure in the United States, researchers used information from the National Health and Nutrition Examination Survey (NHANES) database, which was designed to gather important details about the health and nutrition of people living in the U.S. More than 15,000 individuals with hypertension were included in the analysis.
The study looked at the amount of foods with live microbes people consumed in their diets and how that might connect to a sedentary lifestyle. The researchers suggest that most sterile or processed foods don’t contain many live microorganisms, while fresh fruits and vegetables with their skins on have moderate amounts. Foods like yogurt or fermented vegetables often have the highest levels of live microbes.
To measure this, participants shared what they ate over a 24-hour period, and foods were grouped based on their microbe content. The groups included low microbe intake (mostly processed or sterile foods), moderate intake (some fresh produce) and high intake (fermented or unprocessed foods with lots of microbes). Participants were then categorized into one of these three groups based on their food choices.
To understand how much time people spent sitting each day, researchers used a simple questionnaire called the Global Physical Activity Questionnaire (GPAQ). Interviewers asked participants about their daily sitting time, including activities like working at a desk, commuting in a car or on public transportation, watching TV, reading or using a computer. Based on their answers, participants were grouped into three categories of sitting time: less than five hours per day, five to eight hours per day, or more than eight hours per day.
To examine survival outcomes, researchers used existing health data to understand who was still alive by the end of the study period, which concluded at the end of 2019. Additional factors like diet, use of probiotics and salt intake were considered for a more detailed analysis.
What Did This Study Find?
After analyzing the available data, the researchers found that people who ate the least live-microbe-rich foods had a higher risk of death from all causes and heart disease, while those who ate the most had a lower risk. Additionally, those who spent fewer than five hours a day sitting had the lowest risk of death, but people who sat for five to eight hours and those who sat for more than eight hours had similar risks.
To better understand how diet and sitting time affect health, researchers investigated the link between diet, sedentary lifestyle and health outcomes further. They found that sitting for long hours was linked to a higher risk of death. Specifically, for every extra hour spent sitting, the risk of dying from any cause went up by 6%, and the risk of dying from heart problems increased by 6.5%. On the other hand, eating more live-microbe foods was protective. People with medium or high intake of live-microbe foods had significantly lower risks of death compared to those who ate very little.
Interestingly, the study revealed a “U-shaped” relationship between sitting time and the risk of death from all causes. This means that both very low and very high amounts of sitting are linked to higher health risks, while moderate sitting—around four hours a day—appears safer.
When they split the participants into two groups—one that sat for more than 4 hours a day and one group that sat for less—they found that for those in the more-sitting group, eating live microbe-rich foods was especially beneficial. For individuals who did sit longer, eating moderate or high amounts of those foods helped lower their risk of heart-related deaths significantly.
Even though a clear link between eating these foods and lower overall death risk wasn’t found for all groups, the general trend showed that people who ate more live microbe-rich foods tended to have better health outcomes. These findings underline how combining less sitting with healthier food choices may be beneficial for people with high blood pressure.
There are a few key study limitations to keep in mind. First, while the authors based their classification of dietary live microbes on widely accepted expert guidelines found in many studies, the actual amount of microbes in different foods wasn’t precisely measured, which could lead to some inaccuracies in the analysis. Second, the data used regarding diet and activity levels comes from self-reported surveys, meaning people may not always remember or report their eating and sitting habits accurately. Additionally, the study focuses only on people in the U.S., who may have different lifestyles, health care access, and genetics than people in other parts of the world, so people should be cautious about applying these findings globally.
How Does This Apply to Real Life?
Whether you have a desk job, spend your days driving or prefer to spend your weekends hanging out on the couch, sitting for long periods can easily become a normal part of everyday life. But too much sedentary time can have serious impacts on heart health, due to its effects on the blood vessels. When we sit too much, the normal function of the cells lining our blood vessels gets disrupted. This can make it harder for the blood vessels to relax and work properly, which raises blood pressure and contributes to other health issues.
If you have high blood pressure, this study’s findings suggest that taking certain steps in your daily habits may offer some benefits. By reducing sitting time to less than 4 hours per day, you may lower your risk of death, particularly from heart-related issues, based on these results. Incorporating more live microbe-rich foods—like yogurt, fermented vegetables and fresh produce with skins—into your diet also appears to support heart health. Just remember that very low amounts of sitting—about two hours a day or less—can be hard on your heart (and joints), too. If you feel like you need to get off your feet, listen to your body and take a break.
While live microbes may sound like an intimidating eat, they’re actually pretty easy to ease into. For example, add kefir or yogurt to a for a snack or light breakfast. Or make your day a little more savory by adding or kimchi to your sandwiches. You can even swap sour cream for plain Greek-style yogurt for a probiotic boost to your .
Together, reducing sedentary behavior and maintaining a live microbe-rich diet form a powerful combination that may help you live a healthy life despite the challenges of living with hypertension.
Our Expert Take
This study highlights the importance of small, actionable lifestyle changes that may make a significant impact on the health of those living with high blood pressure. Reducing the time spent sitting each day and incorporating more live microbe-rich foods into your diet may offer protective benefits for heart health and overall longevity. These findings emphasize that even gradual adjustments to daily routines, like standing up more frequently or adding a serving of fermented vegetables to your meals, could prove valuable in managing health risks associated with hypertension.
While there are still gaps in our understanding, particularly regarding the exact role of dietary microbes and how these findings can be applied universally, this research provides a promising glimpse into how simple choices can contribute to better health outcomes.