Swapping ‘wine o’clock’ and sedentary behaviour for ‘walk o’clock’ and improved cardiovascular health

Reference: May-June 2025 | Issue 3 | Vol 18 | Page 48

Nurses are ideally placed to support patients towards a more active and heart healthy lifestyle

Lifestyle choices are known to affect cardiovascular and overall health in positive and negative ways, depending on the nature of these choices. The concept of ‘wine o’clock’ has become a common trend, and one often used as a stress management and coping tool among women.¹ Alcohol consumption in Ireland has been identified as a public health issue, which Government and healthcare systems are trying to address.²

Women are also reported to exercise less often than men due to the burden of household demands and other barriers.^3,6 Overall, many adults do not engage in adequate levels of physical activity for a variety of reasons, and the nurse is often ideally placed to support the patient towards change.

Recommended levels of physical activity

Both men and women benefit from physical activity in a variety of ways, and those who reach target recommendations for exercise enjoy a subsequently reduced risk of adverse health outcomes.³ The European Society of Cardiology (ESC) recommends at least 150 minutes of moderate intensity exercise per week.²

However, 41 per cent of women in Ireland report low activity levels⁶ and the World Health Organisation estimate that 27.5 per cent of adults do not participate in the required physical activity to remain healthy.⁷ Approximately three out of five Irish adults meet the recommended 150 minutes of physical activity per week.⁶

Alcohol consumption: The reality

A large volume of adults binge drink, consuming more than six standards drinks at one time, and drink alcohol regularly through the week, according to the healthy Ireland survey 2023. Binge drinking has been culturally accepted by many in Ireland and in some social groups is considered normal behaviour.²

The ESC 2021 prevention guidelines recommend a maximum of 100g of alcohol per week, which equates to 10 standard drinks and at least two alcohol free nights per week.³ In January 2022, the Irish Government increased the price of alcohol to help reduce consumption and the burden on the health service.⁴ There have been some very small reductions in binge drinking reported since the price increase but further study is required to validate these reports.⁴

There has also been a call to add health warnings to alcohol labels and many believe it may be beneficial to launch a campaign to swap alcohol for physical activity via the ‘Get Active Ireland’ programme.

These strategies aimed at reducing alcohol intake have been formulated due to the wide-reaching negative effects of excess alcohol on physical and mental health, such as low mood, increased cardiovascular risks, weight gain, and increased stress levels, to name only a few.^4,5 As many women in particular use ‘wine o’clock’ to destress, they are potentially increasing their overall risk of developing these and other debilitating symptoms.

Supporting patients towards healthier coping strategies and lifestyle choices is a central role of the nurse. Education about the benefits of exercise and encouragement to replace the ‘wine o’clock’ habit with a ‘walk o’clock’ one will have notable long-term benefits on patients’ overall health, wellbeing, and cardiovascular outcomes.

Benefits of physical activity

Ireland recently launched new physical activity guidelines in 2024, titled Every Move Counts.⁸ Some of the key messages for adults include the importance of moving the body and being active in a way that is enjoyable, which helps to sustain the habit.^8,3

Physical activity has a positive effect on major cardiovascular risk factors.^9,10 Even small changes can have a big impact on cardiovascular health. Structured and regular aerbboic exercise improves mood, reduces weight, increases high-denisty lipoprotein (HDL), and reduces the heart rate, therefore reducing the risk of ischaemia, heart variability and arrthythmias, as well as thrombotic risk and likelihood of developing type 2 diabetes.^10,11

Walking towards heart health

Walking is free, accessible to most, and an easy way for adults to engage in some form of physical activity.¹¹ It is also low impact and easily added into daily routines.¹² Even walking at home if the weather is bad has positive effects on overall health.⁸

Research has shown many benefits associated with walking, including improved overall fitness and general wellbeing, physical and mental health, levels of social activity, and quality of life.^6,13,14,15 Walking also helps to maintain or reduce body weight, strengthen bones and muscles, improve balance and coordination, increase energy levels, enhance mood, cognition, memory and sleep, support the immune system, and reduce stress and tension.^5,16 It is also recognised by the American Heart Association as an independent protective factor against coronary heart disease.⁹

Research consistently shows that regular walking can also help manage various chronic diseases, including diabetes, hypertension, heart disease, and even mental health conditions like depression and anxiety.⁸ Obesity is a global epidemic, which effects around 39 per cent of adults and is closely linked with poor health outcomes and increased risk of comorbidities.⁵

Adults with chronic diseases, overweight and obesity, or at high risk of CVD are strongly advised to avoid inactivity.¹¹ Overall, replacing a ‘wine o’clock’ habit with a ‘walk o’clock’ one offers physical, mental, and financial benefits; however, breaking routines and building new ones can be challenging for patients, particularly if binge drinking is used as a coping mechanism.

Supporting and facilitating behaviour change

Changing a behaviour can be difficult and replacing it with a healthy activity can be equally challenging.¹⁸ The use of a ‘little and often’ approach is a part of the cardiac rehab phase one programme, as is promoting a person’s preferred form of exercise to improve their levels of motivation.¹⁷ Moving from moderate to vigorous levels is associated with additional benefits and positive health outcomes.³

Walking is generally enjoyed by many and can be tailored to the individual’s level of need and capability. Healthcare professionals should promote and prescribe walking or other forms of physical activity in the same ways they prescribe drugs and other treatments to promote overall health.³

Developing SMART (specific, measurable, achievable, relevant, and time-bound) goals is also helpful in supporting behaviour change.¹⁹ Planning weekly physical activity, when and how it fits into a patient’s life, and establishing exactly what fits into their daily routine, improves the likelihood of a new behaviour becoming a lasting habit.³ Starting with small goals that the patient selects is vital, with the overall aim of building up to the recommended 150 minutes per week. It is important not to overload patients with too much too soon.

With the advent of wearable fitness trackers and mobile apps, individuals can easily monitor their progress, set goals, and stay motivated on their journey towards better health.¹⁹ Wearable devices not only help motivate patients, but can be helpful for healthcare professionals managing their chronic disease to assess the levels of activity they are engaging in.^3,6 Other digital platforms like YouTube can also be useful for patients to source motivational walking sessions, or music to listen to while walking, that encourages them to reach their goals.

Conclusion

Currently, life is fast paced, driving more than ever and sitting for longer periods of time have become negative trends, which can be difficult to break and result in negative outcomes.²⁰ Physical exercise reduces cardiovascular risk, maintains or aids the loss of body weight, positively benefits those with and at risk of chronic disease, and is associated with a huge variety of other positive benefits. It is also an ideal substitute for a ‘wine o’clock’ habit.

With coaching and behaviour change we can encourage our patients to make small changes. Incorporating walking into daily life does not have to be a daunting task. Small changes like a 10 minute walk each day, with the aim of building up to 30 minutes, will have an impact.

Making even small changes can be difficult for patients though, therefore, support and education are vital elements of holistic care. Setting SMART goals and helping patients to find practices they enjoy can promote better long-term outcomes, as can an approach that builds gradually.

It can be as simple as taking the stairs instead of the lift, parking the car farther away from the entrance, getting off the bus a few stops earlier, or scheduling regular walks with friends or family. By embracing ‘walk o’clock’ as a daily ritual, individuals can take proactive steps towards safeguarding their health, enhancing their quality of life, and reclaiming control over their wellbeing.

HSE