Don’t Just Sit There, Stand Up for Health
Moving Toward Health
Theresa Oswald, MD
July 31, 2019
Humans are designed to move, but as a society we are becoming increasingly sedentary. Our Paleolithic ancestors took an estimated 10,000–20,000 steps a day. Today in the United States, most adults walk only about 5,000 steps a day or less. When you combine working, commuting, and TV watching, many Americans spend more than 10 hours a day sitting. In today’s world we need to exercise on purpose, because physical activity is no longer a significant part of our daily routine.
Inactivity is responsible for an estimated 5.3 million deaths a year worldwide. If we could reduce inactivity by 10%, we could reduce deaths by 533,000. Reducing inactivity by 25% would reduce deaths by 1.3 million. To lower the number of deaths from too much sitting, we need to move more and sit less, but most important, we need to stand up and move frequently throughout the day. I like to refer to these short bursts of activity as “exercise snacks.”
How Prolonged Sitting Affects Our Health
Too much sitting contributes to numerous diseases—from diabetes and cardiovascular disease to memory loss. Let’s look first at some of the metabolic effects of prolonged sitting. Research shows that sitting for more than 6–10 hours a day increases fats, sugars, and inflammatory markers in our blood; it also increases our waist circumference. The combination of these factors leads to metabolic syndrome—a precursor to diabetes that can also result in obesity and cardiovascular disease. There is a dose-response association between sitting and type 2 diabetes—the more you sit, the greater your risk of developing this condition—and there is a similar correlation between sitting time and cardiovascular disease mortality. Extensive sitting decreases “good” (HDL) cholesterol and increases “bad” (LDL) cholesterol. Obese people who spend most of their time sitting have higher mortality rates than obese people who are more active.
In addition to its metabolic effects, prolonged sitting increases the risk of high blood pressure and certain types of cancer—such as breast, colon, and prostate cancers. It also increases the chances of developing osteoporosis and of falling. And not least, sitting long hours affects the mind and brain: It increases the risk of developing depression by nearly 50%, and it contributes to the thinning of memory-related structures in the brain’s cortex, specifically the medial temporal lobe. This thinning may be an early sign of cognitive decline and dementia. In fact, the World Health Organization’s guidelines for reducing cognitive decline and dementia address inactivity as the foremost risk factor.
Physical Activity: How Much and What Kind?
We know that a physically active lifestyle is linked to lower rates of disease and premature death. How much and what types of activity do we need? The amount and intensity of physical activity appropriate for each of us depend on our capacity and age; even gentle activity is quite beneficial. Exercise researchers measure the intensity of our activity using the metabolic equivalent (MET) scale, which measures the amount of energy needed to perform an activity. The scale starts with 1 MET, the metabolic activity level of a person sitting. The next step up is light-intensity physical activity, such as bed making, cooking, or walking less than 4 miles per hour, all of which require less than 3 METs. Moderate-intensity activity, such as brisk walking or vacuuming, ranges from 3 to 6 METs, while running and other types of vigorous-intensity activity require more than 6 METs. A quick test for knowing whether we’re performing moderately intense or vigorous activity is that we are able to talk in complete sentences (but not sing) when engaging in moderate-intensity activity but only speak single words while doing vigorous-intensity activity.
The Centers for Disease Control and Prevention’s Physical Activity Guidelines recommend that adults 18–64 years old exercise at least 150 minutes a week at moderate intensity, or 75 minutes a week at vigorous intensity, spread throughout the week. Research reveals that even light-intensity physical activity can offer significant benefits when performed throughout the day. Slow walking at 1.5 miles per hour for 15 minutes after meals reduces the meal-related rise in blood glucose by half. Thirty minutes a day is the normal recommendation for exercise.
But the most important thing to remember is that a daily 30-minute (or even 60-minute) exercise session alone, while beneficial in many ways, will not lessen the ill effects of sitting for 10 hours, because the main danger we must reckon with is too much continuous sitting. What will significantly lessen the effects of too much sitting is to include frequent, shorter periods of activity—exercise snacks—throughout our day, to break up our sitting.
Exercise Snacks and Other Ways to Reduce Sitting Risks
Instead of eating snack foods or drinking coffee when you are tired (did you know that too much sitting can also cause fatigue?) I suggest using exercise snacks as a practical tool to interrupt continuous sitting and increase light-to-moderate-intensity activity. While ideally you want to do this kind of activity for about 5 minutes each hour, even short, 1-minute spurts of activity add up over the course of the day. It’s important to remember that most benefits are derived from starting at no activity and moving to some activity. Activity is activity, no matter how small. Even just standing is beneficial, because it requires your muscles to contract to keep your body upright, which gets your blood pumping, stimulates your metabolism, and burns energy, or fat.
In addition to reducing health risks from sitting, exercise snacking improves your mood and energy level while boosting productivity. This interspersed movement stretches joints and eases the mild discomfort that often comes from sitting in one position too long. Greater comfort frees your mind to increase its creative potential.
Here is a snack menu to add activity to your day. I’ve also included suggestions for more active ways to sit or stand as alternatives to using a chair, as well as ways to keep yourself motivated to get up and move.
- Introduce the practice of walking meetings.
- Enjoy a slow, 15-minute walk after meals.
- Stand while talking on the phone or watching television.
- If you can’t stand up, engage your core abdominal muscles for a count of 10, which is equal to one sit-up.
- Strengthen your thigh muscles by standing from a sitting position without using your arms.
- Use the stairs instead of an elevator.
- Try push-ups against a wall, or a desk plank (place your hands or forearms on your desk, your legs stretched out behind you, and your body in a straight line). These exercises will strengthen your chest and core abdominal muscles.
- Do neck and shoulder rolls, seated or (preferably) standing, to reduce tightness in these areas.
More Active Alternatives to Sitting in a Chair
- Consider using a balance-ball chair, which requires you to engage your spinal and abdominal muscles to help you maintain an upright position.
- Try sitting on the floor from time to time to strengthen your back muscles and the muscles used to help you get on and off of the floor, all of which help protect you from falls.
- Look for options in a standing landscape, like standing desks. Because muscles contract to keep you standing, you burn 30% more calories standing than sitting.
- If you want to consider a treadmill desk, please note that while these desks increase your energy expenditure, they’re best used for activities that don’t require great mental focus (such as reading emails or watching a training video), since using these desks has been shown to reduce concentration and mental productivity.
- Use a simple fitness tracker to track your standing and steps.
- Set reminders and enlist exercise buddies to create a new habit. Benefit from the group effect.
Support your health by finding fun ways to move more and sit less throughout the day. A side benefit of moving more is that it tends to increase our interactions with other people and thus our sense of social connection, which also enhances our health. And once we start moving, we develop the habit of being more active. Think of movement as medicine. If the positive health effects of movement could be put into a pill, that pill would be the most beneficial and highest-selling medicine of all time.
In the next post in this series, we’ll explore how to use different types of movement to balance our doshas—the three elemental forces or tendencies that have shaped our physical and mental constitution and have a profound, continuing impact on our health.
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