Get Up, Stand Up (To Improve Your Health)

The lyrics of Bob Marley’s song, Get Up, Stand Up, reflect a fight for religious freedom. The title, however, makes a great public health message if taken literally. You may have seen news headlines recently claiming that “sitting is the new smoking”, suggesting that being sedentary is just as bad for one’s health as smoking. Cigarette packages carry a Surgeon General warning – should your Lay-Z-Boy have one too?

There has been a surge of studies over the past decade looking at the health implications of sitting. These studies typically find that the more time people spend sitting, the greater their risk of having or developing: type-2 diabetes, metabolic syndrome, cancer, cardiovascular disease, obesity, depression, and premature death (1-7). It should be noted that these are observational studies that can’t prove cause and effect, and that some of the results may be due to something called reverse causality (i.e. sitting doesn’t lead to depression, depression leads to sitting). However, just like observational data was used to establish the link between cigarette smoking and lung cancer, I think there is enough data to make the bold claim that sitting for long periods of time isn’t very good for our health.

How do you know if you’re too much? Most of these studies placed people in the “high” sitting group if they were sitting for six or more hours per day, but it’s likely a dose-dependent relationship (as sitting hours go up, so does the risk of disease). Any strategy aimed to reduce the amount of time spent on our butts is likely beneficial (unless it’s going out for a smoking break or walking to McDonald’s for a Big Mac).

Numerous studies have shown that breaking up prolonged sitting time with short bouts of light activity can reduce or eliminate the negative metabolic changes that occur during prolonged sitting (8-12). These breaks were usually taken every 30-60 minutes, and the bouts of light activity were usually in the form of walking. It has also been shown that regular moderate-intensity exercise may reduce or eliminate the harmful long-term effects of sitting (13). This is good news for those stuck at a desk job all day. By getting up for a short walk every hour (set an alarm if you have to), and getting regular exercise before or after work, you can offset the negative effects of time spent sitting.

Most sitting is done in three locations: at home, at work, or commuting between the two. Here are some ways to sit less at these three locations:

At work:

• As mentioned above, take short (3-5 minute) walking breaks every 30-60 minutes.
• Increase your total activity by taking the stairs instead of the elevator.
• Park farther away.
• Go outside for lunch, instead of eating at your desk.
• Ask for a standing, or better yet, a walking desk.

Commuting:

• Walk or bike to work if you can. This would be ideal.
• If taking a train or bus, choose to stand instead of sit.

At home:

• Make sure you are exercising daily—at least 30 minutes of brisk walking or something more intense.
• Adopt a rescue dog—this guarantees at least three short walks per day.
• If you can, walk or bike to restaurants, stores, and movie theaters—instead of driving.
• Turn off the television, or at least get up and walk around during commercials.
• If you don’t already, start taking regular walks, especially after meals.

Humans are not like dogs, in that we don’t get a treat for sitting. For us, sitting long periods of time appears to boost our risk of developing numerous chronic diseases. Unfortunately, most of us work jobs that require us to sit for long durations. This time can and should be broken up by short bouts of activity. We should also make a point to engage in regular moderate-intensity exercise on a daily basis. Other efforts should be made to reduce the total time spent on our butt, and increase the time we’re up moving around. Instead of “Netflix and chill”, think “tennis shoes and walk”. Speaking of which, it’s time for me to take the dog out.

“Walking is the best possible exercise. Habituate yourself to walk very far.” – Thomas Jefferson

References:

1. Associations of total amount and patterns of sedentary behaviour with type 2 diabetes and the metabolic syndrome: The Maastricht Study
2. Leisure-time spent sitting and site-specific cancer incidence in a large US cohort
3. Sedentary Time and Its Association With Risk for Disease Incidence, Mortality, and Hospitalization in Adults:A Systematic Review and Meta-analysis
4. Occupational Sitting and Weight Status in a Diverse Sample of Employees in Midwest Metropolitan Cities, 2012–2013
5. Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults
6. Associations of objectively measured sedentary behaviour and physical activity with markers of cardiometabolic health
7. Sitting-Time, Physical Activity, and Depressive Symptoms in Mid-Aged Women
8. Effects of Interrupting Children’s Sedentary Behaviors With Activity on Metabolic Function: A Randomized Trial
9. Effect of prolonged sitting and breaks in sitting time on endothelial function.
10. The Effects of Breaking up Prolonged Sitting Time: A Review of Experimental Studies.
11. Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not.
12. Breaking Up Prolonged Sitting With Standing or Walking Attenuates the Postprandial Metabolic Response in Postmenopausal Women: A Randomized Acute Study.
13. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonized meta-analysis of data from more than 1 million men and women