So the whole world has more or less just been ordered to sit inside on their rumps for the next indefinite period of months, it seems like a good time to go over a topic which I studied at university yet haven't been able to express while training clients at the gym. Sitting down as a risk factor for health.
We've all heard before that sitting down will lead to bad posture and bad posture will lead to back pain. This has since been proven untrue, since people can have horrendous degeneration in the spine and have no back pain whatsoever (1,2). Sitting down, however, will affect more than just your posture and this article is about more than that. You may have seen or heard this slogan before:
This slogan took off, unfortunately the people who read it didn't take off from their chairs. Sitting rates are still increasing over time.
So this sounds straight up ridiculous, everyone sits! But I suppose that's how people used to think about smoking back in the day... So let's have a look at what the literature says:
A large study conducted in 2012 estimated that sitting time accounts for 7% of all deaths in adults aged 45 years and older (3). A separate meta analysis in 2013 found a 34% higher mortality risk for adults sitting 10 h/day, with the effect increasing as sitting time increases (4). 10 hours may sound like a lot but if you work a full time desk job that is 7 and a half hours sitting already. Add in an hour and a half for TV at the end of the day, an hour for eating and an hour on your computer/phone and you're right up there. Now that the whole world has been thrust into a lockdown scenario (Britain has just announced you can only walk your dog once per day!) these numbers sound much more realistic.
Now these statistics are nowhere near as bad as smoking a pack a day (5), so the question "is sitting the new smoking?" has been answered: it is nowhere near as bad. There is a lot of stress going on in the world right now, you have no need to get super pedantic about how long you spend relaxing at home. But these are still unwanted results from the studies showing that sitting down for extended periods of time isn't ideal and given how we're all rather limited on other options right now I figure it's a good time to dive into the topic.
Some people used the phrase as a scare tactic, look how dramatic this one is. Come on, what is this A Current Affair?!
But how does sitting down kill me?
These studies all mention the rate of "all cause mortality" rising. All cause mortality is the total number of deaths caused by anything. Sitting can increase the risk of obesity, cardiovascular disease, diabetes, some cancers and can even lead to mental health problems. It is this assistance that sitting down lends to other diseases which leads to the increased rate of all cause mortality with increased time spent sitting.
Well it's a good thing I do crossfit/run ultra-marathons/smash myself in the gym on my days off so I'm fine!
uhh no. (well yes exercise is incredible for your health, but also no) According to the study I mentioned earlier: "The association between sitting and all-cause mortality appeared consistent across the sexes, age groups, body mass index categories, and physical activity levels and across healthy participants compared with participants with preexisting cardiovascular disease or diabetes mellitus" (3). What that means in non-scientific-study speak is: the increased risk that comes with sitting was the same regardless of age, gender, weight, fitness levels, and even whether or not you have a preexisting disease. Just because you are young and healthy and do sport on the weekend doesn't mean you get a free pass on sitting down as long as you like. Unfortunately :(
But what if I sit like this? *sits upside down on the couch with an exercise ball balanced on the bottom of the foot*
It's not actually a problem with sitting, the problem comes from the extended sedentary behaviour that sitting consists of. Sedentary behaviour is any behaviour that does not rise metabolic demand above resting levels significantly. This is a different concept to physical inactivity, which is not getting enough regular exercise, a topic that is spoken about very frequently (short version: regular exercise = very good for your health). Sitting upside down on the couch while balancing an exercise ball on your foot would, aside from being impressive, actually be a great way to sit. Not because it's in a great position for your back but because it is likely to be uncomfortable so you'll have to be shifting around a lot, reducing the amount of time spent sedentary. Balancing the exercise ball is also a stroke of genius as balance requires you to continuously fire off muscles which will increase your metabolic demand. So while I don't recommend sitting like that for everyone, I do approve of that position, good idea!
The good news is there are a couple easy things you can do to reduce your sedentary time.
1. Do something.
Yes that's really number 1 on this list. Just do something that doesn't involve sitting or lying down. Housework, cooking, cleaning, exercise, stretching, moving furniture, painting, playing with your dog, anything. As long as it keeps you on your feet it will reduce your sitting time. The longer you're doing something else, the less time you are sitting for. Sometimes the simplest solutions are the best solutions.
2. Take regular breaks.
If you ever became a professional tennis player in Wii Sports (like I did when it came out back in 2006) you will be familiar with the message that comes up between games about taking a break (and if you were like me you became a professional at ignoring that message too!). Setting reminders like that on your applications to get up and move is a great idea to avoid spending too long in sedentary positions (and to avoid spending too much Junk time). Stand up, reach your arms to the roof, touch your toes, practice your dance moves for when the clubs reopen, sacrifice a small animal to the corona gods to keep your family safe, I really don't care what you do when you stand up, as long as you're moving around as much as possible. Some studies say to do this every 30 minutes, some say every 15 minutes, I say do it as often as you can. You don't have to complete a new 10 rep exercise challenge (push up challenge anyone?) just increase that metabolic consumption a little bit every time. Similar to protein consumption^: you won't hit the upper barrier of doing too much (unless you're someone who does ultra-marathons for fun, even then only maybe). Move around as often as you can, the more often you can break up sedentary behaviour by moving the better.
^Off topic: You won't eat too much protein because protein is not easy to get in a regular diet, especially given how readily available fats and carbohydrates are in most foods, so while yes, there is a point where it becomes more beneficial to eat something else, it is very difficult to reach that point. I feel confident to say eat as much protein as you can fit into your daily diet without there being much risk of you overdoing it.
3. Get uncomfortable.
The less comfortable you are, the more you'll be moving around while you change positions and the less time you'll want to spend sedentary. Chairs are getting more and more comfortable which means that people will spend longer and longer sitting down. Try sitting in different positions on the floor. See how long you last.
If you need ideas on how to move around or sit down, The Foot Collective on Instagram are a creative bunch focused on spreading information on how to keep healthy feet (hint: that involves not sitting down for long periods of time!). This challenge in particular is VERY difficult but a lot of fun to mess around with. I recommend following them on Instagram (although they do tend to lean a bit too heavy towards a hippie approach for my liking...)
There are a lot of totally motivational quotes on what "comfort is the enemy of...". Progress, achievement, greatness. I think I can add to that list:
Majestic. Beautiful. Google image-worthy. Okay maybe not
I hope this article has come across as a reason to get up and dance in your room spontaneously for health reasons rather than another yet another article on things for you to not do. Sitting should be far from your biggest concern now or ever, but it is just another little thing to be aware of and I believe that holds importance now more than ever while we're stuck at home. Yes, you can still sit down and watch a movie to relax, yes I sat down for longer than 15 consecutive minutes to write this article just remember not to overdo it while socially isolating!
Stay safe everyone and keep moving!
REFERENCES: