Sitting On Your Ass Is Hazardous To Your Health

by Dr. Christopher on July 18, 2011

Writer’s note: This post is meant to include everything.  Skip to appropriate sections as needed.  And the last thing I need is you telling me your sciatica flared up reading this thing, so take a break and do some jumping jacks in between.

For those of you who came to the lecture, we raised $172 for The Roots and Wings Foundation.  Thank you for contributing to a worthy cause. 

Introduction: Break Nature’s Rules and Get Punished

Chronic diseases such as coronary heart disease, hypertension, diabetes, and some forms of cancer are also virtually unkown in comtemporary hunter-gatherer societies, even in those individuals over 60 years of age. (8)

Rump rester? Or life waster? You be the judge.

How many of you have a strong Italian heritage?  Irish?  Spanish?  Polish?

Surely, there are traits that are unique to “your people” that help identify you.  Italians eat.  Irish drink.  Spanish do the flamenco (I think).  Polish clean.

I’m mostly Polish.

Coming home from high school, it wasn’t unusual for me to come home to my Babci sweeping the street.  You can imagine the comments I had to fend off from friends who observed this unique behavior.

Sweeping the street explains one aspect of my grandmother’s life, which consisted of cooking, cleaning, and taking care of her family.  From morning until about four in the afternoon, all I had to do to find her was to use my senses.  The smell of sauteeing garlic and onions, the daily sound of a vacuum cleaner over the floors, the whistling of the clothes line as she hung her clothes to dry in the sun, or the cuss words she spoke in Polish over some angst about the world news.

Moving most of Babci’s life allowed her to get to 86 years old doing what she wants.  Then she had a stroke.  Then it was one and a half years of her health heading downhill.

86 years is more than the average American lifespan of 77 years.  But Deepak Chopra says that you can live happily to age 120 if you give your body what it needs for health.

For any of you that have witnessed the failing health and suffering of a loved one, you wouldn’t wish it on anyone.

The physical struggles and witnessing the crying weighed on everyone.

“Why does God do this to me?”  She’d ask every day.

Finally, Babci got what she asked for and died.

Babci followed Polish wisdom as well as she could.  She ate mostly whole foods, although she bought grain fed meats, chicken, and non-organic vegetables.  Living through the depression, she advocated saving her money.  She didn’t realize that she could invest in her health by spending more on food and less on trusting the medical doctor for her medications.  Babci also moved her body throughout most of the day.

What I didn’t add was what she would sit on her ass and watch television from 4 PM everyday until 11 PM, not getting off the couch for much except a glass of gin and tonic.

The point?  Just like you can’t out-exercise a bad-diet, you can’t out-exercise sitting on your ass.

Let’s Look At The Research

With the possible exception of diet modification, we know of no single intervention with greater promise than physical exercise to reduce the risk of virtually all chronic diseases simulatenously. (8)

Did you know that Hippocrates (460-370 BC) advocated a balanced physically active lifestyle?  He also said “let food be thy medicine.”

If it’s good enough for Hippocrates, then it’s good enough for me!

  • physical inactivity is second leading single cause of death behind tobacco.(4)
  • 250,000 deaths per year in the U.S. are premature due to physical inactivity. (8)
  • physical inactivity is involved with no fewer than thirty chronic conditions including: coronary heart disease, stroke, some types of cancer, type 2 diabetes, depression, anxiety, erectile dysfunction ,hypertension, arthritis, asthma, etc. (2,3)
  • men who reported more than 10 hours a week riding in a car or more than 23 hours a week of combined sedentary behavior (watching tv and riding in a car) had 82% and 64% greater risk of dying from CVD than those who reported less than 4 or 11 hours a week, respectively.(4)
  • Adults spend 170 minutes a day watching TV.  On average, adults spend 7.7 hours a day in activities with a low energy expenditure. (4)
  • In 2005, The Center for Disease Control and Prevention estimated 37.7% (about 1 in 3) of the US population did not participate in recommended amount of physical activity. (4)
  • Caged experimental rats naturally exercise about 3 hours a day when given access to a running wheel.

We all know that exercise and physical activity is important for us.

But until now, we thought that all we had to do was to follow the Center for Disease Control’s guidelines for physical activity during exercise sessions and we’d be fine.

More recent research is saying that this is not the case.

We just aren’t really structured to be sitting for such long periods of time, and when we do that, our body just kind of goes into shutdown. ~Tony Yancey, a professor in the health services deparment of the Kaiser Permanente Center for Health Equity at the University of California, Los Angeles.

  • Men who spend 6 hours or more per day of time sitting had overall death rate than was 20% higher than the men who sat for 3 hours or less. (5)
  • Rats were restricted from moving, even from low-intesity standing and spontaneous amublation.  Plasma triglyercides and HDL cholesterol clearance were impaired by 75% immediately (5), along with 90% reduction in lipase activity locally in the legs. (3)
  • Each additional hour of tv a person sat and watched per day rose the risk of dying by 11%. (5)
  • More breaks (minimum of 1 minute) in sedentary times (independent of total sedentary time and moderate to vigorous activity) was beneficially associated with waist circumference, triglycerides, and 2-h plasma glucose.  It’s not the amount of time that’s important, but how quickly it is accumulated. (3)

Let’s say you do 30 minutes of walking five days a week (as recommended by federal health officials), and let’s say you sleep for eight hours.  Well, that still leaves 15.5 hours.”  Many of us, he points out, have sedentary jobs and engage in sedentary activities after work, like watching television or sitting around a dinner table talking.  “When you add it all up, it’s a lot more sitting than moving.  ~Epidemiologist Steven Blair, a public health professor at the University of South Carolina

Someone could work out 30-40 minutes a day, four days a week, but still sits for eight hours a day and still suffer prematurely from cardiovascular disease, obesity, or diabetes.

What Exactly Is Going On? (on a system level)

 The only healthy posture is one that is always changing. ~Stuart McGill

Research has begun to figure out exactly what is going on.

  • dramatic decrease in lipoprotein lipase enzyme activity (by 80-90%) during sitting compared with standing or ambulating (2)
  • decreased lipase activity is linked with coronary heart disease through impairment of local lipid metabolism in the capillaries. (2)
  • intense activity has no effect on lipase activity, which explains why sitting is an independent risk compared with exercise. (2)  The physiological mechanisms associated with excessive sedentary behavior are different than the benefits of regular execise. (4)
  • intense activity is thought to affect cardiovascular health through anti-inflammatory benefits, improvement in endothelial function, lipid profile, and blood pressure lowering.  (2)
  • a single bout of prolonged, uninterruped sedentary time has shown “rapid alterations in biological pathways affecting lipid metabolism,” concerning triglycerides and HDL cholesterol (3)
  • skeletal muscle is one of major sites for clearance of triglycerides and glucose.  Sedentary activity = no skeletal muscle contractions.
  • calorie-burning immediately falls to one per minute, a third of what it would be if you got up and walked. (5)
  • moving reflects higher total energy expenditure and resistance to fat gain, even in activities such as standing, rather than sitting.
  • 14 young, fit, and thin volunteers had a 40% reduction in insulin’s ability to uptake glucose after just 24 hours of being sedentary. (5)
  • single bouts of inactivity, such as days and weeks of bed rest, decrease insulin sensitivity in healthy humans (3)

You have decreased ability to break down fat, decreased ability for fats to move through the bloodstream, lower metabolism, and decreased ability for insulin to put sugar into cells for storage.

James Levine, a researcher at the Mayo CLinic in Rochester, Minn, asked “why do some people who consume the same amount of food as others gain more weight?”  With the help of motion-tracking underwear, he found the answer.  “The people who didn’t gain weight were unconsciously moving around more.”

Given that cardiovascular disease is the main cause of death in the United States and that insulinemia (insulin in the blood) is directly correlated with decreased life span … sitting becomes indirectly linked to death.

Exercise is not a perfect antidote for sitting. ~Marc Hamilton, an inactivity researcher at the Pennington Biomedical Research Center (5)

What Exactly Is Going On? (on a musculoskeletal level)

The above describes what happens to your systemic, internal health.

What about your musculoskeletal system?

Anatomy, particularly of the bones, muscles, ligaments, and nerves, is my specialty.

Understanding how aches and pains develop, first through load exceeding capacity leading to injured tissue, then to scar tissue, and finally to osteoarthritis and whole body degeneration is the key to realizing that your body is not meant to sit.

Here’s how the all too common scar tissue develops:

Muscles are pumps that help blood filter through the body.  When muscles are held in a static position (like sitting) for too long, there is a lack of blood flow.

Since blood carries oxygen, a lack of blood flow leads to a lack of oxygen.

No oxygen creates damage and cancer-causing free radicals in the area.

Because free radicals cause damage like pinballs flying around your body, your immune system is dispersed to repair the damage.

The immune system sends repairmen called fibroblasts to the area.  Fibroblasts lay down concrete, bubble gum, and superglue (aka scar tissue) to repair the damage.

Scar tissue is a smart response by the body to fix it.  Unfortunately, it’s not a long-term solution, restricting range of motion and decreasing force production capacity ( how strong a muscle is) as scar tissue accumulates.

You can see how lack of movement can cause problems in so many places.

A few body parts that are particularly susceptible to scar tissue accumulation are the neck (longus coli, levator scapula, lower cervical facet capsules), shoulders (pec minor, subscapularis), low back (psoas, iliacus, multifidi, longissimus, iliocostalis, lumbar facet capsules), and hips (psoas, iliacus, hip external rotators, and the sciatic nerve at the hip external rotators).

Remember that scar tissue causes you to be inflexible and less strong than you should be.  Your body starts to compensate as it accumulates.  It compensates more and more, allowing you to function the best you can for as long as you can.  The problem is that eventually, you hit a wall.

We know that sitting affects not only our system health but our musculoskeletal health as well.

If you already have pain, you should get the cause of your pain (scar tissue, weakness, diet, stress, psychology) addressed by the appropriate health care practitioner.  In Northern NJ, I can help.

Before pain and degeneration set it, what can you do about it?

Guidelines Addressing Sedentary Behavior

Public health recommendations have addressed exercise sessions to reduce the risk of type 2 diabetes, cardiovascular disease, and some cancers, but they haven’t addressed sedentary behaviors yet. (3)

Still conventional medicine would rather treat disease after it has manifested compared with before.  People will wash their cars and get oil changes before a problem develops.  They’ll vaccinate and check their blood before they catch a disease.

If they won’t make the recommendations to aggressively prevent disease before, we will.

Scientists talk about NEAT (non-exercise activity thermogenesis).  NEAT is energy expenditure through habitual and unstructured daily physical activity of mainly light intensity.

All of these guidelines are designed to increase NEAT.

When you sit, the muscles go as silent as those of a dead horse. ~Marc Hamilton (5)

1. Redesign movement into your environment. (with the help of Toni Yancey of Instant Recess)

“In a nutshell, technological advances and the structure of modern life have made sitting a seemingly unavoidable habit for most of us.”  (2)

Technology isn’t going anywhere, so let’s restructure modern life.

  • Commit to moving a few minutes every hours.
  • Mow the lawn instead of using the auto-mower.
  • Take the stairs instead of the elevator or escalator.
  • Shovel the snow instead of getting your children to do it.
  • Weed your own garden instead of hiring the gardener.
  • Stand instead of sitting at your desk (or get a treadmill desk).
  • Kneel instead of sit and switch legs every few minutes.
  • Drink lots of water so you have to pee often.
  • Reduce the amount of television we watch or put a treadmill in your living room.
  • Propose a chairless classroom for your children.
  • Park farther away from the places where you work, shop, play, study, and worship.
  • Schedule a 10 minute activity break at the same time every day.
  • Fidget, stand up, and stretch at intervals during meetings
  • Put printers a short walking distance away from your work or study space instead of right next to it.
  • Replace desk chairs with stability balls – or use a standing desk to get rid of the chair entirely. (only if no history of low back pain and pre-screened with strong core and hip flexibility)

You can buy a uniaxial accelerometer (www.theactigraph.com) if you’d like to know just how much more you’re moving.  One study even mentioned motion tracking underwear, not sure where you’d find those though (Let me know if you find them.  I want a pair!)

2.  Take micro-breaks from sitting.

Research has shown that 2 minutes of light activity (slow walking) every 20 minutes during long periods of TV watching is beneficially associated with reduced glucose levels. (2)  Micro-breaks also lower adiposity, improve postprandial (post-meal) glucose and triglyceride levels.  (2)

The added benefit in reducing scar tissue to the target muscles can be achieved by performing:

  • Reverse Lunges (hip extension, which reverse the hip flexion of sitting)
  • Chin Retraction exercises (I’d do the movement while rotation the head from side to side)

3.  Exercise.

Performing certain exercises can keep your capacity up so that scar tissue takes longer to build before pain sets in.

4. Eat like a human.

Inflammatory foods, toxins, and sugar cause more free radicals to bounce around your body than an anti-inflammatory diet like the paleodiet.  The paleodiet also will keep your symptom threshold high so that you don’t experience pain with minor problems.

Sitting for a meal with family, friends, or loved ones is a sedentary activity that may actually benefits your health more than not sitting.  Your social health is more important than most give credit.  Eat with others and talk about life.  Don’t feel guilty about meal times.

(5.  Squat like a human.)

We were not meant to sit on toilets, we were meant to squat in the field. ~ Proctologist Michael Freilich, when asked to explain President Carter’s hemorrhoids (6)

It’s not too practical to squat to go to the bathroom in today’s society.  I know from personal experience.

You can find an area of the woods that has no people around and do it.

Or you can perch up on the toilet like a gargoyle, but you’ll have to derobe everything from your shirt down because there is not much room on the toilet for your feet.

But, when I do get the pleasure of squatting to go to the bathroom, I take it.  It is a pretty awesome experience.

And the 1.2 billion people who squat because they don’t have a toilet surely can’t be wrong in doing what’s natural to them.  After all, the flush toilet was only invented in 1591 (6).

Just had to throw this last one in here.

Conclusion: Don’t Gamble With Your Health

In our previous lives as hunter gatherers, sitting was just not a possibility.  If you wanted to get somewhere, you walked (instead of driving or flying).  There was no television, computer, or books to read.  Writing happened on the cave walls and you ate picking berries or squatting over an animal after a kill.

Today, sitting is built into our lifestyles.

Babci followed her family wisdom, but fell victim to the current lifestyle, watching television whenever she wasn’t cleaning.

All that I ask of you with this information is to respect it.  Bring to your consciousness what sitting for too long, not exercising, eating lots of grains, dairy, and sugar, can do to your health and happiness.

Ignorance is not an bliss or an excuse because you’ve read this far.

The fact that so many people become diagnosed with cancer, diabetes, or heart disease and then make lifestyle changes proves that people really do want to live on Earth and enjoy their lives.

Don’t wait for the wake up call.

Please don’t gamble with your health.

When’s the last time you got up from where you are sitting right NOW?  

Give yourself a little break.  Doctor’s orders!

Dr. Christopher Stepien is a chiropractor, chronic pain specialist, and A.R.T. provider, and clinic director of the Barefoot Rehabilitation Clinic in Morristown, NJ.  He practices out of Crossfit Morristown.

References

(1)  Burton et al.  The association between sedentary leisure and physical activity in middle-aged adults. Br J Sports Med.  2 May 2011.

(2) Stamatakis, Emmanuel and Mark Hamer.  Sedentary behaviour: redefining its meaning and links to chronic disease. Br J of Hosp Med. 2011;72(4):192-195.

(3) Healy et al. Breaks in Sedentary Time. Diabetes Care. April 2008;31(4):661-6.

(4) Warren et al.  Sedentary Behaviors Increase Risk of Cardiovascular Disease Mortality in Men.   Med Sci Sports Exerc. 2010 May;42(5):879-85.

(5) Vlahos, James.  “Is Sitting a Lethal Activity?” 14 April 2011.  10 May 2011.

(6) Patti Neighmond.  “Sitting All Day: Worse For You Than You Might Think” 25 April 2011.  10 May 2011.

(7) Daniel Lametti.  “Don’t Just Sit There!” 26 Aug 2010.  10 May 2011.

(8) Booth et al.  Waging war on modern chr0nic diseases: primary prevention through exercise biology.  J Apply Physiol.  2010;88:774-787.

 

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{ 8 comments… read them below or add one }

Dan O'Neil July 19, 2011 at 4:12 am

Great info – if people can’t work out by themselves that moving about is good for you, this should nicely scare them into action!

I’ve recently started having enforced breaks every 25 minutes of my working day where I will deliberately stop what I am doing and get up and move about. It’s actually really good for productivity too, as well as your health! In the 5 minute breaks, I always come up with a great idea or can see what I’m doing from a new perspective and save myself loads of time.

Incidentally – your tweet button doesn’t add your twitter userid to the tweet!
Dan O’Neil recently posted..Build Work Profile Series – #2 Positioning

Dr. Christopher July 19, 2011 at 4:20 pm

Hi Dan,

Thank you for the comment. Sometimes we forget the whole picture of health. That’s why exercise, movement, diet, stress, community, and fun … not one piece can be removed.

It’s nice to hear you’re taking breaks and finding that it increases your productivity. Good for your business health, and good for your bodily health too.

Thanks for informing me of the tweet button too.

Chris

Kylee Brand March 13, 2012 at 6:38 pm

I am really glad I have been introduced to your articles through twitter. A lot of what you are saying and sharing is really resonating with me and inspiring me to keep going on the track I’m on at the moment.

I spent most of my life thus far working in industries where I was moving all day and generally the only opportunity I had to sit (if at all) was during my lunch break. I always thought that moving wasn’t as easy as it should be for me and every night I would be woken by lower back pain, but this would ease when I got up in the morning (I spent a lot of money on trying new mattresses!). About 6 years ago I got my first “office job” and I have been in agony ever since! The firm were great buying me a new, very expensive, ergonomic chair which I thought would solve the hip pain I had never had before but it didn’t help. Turns out my hip had been a problem all my life but my body had adapted to best cope with the problem, but once I started to sit all day my body just couldn’t cope anymore.

I tried various treatments suggested by the doctor (injections in SI joint, then injection to help with bursitis etc). When I expressed concern that I was having trouble losing weight (that I had gained from sitting all day, if I tried to do anything like power walking or jogging the resultant pain would be too much, I was told to take up swimming and avoid activity that impacted heavily on the hips. So I joined a gym with a pool and in the process met a trainer who did CrossFit. He took an interest in me and got me doing things I was advised not to do – all the exercises you mentioned above. I had no hope of squating when I started and 12 months on my squats still aren’t as deep as they should be but we are getting there. Simple daily tasks have become so much easier and whilst I am still in pain, I do have pain free days. With the help of an osteopath, my CrossFit coach and those simple exercises you mentioned sitting has become more bearable and progress is being made. Having a problem in this area has really highlighted for me that sitting is not what we are meant to do and I am totally at a loss to understand how people do this for their entire working lives!

Dr. Christopher March 13, 2012 at 8:43 pm

Kylee!!

I’m happy that you enjoy reading this material. It has changed my life, definitely changes the patients that I see, and my hope is that it continues to change the lives of others who cross upon it.

I’m grateful for that CF trainer who found you. I bet you are too? It’s funny, when I was training in Buffalo, NY, I wanted to teach an older woman how to squat, and the trainer who was above me told me she was too old to squat. I thought to myself, “How does this woman use the toilet?”

In your case, it sounds like you were a bit deconditioned (relative weakness) for much of your working age. So really, finding a good personal trainer would have been my first advice to you.

Continue to ask me if you need any help?

Kylee Brand March 14, 2012 at 1:47 am

Thank you, I will ask.

I consider it best thing to have happened for my physical health that I booked in to see a trainer that day. I wasn’t going to do it, but figured that seeing as the initial consultation was part of membership I thought “why not”. It’s a big gym, I could have got anyone!

He asked what I wanted and when I said less pain and more movement through the hips that was his green light to introduce me to CrossFit (which certainly wasn’t a feature of that gym, or encouraged). I admit, I did think he was mad when he said that I was going to squat but when he showed me how I was going to build up to a squat I had full confidence that I had finally found someone who really had my best interests at heart.

Luckily for a lot of people he left the “big gym” and opened his own CrossFit Affiliate. I never would have thought I would be doing things that I wasn’t even able to do as a child, but it’s all down to someone guiding me through those basic exercises you mention!

Dr. Christopher March 14, 2012 at 11:04 am

I love your story Kylee. Now make sure to share it with your friends. People say this Crossfit and Paleo stuff is a fad, but I see lives changed everyday. Share the love and happiness.

cholesterol and plantsterols May 25, 2012 at 4:13 am

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policosanolsideefects.net May 26, 2012 at 10:51 am

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