For many people,
work means hours and hours of sitting, with rare pauses
for a walk around the block or even down the hall. While
it’s easy to dismiss this as a routine part of adult
life, it is becoming a growing concern among researchers.
Studies suggest that spending hours in a chair can cause
all kinds of damage to your body, and even shorten your
lifespan.
Last year the
Annals of Internal Medicine published a study of 8,000 adults
that showed an association between prolonged sitting and
a risk of early death from any cause. (People who sat for
no more than 30 minutes at a time had the lowest risk in
that study.) Other research has linked prolonged sitting
or other sedentary behavior to diabetes, poor heart health,
weight gain, depression, dementia, and multiple cancers.
It's a habit
that seems to start early. One of the most recent studies,
published in JAMA, found that in more than 51,000 Americans
surveyed, the amount of time spent sitting increased in
a range of age groups by about an hour a day between 2007
and 2016, and that included a notable rise among adolescents.
“Prolonged
sitting is one of the main causes for many of the conditions
treated in my musculoskeletal clinic. It often results in
office visits with other types of doctors as well,”
says Eric K. Holder, MD, a Yale Medicine physiatrist (a
physician who specializes in the nonsurgical care of patients
with musculoskeletal issues). “It is so ingrained
in our society now—people are stationed at desks,
seated in front of computers or the TV for extended periods,
constantly traveling in cars, trains, and on planes. It’s
a major health problem that can lead to many chronic diseases.”
We asked five
Yale Medicine specialists how prolonged sitting could be
affecting your health and what you can do about it.
VASCULAR PROBLEMS
If your lower
legs and feet get tired, swollen, and achy, you could be
experiencing blood and fluid pooling in those areas after
a long period of sitting, says Britt H. Tonnessen, MD, a
vascular surgeon. In the worst cases, you can develop deep
vein thrombosis (DVT). This is when a blood clot forms in
a deep leg vein, which is dangerous because it can travel
to the lung. “Blood clots tend to originate for three
reasons,” Dr. Tonnessen says. A blood disorder can
make a person prone to clotting, while an injury or related
trauma may also raise risk for DVT. But the third reason
– the one over which we all have control—is
stasis, being still or sedentary. Women who are pregnant
or taking birth control, elderly people, and people who
smoke are at especially high risk, says Dr. Tonnessen. “Not
exercising or moving around on occasion can lead to a more
extensive blood clot.”
Dr. Tonnessen’s
advice: “Take steps now. First, tell your doctor if
you have risk factors for blood clots, especially if an
immediate family member has had a clot in the legs or lungs
at a young age, so you’ll better understand your risk.
Then, whether you have a family history or not, move around
every 30 minutes or hour to pump the blood out of your calf
muscles. Take a short walk. Do something, anything.”
Another suggestion:
“Try wearing elasticized compression stockings [15
to 20 or even 20 to 30 mm Hg]. Medical professionals often
wear these; they stretch from foot to knee and can help,
especially if you are experiencing leg aches, swelling,
or restless legs. These stockings are comfortable and take
away that tired feeling and achiness.”
Prolonged sitting
puts significant stress on spinal structures as well as
other joints, such as the shoulders and hips, especially
when sitting with poor posture, says Dr. Holder. “When
we sit at our computers, we often slouch, craning our necks
forward which, over time, can lead to persistent postural
misalignment. Sitting can also lead to overall deconditioning,
early muscle fatigue, weakened core stabilizers, and tightening
of the hip flexors, resulting in increased stress on your
low back and reduced spine flexibility. It also affects
the gluteal buttock muscles over time, leading to deactivation
and weakening of these muscles,” he says. Sometimes
this is referred to as gluteal amnesia, which can lead to
low back pain and hip pain. He also notes that inactivity
and prolonged sitting can lead to weakening of the bones
(osteoporosis). The government’s recommendation of
at least 150 minutes a week of moderate aerobic activity
for people ages 18 to 64 can help, says Dr. Holder, but
it may not be enough as prolonged sitting can negate all
of that exercise. “It is important to move frequently
throughout your day to counteract the negative effects of
sitting.”
Dr. Holder’s
advice: “Take stock of your office workstation. Make
sure you have an ideal ergonomic setup. A sit-to-stand desk
is a great option to decrease your sit time. If a standing
desk is not available, you can move your laptop or desktop
computer to a high counter. When sitting, consider using
a lumbar roll (or a rolled-up towel) placed at the small
of your back, between your back and the chair to improve
alignment. For the more adventurous, consider a treadmill
desk.”
More advice:
“If a standing desk is not an option, I usually recommend
getting up every 30 minutes or so to move and stretch. Instead
of sending an email to your co-worker down the hall, discuss
the issue with them in person. Use a smaller water bottle
that requires you to walk to the cooler to fill it more
frequently throughout the day. A pedometer to monitor your
steps is also a great way to keep track of your activity,
especially if you share step counts with friends or co-workers
to keep each other motivated. If you’re watching TV
at home, take standing, walking, and stretching breaks during
commercials. I am a fan of any healthy motivational tool
to keep you up and moving throughout the day—movement
is medicine.”
It’s clear
that sitting—like a lack of physical activity in general—is
a contributing factor in many cases of cardiovascular disease,
which is the leading cause of death in both men and women,
says cardiologist Rachel Lampert, MD. “The body has
all kinds of negative reactions to sitting for long periods,”
she says. “In addition to decreasing the blood flow
to the legs, sitting impacts things like sugar regulation
and blood pressure—by altering the normal function
of blood vessels, it feeds into diabetes and heart attacks.
We know that the more you sit, the more likely you are to
have a heart attack or die from a cardiac cause,”
says Dr. Lampert. “It’s an independent contributor,
along with how much physical activity you are getting.”
Other considerations in heart health are body mass index
and waist circumference—in both cases the numbers
will go up the longer you sit.
Dr. Lampert’s
advice: “There is no exact formula for how often you
should stand up from your desk. But it makes sense to increase
the amount of time you are active, whatever you’re
doing. Even a short walk every hour is helpful. Many people
track their habits and increase their activity once they
have clear evidence of their sedentary behavior, too. Anyone
can use a step-counting device such as a Fitbit or a mobile
device reminder app [free and low-cost ones are available].”
WEIGHT GAIN
AND OBESITY
Some studies
show an association between prolonged sitting and weight
gain—and an especially strong link with diabetes,
says Wajahat Mehal, MD, director of the Yale Medicine Metabolic
Health & Weight Loss Program. This makes sense, he adds.
“If you go back 100 years, movement was a constant
part of our lives. If you wanted water, you’d have
to go out to the well. If you wanted to talk to a neighbor,
you’d walk next door.” Today, people eat at
their desks or in front of a TV set, where they are distracted
while eating their food. This puts them at risk for eating
larger portions, and portion control is key to keeping weight
down, he says.
Dr. Mehal’s
advice: “Give your food undivided attention. Don’t
eat your lunch at the same time you are browsing online,
reading the news, or watching YouTube. When we do that,
we have the meal, but it doesn’t fully register, because
our mind is distracted.”
Another bit
of advice: “Have varied types of physical activity.
Some get too focused on super-vigorous cardiovascular exercise.
This is fine, but it is a mistake to think that unless you’re
working out like an Olympic athlete, it doesn’t count.
The truth is that a comfortable 15- or 20-minute walk accomplishes
a lot when done regularly.”
CANCER
Sitting at work
and a sedentary lifestyle, in general, both appear to be
independent contributors to cancer, just like eating too
much red meat or smoking, says Xavier Llor, MD, PhD, co-director
of the Smilow Cancer Genetics & Prevention Program and
medical director of the Colorectal Cancer Prevention Program.
“What we need is a general culture change,”
he says.
Dr. Llor’s
advice: “Do as much of your job standing as possible
and move as much as you can beyond that. Extra weight is
a cancer risk and standing burns twice the number of calories
as sitting. It’s definitely challenging. We all have
jobs to do and many people don’t have that much time.
So, do as much as you can. The key is to foster and promote
a healthy lifestyle in general. This includes regular physical
exercise, not smoking, minimizing alcohol and meat, and
eating enough fruits and vegetables.”
This article was
originally published at www.yalemedicine.org/news/sitting-health-risks.
