Is Prolonged Sitting Worse than Smoking?

It is not that often that reading research makes me immediately change what I do at work and home, but it happened to me over five years ago. This article is a must-read for everyone.

Sitting has become a standard and seemingly harmless part of daily life in a world increasingly dominated by desk jobs and digital entertainment. However, emerging research, including insights from Dr. James Levine’s book Get Up!: Why Your Chair Is Killing You and What You Can Do About It, reveals a startling truth: prolonged sitting is a significant health hazard comparable to smoking.

This article uncovers the harmful effects of prolonged sitting and underscores the importance of rethinking sedentary lifestyles.

The Scope of the Problem

The average person in a modern, urban setting spends a substantial portion of their day seated—from working at a desk to commuting and unwinding in front of the television. Studies show that people in farm communities sit for about three hours daily, whereas the average American office worker might sit for thirteen to fifteen hours. This drastic contrast highlights a lifestyle shift that has profound health implications.

Sitting for extended periods, particularly over eight hours a day, has been linked with a staggering:

  • 112% increased relative risk of diabetes
  • 147% increased relative risk of cardiovascular events
  • 50% jump in all-cause mortality

Health Risks of Chronic Sitting

1. Chronic Diseases and Premature Death

Prolonged sitting actively promotes numerous chronic conditions, notably obesity and type 2 diabetes. These risks persist even for those who are otherwise physically active and fit. Alarmingly, the mortality rate associated with chronic sitting is comparable to that of smoking, positioning it as a significant public health issue.

2. The “Active Couch Potato Syndrome”

An intriguing phenomenon linked to prolonged sitting is the “active couch potato syndrome.” Here, individuals who meet the recommended physical activity guidelines but spend considerable time sitting (especially watching TV) still face elevated risks. These conditions include abnormal glucose metabolism, high waist circumference, elevated blood pressure, and increased glucose levels, irrespective of their exercise habits.

A critical revelation from recent studies is that regular exercise, while beneficial, cannot fully counteract the effects of prolonged sitting. This revelation challenges the common belief that a good workout can undo the harms of a sedentary day. Instead, it points to the need for a more comprehensive approach to lifestyle changes, emphasizing both regular physical activity and reduced sitting time.

A 2015 study highlighted a stark contrast: individuals who exercised frequently but also engaged in minimal sedentary activities had a significantly lower risk of premature death compared to those who exercised less and sat more. The latter group faced an almost eightfold increase in the risk of early mortality.

The evidence is clear: prolonged sitting is a foundational contributor to chronic health problems and premature death. The solution lies not only in meeting physical activity guidelines but also in breaking up sedentary time. Simple changes like standing while working, taking frequent breaks from sitting, and reducing TV time can profoundly impact our overall health.

3. Metabolic Health Compromises

Sitting for extended periods leads to physiological changes detrimental to health. It suppresses skeletal muscle lipoprotein lipase activity, which is crucial for triglyceride uptake and HDL cholesterol production, and reduces glucose uptake. These changes contribute to poor metabolic health, even in physically active individuals.

Contrary to sitting, standing is not a sedentary behavior. Research indicates that standing can help protect against many ailments that prolonged sitting exacerbates. This protection includes vital glucose metabolism and reduced risk of developing metabolic syndrome. Metabolic syndrome, or syndrome X, encompasses high blood pressure, high blood sugar, excess body fat around the waist, abnormal cholesterol levels, increased risk for heart attack, and potential stroke.

The Synergistic Effect of Exercise and Movement

It is not just about the exercise bouts but the continual movement that contributes most significantly to health. A systematic review examining 47 studies on sedentary behavior supports this assessment. The findings were unequivocal: the time spent sitting each day has detrimental effects that surpass the positive impacts of exercise.

The Heightened Risks of Excessive Sitting for Women

A study featured in the Mayo Clinic Proceedings explored the relationship between standing, obesity, and metabolic syndrome, considering both the presence and absence of exercise. The findings revealed a gender-specific impact of prolonged sitting. For men, increased standing time correlated with a lower likelihood of high body fat percentage, but it showed no significant association with metabolic syndrome. In contrast, for women, standing for half of the day not only decreased the risk of obesity but also led to a 41% reduced risk of metabolic syndrome.

Remarkably, women who stood for at least three-quarters of the day saw a 53% decrease in the odds of developing metabolic syndrome. Additional studies have echoed these findings, suggesting a more significant risk associated with sitting for women.

The Underlying Reasons for the Harmful Effects of Sitting

The reason prolonged sitting adversely affects health and facilitates disease is grounded in the molecular responses initiated by standing. Muscular and cellular systems responsible for processing blood sugar, triglycerides, and cholesterol—regulated by insulin—are activated by simply carrying your body weight on your legs. As elaborated in Dr. Levine’s book Get Up!, these molecular mechanisms are triggered within 90 seconds of transitioning from sitting to standing.

These systems play a crucial role in channeling nutrients into cells. Regularly activating these mechanisms through standing and movement significantly reduces the risk of diabetes and obesity. At the molecular level, the human body is designed for constant activity and movement. Extended periods of inactivity signal the body to enter a shutdown mode, akin to preparing for death.

Prolonged Sitting and Fatigue in the Workplace

If you often feel drained after a day at the office, excessive sitting might be a contributing factor. A 2017 study published in the Journal of Lifestyle Medicine, involving 447 office workers, sheds light on this connection:

The study found that participants typically spent 6.29 hours of an 8-hour workday seated. Notably:

  • 48.8% reported discomfort with their workstations.
  • 73.6% experienced exhaustion during their workday.
  • 53.5% complained of neck pain.
  • 53.2% suffered from lower back problems.
  • 51.6% developed shoulder issues

The study’s findings indicate a clear association between lengthy sitting periods and various adverse outcomes. These include increased feelings of exhaustion during the workday, diminished job satisfaction, hypertension, and musculoskeletal disorders affecting the shoulders, lower back, thighs, and knees.

This research underscores the importance of addressing the sedentary nature of office work and its potential impact on employee health and productivity.

Rest and Activity: Striking the Right Balance

While rest is necessary, it should be a brief interlude in a day filled with activity, not the dominant state. Sitting, especially in chairs, is an unnatural posture that adversely affects the back and metabolism.

The remedy to counteract the harmful effects of sitting is straightforward: incorporate more movement into daily life. A standing desk can be a beneficial investment for those with desk jobs. Dr. Levine suggests standing for at least ten minutes every hour as a starting point. Sitting for a full hour is already too long. Ideally, sitting should be limited to three hours daily, with frequent breaks for movement and standing.

To mitigate the harmful effects of prolonged sitting, researchers recommend several strategies:

1. Monitor and Reduce Sitting Time: Keep track of your daily sitting duration and progressively decrease it week by week. An effortless way to do this is with an Apple watch. Over the last week, I averaged 14 hours per day standing.

2. Adopt a Standing Desk: Use a standing desk at work to reduce sitting time. You can alternate working from a high counter. Be sure your computer or workstation is at eye level.

3. Stay Active While Watching TV: During commercial breaks, make it a point to stand up, walk around, or engage in periodic physical activity.

The dangers of prolonged sitting are a wake-up call to rethink sedentary lifestyles. It is not just about adding more exercise to routines; it is about integrating movement throughout the day and recognizing the profound impact that seemingly benign habits like sitting can have on long-term health. As we become more aware of these risks, adopting a more dynamic lifestyle for well-being is crucial.

For your health

Dr. Pat

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Dr. Pat Luse

I'm the president and CEO of one of the largest multi-disciplinary clinics in the Midwest. As one of the most highly trained health coaches in America today, I am uniquely qualified to help individuals have amazing health transformations and I can't wait to help you!


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