Movement at Work
The Implications of Sitting Less
Abundant research now shows that too much sitting is hazardous to our health. In 2011, the American Journal of Health Promotion published an analysis of multiple studies which concludes too much sitting, independent of structured, leisure-time physical activity, is associated with higher rates of all-cause and cardiovascular mortality, obesity, type 2 diabetes, and metabolic syndrome, as well as other negative health states. These studies find that low intensity standing and movement done intermittently throughout the day may be as important for disease prevention and optimization of health as is structured exercise. This presents new clarity on the likely health implications for individuals in sedentary occupations and the resulting impact on employers.
Dr. James Levine, the director of the Mayo Clinic-Arizona State University Obesity Solutions Initiative and inventor of the treadmill desk, contends that we lose two hours of life for every hour we sit and states, "Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting. We are sitting ourselves to death." A study published in the Archives of Internal Medicine found that adults who sat for 11 or more hours a day had a 40 percent increased risk of dying within the next 3 years from any cause compared with those who sat for less than 4 hours a day. In addition, the chances of dying were 15 percent higher for those who sat 8-11 hours a day, compared to those who sat less than 4 hours a day. A growing body of research continues to link the increased risk of poor health, disease and reduced longevity directly with prolonged sitting.
What is happening?
When people sit, slack muscles do not contract to effectively pump blood to the heart. Muscle contractions help to stimulate blood flow and remove toxins from the body via the lymphatic system, a complex filtering system in our bodies. Muscle contractions are important to help clear fat (triglycerides) and glucose from our bloodstream. Without proper muscle contraction, our pancreas can produce too much insulin, leading to higher risks of diabetes. Excess insulin could lead to increased risk of certain cancer cell growth. Blood can pool in the legs and affect the endothelial function of arteries or the ability of blood vessels to expand from increased blood flow. Our brain function slows without the added blood flow, oxygen and beneficial mood-enhancing chemicals that movement brings. Other hazards include the risk of developing deep-vein thrombosis, varicose veins and swollen ankles as fluid gathers in our lower legs while sitting. Higher cholesterol levels and greater waist circumference are linked to prolonged sitting, risk factors which can lead to cardiovascular and metabolic disease. Musculoskeletal disorders increase as the natural curves of the spine are compromised with poor sitting posture. Bones get softer when not bearing the full weight of the body, hip mobility reduces and our core musculature becomes weaker.
A study published in July by UT Southwestern Medical Center found that six hours of sitting counteracts the positive health benefits of one hour of exercise, suggesting that the negative effects of extended sitting cannot be countered by brief bouts of strenuous exercise. The solution doesn’t simply lie in hitting in the gym once a day.
What can we do?
What does the most current research recommend? Get up and move as much as possible! Simply breaking up bouts of sitting with moderate exercise or regular movement has a positive impact. This includes incorporating proper sitting posture, stretching, walking and other physical activity throughout a normal day. Unfortunately, the longer people sit at work, the more likely they are to sit outside of work as well, which further compounds the issue due to ongoing lack of physical inactivity.
A study published in 2012 by the American Diabetes Association found that breaking up prolonged sitting with light or moderate walking breaks reduced the blood pressure of a group of obese adults in a randomized trial. Researchers at Indiana University founds that the impaired blood flow in leg arteries can actually be reversed by breaking up your sitting regimen with an easy, even slow, five-minute walking break each hour. The Journal of Science and Medicine in Sport published a study in March which found that breaking up sitting with light activity improved blood sugar levels. It also found, however, that simply breaking up sitting with bouts of standing did not have the same impact. The UT Southwestern Medical Center study finds that when sitting for prolonged periods of time, movement is the key, and any movement is good movement, which means it is beneficial to shift positions frequently, stand and stretch in the middle of a thought, pace while on a phone call, or even fidget. The preventative cardiologists from this study recommend taking short walks during lunch and throughout the day, using a pedometer to track daily steps, taking the stairs instead of the elevator, hosting walking meetings at work, and replacing a standard desk chair with a fitness ball or even a treadmill desk, if possible.
Employers have a unique opportunity to positively affect the lives of their employees in the environment where they spend the majority of their day. This in turn positively affects productivity, presenteeism, injury rates and ultimately, the bottom line of the organization. A cultural shift which requires buy-in from leaders, management and supervisors, takes perseverance, but the long term benefits make it worth the effort. The following are recommended actions that can be implemented in the workplace.
* Provide education for your employees highlighting the importance of personal responsibility, including understanding and practicing proper sitting posture and incorporating regular intervals of movement, stretching and physical activity into their day.
* Provide ergonomic assessments to address current sitting environments. Consider installing sit/stand or standing desks with computer screens at eye level.
* Encourage employees to take 5-minute walking breaks once per hour.
* Provide tips to increase walking like parking your car farther away from your building if safe; using stairs not elevators; taking a long route to the restroom; taking walks after meals; walking over to a nearby co-worker instead of sending an email.
* Create walking paths from department to department or around the building.
* While computing, employees can set a timer on their computer or smart phone to remind them to stand up and stretch (use the current Savvy Health Solutions “Take Two” handout) every half hour.
* Consider providing a sounded reminder for employees once per hour.
* Self-monitoring devices like pedometers and FitBit wristlets can be helpful in keeping employees motivated to move and can be distributed as rewards during incentive campaigns.
* Encourage meeting policies across the board:
* Set meeting locations further away in the building.
* Hold “walking meetings” when possible.
* If meetings go for an hour or more, stand up and take a group stretch break (“Take Two”).