The sitting disease is real

Hours of excessive time in your chair can mess up your health. Here's what you should know about the sitting disease. 

By Jackie Middleton

The sitting disease is real
Photography by ©iStock.com/Elenathewise
For most Canadians, the average day is a blurred haze of work, commuting and relaxing at home. And most of that time is spent comfortably seated. Unfortunately, there are deadly health consequences associated with our fondness of sitting. Researchers have found our cosy respite brings diabetes, heart disease and early death – all due to an illness experts call sitting disease.
 
Sitting disease? Seriously?
Sure, have a laugh. Get the giggles out of your system. Sitting disease, as it's known, might sound wacky (or made up to snatch newspaper headlines), but it's a real concern. This relatively new health phenomenon has made its way into the spotlight and is here to stay. The term "sitting disease" is used by the scientific community to corral the host of life-threatening health woes that are proliferating in our society because of our penchant for a sedentary lifestyle. We've all heard the stories of bum-numbingly long flights on which air travellers were plagued with deep-vein thrombosis (a serious circulatory condition in which blood clots develop due to lack of movement in the legs), but sitting disease is something much more common and sinister. And we're all at risk – even if we don't know it.

According to Dr. Mark Tremblay, the director of Healthy Active Living and Obesity Research at the CHEO Research Institute in Ottawa, Canadian adults spend three-quarters of their waking hours each day sitting or reclining.

Think your kids have escaped the sitting trap? Think again. On average, Canadian children spend two-thirds of their daytime hours being sedentary. While their static lifestyles haven't quite caught up with those of their parents, these kids are on the path to becoming couch potatoes, and they're already falling victim to diabetes, heart problems and obesity. This fall, with students heading back to classrooms where they'll be seated for almost six hours a day, parents, teachers and education administrators should be making this problem a top priority.

Dr. Emma Wilmot, a clinical research fellow from England's University of Leicester, combed through 18 studies that looked at almost 800,000 participants. What she found was a frightening connection between a sedentary lifestyle and serious health outcomes. In fact, compared to people who sit minimally during the day, longtime sitters have a 112 percent increased risk of developing diabetes and a 147 percent increased risk of having a heart attack or stroke, coupled with a 90 percent chance of dying from such an event. In addition, longtime sitters have a 49 percent increased risk of dying prematurely.

Yes, sitting is deadly – especially when done for prolonged periods. The illnesses that sitting disease can unleash don't discriminate; they strike people without regard for age, sex, culture or income bracket. And, most surprisingly, gym aficionados aren't necessarily safe either.

Why sound the alarm now?

People have been sitting since the dawn of time, so if the recent hype over it has left you baffled, you're not alone. To better understand, turn back the clock a few years to when many researchers, physiologists and health experts were looking for an explanation for the worldwide obesity epidemic. Waistlines of the young and old were expanding at a frightful pace. By comparing the lifestyles of previous generations to our own, researchers made an eye-opening discovery: The rise of technology had altered our lives for the better – but also for the worse. "In the past, most people didn't sit at work," says Tremblay. "A hundred years ago, they may have had agricultural-based lifestyles, worked as tradespeople or did other tasks that involved standing and moving. Today, we drive when we would have walked or biked. We sit in front of a screen when we would have shovelled, nailed or carried. And all of our discretionary time is in front of a computer or television screen."

Think about it: In the era of your great-grandparents, most people toiled on their feet, not in an office, and moved regularly all day long. Sitting glued to a chair for nine, 10 or even 15 hours a day was unheard of. "The problem with today's society is that we're obsessed with labour-saving devices, anything that makes life easier," says Joseph Henson, a PhD student at the University of Leicester's Department of Cardiovascular Sciences. "As a result, people aren't moving as much and obesity levels have increased." Technology has made our day-to-day lives less physically demanding. We're moving less, sitting more and thereby making ourselves vulnerable to disease.

And here's the inside story

Hour upon hour spent planted on your tush means your body's tissues, organs and metabolism aren't engaged. The longer you sit, the less efficient your body's systems become. Eventually, they start to stumble. "The metabolism of fats and glucose gets disrupted, and you're not burning many calories," says Tremblay. "Your heart, lungs and muscles go into hibernation mode and they atrophy. Over time, they decay." Your leg muscles, which are the largest muscle mass in your body, aren't stimulated while sitting, "so you're effectively shutting down large parts of your active tissue," says Peter Katzmarzyk, an epidemiology professor and associate executive director for Population Science at the Pennington Biomedical Research Center in Baton Rouge, Louisiana. Prolonged sitting turns an efficient body into a sluggish mass of unhealthy organs.

But if sitting slows internal processes to a crawl, how does disease gain a foothold? Katzmarzyk says studies linking excessive sitting with negative health consequences commenced only a few years ago, so researchers are still trying to work out how inactivity causes disease. In that time, however, a clearer picture has developed of the toll that sitting takes on the body, and the way it corrupts normal processes. For example, when a healthy person eats a meal, the pancreas releases insulin into the bloodstream to help the muscles absorb glucose from the food. Routine physical exertion, such as standing or walking, aids in this absorption process and prompts the muscles to burn glucose and refill their stores.

If you're sitting around for most of the day, metabolic activity stalls. Insulin isn't used effectively and, instead of being absorbed by your body, glucose builds up in your blood. Cholesterol levels increase as well. "We think that these metabolic changes are what's linked to the increased risk of disease over the long term," says Katzmarzyk. Eventually, you'll become a candidate for insulin resistance (also known as metabolic syndrome), type 2 diabetes and other frightening problems including heart attacks or strokes. "Diabetes is a major risk factor for heart disease," says Wilmot. "If you have factors that put you at risk for diabetes, they also increase your risk for cardiovascular disease. It's all related."

Inflammation, obesity and, particularly, increased weight gain around your middle are other possible consequences. Deep-vein thrombosis, once solely the scourge of long-distance jet-setters, is now plaguing people on the ground as well. While these blood clots aren't life-threatening when they're located in the legs, if they start travelling up toward the lungs, they can cause life-threatening pulmonary embolisms. And if the metabolic symptoms and diseases haven't scared you out of your chair yet, you should also know that a sedentary lifestyle creates poor posture, curvature of the spine and painful protruding discs in the neck and back. Sitting is anything but pretty.

Is Regular exercise enough?
Surprisingly, meeting Canada's physical activity guidelines doesn't appear to erase the health risks associated with prolonged sitting. Henson's studies have found that the amount of time people spend sitting each day has a bigger impact on their health than the amount of exercise they get each day. "Sitting has such a detrimental effect on health," says Henson. "Even if you reach the exercise recommendations for good health, if you spend the rest of your time sitting down, it effectively undoes the good work you've done with exercise. We found that the longer people spent sitting, the worse their blood sugar and cholesterol levels became, regardless of how much exercise they did. The amount of time sitting had the strongest impact on these variables, not the amount of exercise."

Despite all of these findings, Henson stresses that you shouldn't abandon your daily workouts; they're still a key component in maintaining a healthy lifestyle. Katzmarzyk agrees. While exercise might not reduce the risks of sitting disease, "there's clear evidence that it's important [for good health]," he says. And fortunately, it's during those nonsitting hours that you can make positive changes to your health  and lower your risk for sitting disease.

No-brainer ways to lower your risks
Reducing your risk for sitting disease is pretty easy. There is no gym membership or expensive workout gear required. The answer is to "look for opportunities to reduce and frequently break up your sitting time," says David Dunstan, head of the physical activity laboratory at the Baker IDI Heart and Diabetes Institute in Melbourne, Australia. "Stand up, sit less, move more, more often," he says. People who interrupt long sitting spells have better health than those who remain seated for prolonged periods of time. It may sound uncomplicated, but the answer really is that simple, regardless of whether you're a bus driver, waitress, student or executive assistant. "The same guidelines that you follow on the airplane – fidget, move, stand, go to the bathroom more often – should be applied across your life," adds Mark Tremblay, from the CHEO Research Institute in Ottawa. "The more variety, the better. Don't stand for too long; don't sit for too long. Sitting, standing and walking in various combinations for various lengths of time keeps your skeleton, muscles and organs healthy."

You may not have known that standing up every time you answer a phone call is good for you, but that simple movement can help combat sitting disease. You can also stand up and walk around during meetings at work or take a stroll to pick up documents from a printer located farther from your desk. Incorporating these kinds of basic movements into your day can drastically reduce your risk. "The more you move, the better your health will be," says Henson. "It's quite simple. The more people get up, the slimmer they become," he says. So take a shower instead of a bath. Purchase standing-room tickets for your next concert or sporting event. Play pool or darts while hanging out at your favourite bar. Walk around stores instead of shopping online. Drink more water so you have to walk to the bathroom more often. Do your dishes by hand. When watching TV, stand up or do squats or lunges during commercials. Instead of taking your family to a movie, try bowling, mini-golf or indoor rock climbing. Walk your kids to school. Get the whole family involved in making beds, housecleaning and yard work. Every bit of movement helps.

Of course, it's only natural to wonder: How long can I sit without consequence anyway? Save yourself the trouble and don't go looking for guidelines. Sitting disease is a relatively new area of study, and science has yet to discover how much sitting is too much. For now, the experts suggest that you be more mindful of extended sedentary periods and proactively increase your movements. "It's like sun exposure," says Katzmarzyk. "We don't have guidelines that say we should only go out in the sun for 10 minutes a day. We say that you should limit your sun exposure and wear sunscreen. It can't be prescribed down to the minute. That's where we are in this field." In other words, move as if your life depended on it.


Want more information? Find out if sitting for too long is really killing you. Here are four exercises you can do at work to keep yourself moving throughout the day.


This story was originally titled "Rise up" in the September 2013 issue.

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