sitting

Posted on Cardiovascular disease, Exercise

Sitting down too long can harm heart health, even for active people

Approximately 10 hours or more of sedentary behavior per day is associated with heightened risk of heart failure and cardiovascular death, even in those who regularly exercise
Spending ten or more hours per day in sedentary behaviour is linked to an increased risk of heart failure and cardiovascular death, even in individuals who exercise regularly.

A study published in JACC, the flagship journal of the American College of Cardiology, and presented at the American Heart Association’s Scientific Sessions 2024, indicates that spending more time sitting, reclining, or lying down during the day may increase the risk of cardiovascular disease (CVD) and death. Specifically, the study found that engaging in more than roughly 10 and a half hours of sedentary behaviour per day is significantly associated with an increased risk of future heart failure (HF) and cardiovascular (CV) death, even among individuals who meet the recommended levels of physical activity.

“Our research indicates that reducing sedentary time can lower the risk of cardiovascular issues. We found that spending 10.6 hours a day in sedentary activities may be a critical threshold associated with an increased risk of heart failure and cardiovascular mortality,” said Dr. Shaan Khurshid, a cardiologist at Massachusetts General Hospital and co-senior author of the study. “Excessive sitting or lying down can be detrimental to heart health, even for otherwise active individuals.”

Insufficient exercise is a well-recognized risk factor for cardiovascular disease (CVD). Current guidelines recommend 150 minutes of moderate-to-vigorous physical activity each week to support heart health. However, experts note that exercise constitutes only a small part of our daily activity. Additionally, the guidelines do not address sedentary behaviour, which is a much larger portion of our daily routines. This is noteworthy because evidence shows that sedentary behaviour is directly linked to an increased risk of CVD.

This study analyzed the levels of sedentary time linked to the greatest cardiovascular disease (CVD) risk and investigated how sedentary behavior and physical activity combined influence the likelihood of atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), and cardiovascular mortality.

The average age of the 89,530 study participants in the UK biobank was 62, and 56.4% were women. Participants submitted data from a wrist-worn triaxial accelerometer that captured movement over seven days. The average sedentary time per day was 9.4 hours.

After an average follow-up of eight years, 3,638 individuals (4.9%) developed incident AF, 1,854 (2.1%) developed incident HF, 1,610 (1.84%) developed indecent MI and 846 (0.94%) died of CV causes, respectively.

The effects of sedentary time varied by outcome. For AF and MI, the risk increased steadily over time without major shifts. For HF and CV mortality, the increase in risk was minimal until sedentary time exceeded about 10.6 hours a day, at which point risk rose significantly, showing a “threshold” effect for the behaviour.

For study participants who met the recommended 150 minutes of moderate-to-vigorous physical activity or more, the effects of sedentary behaviour on AF and MI risks were substantially reduced, but effects on the higher risk of HF and CV mortality remained prominent.

“Future guidelines and public health efforts should stress the importance of cutting down on sedentary time,” Khurshid said. “Avoiding more than 10.6 hours per day may be a realistic minimal target for better heart health.”

In an accompanying editorial comment, Charles Eaton, MD, MS, Director of the Brown University Department of Family Medicine, said the use of wearable accelerometers has shown that self-reporting significantly overestimates exercise and underestimates sedentary behavior.

Eaton said that replacing just 30 minutes of excessive sitting time each day with any type of physical activity can lower heart health risks. Adding moderate-to-vigorous activity cut the risk of HF by 15% and CV mortality by 10%, and even light activity reduced HF risk by 6% and CV mortality by 9%.

Posted on Cardiovascular disease, Exercise

Prolonged sitting can sabotage health, even if you’re young and active

Millennials sit more than 60 hour per week, fueling heart disease risk and accelerating aging
Millennials sit more than 60 hours per week, fueling heart disease risk and accelerating ageing.

Recent research from CU Boulder and the University of California, Riverside, reveals that millennials are spending over 60 hours a week sitting due to long commutes, back-to-back Zoom meetings, and evenings spent streaming and scrolling through social media. This sedentary lifestyle could increase their risk of heart disease and accelerate other signs of ageing.

The study of over 1,000 individuals from Colorado, including 730 twins, is one of the first to investigate how prolonged sitting affects health metrics such as cholesterol levels and body mass index (BMI) in young adults.

Research shows that simply meeting the minimum physical activity guidelines—approximately 20 minutes of moderate exercise each day—is insufficient to offset the risks associated with spending most of our waking hours sitting.

“Our research indicates that reducing the sitting time during the day, engaging in more vigorous exercise, or implementing a combination of both may be essential for lowering the risk of premature ageing in early adulthood,” stated the study’s senior author, Chandra Reynolds, a professor in the Department of Psychology and Neuroscience as well as the Institute for Behavioral Genetics.

After the COVID pandemic, Bruellman noticed that he and others his age were sitting more. He set out to learn more about the consequences.

“Young adults often believe they are immune to the effects of aging. They think, ‘My metabolism is excellent, so I don’t need to worry until I reach my 50s or 60s,’” said Bruellman. “However, what you do during this crucial stage of life is important.”

A walk after work isn’t enough.

The authors analyzed data from participants aged 28 to 49, with an average age of 33, from CU’s Colorado Adoption/Twin Study of Lifespan Behavioural Development and Cognitive Ageing (CATSLife), which has followed twins and adopted individuals since Childhood.

Participants reported sitting almost 9 hours daily, with some sitting as much as 16 hours. On average, they reported between 80 and 160 minutes of moderate physical activity weekly and less than 135 minutes of vigorous exercise weekly. The authors note that these results are likely better than national averages due to Colorado’s active lifestyle.

The researchers looked at two key heart and metabolic ageing measures: total cholesterol/high-density lipoprotein and body mass index (BMI). The study found that the more one sat, the older one looked. Adding a little moderate activity on top of a long day of sitting did little to buffer these impacts.

Young adults who sat 8.5 hours per day and performed at or below current exercise recommendations could enter a “moderate to high risk” category for cardiovascular and metabolic disease, the authors said.

“Taking a quick walk after work may not be enough,” said Reynolds. “While this is increasingly apparent with age, we show that associations are already emerging in early adulthood.”

Adding vigorous activity did have a buffering effect.

For instance, those who exercised vigorously (think running or cycling) for 30 minutes daily had cholesterol and BMI measures that looked like those of individuals five to 10 years younger who sat as much as they did but didn’t exercise.

However, even vigorous activity could not fully buffer the negative impacts of prolonged sitting, the study concluded.

Same genes, different lifestyles

Identical twins are handy to study because they share 100% of their genes, making it easier to rule out genetic factors that might contribute to different health outcomes and zero in on lifestyle differences.

When looking at a subset of twins with different sitting and physical activity habits, the researchers found that replacing sitting with exercise seemed to improve cholesterol better than simply adding exercise to a full day of sitting.

The bottom line, the researchers said, is to try to do both.

To reduce sitting time at work, use a standing desk, take breaks, and organize walking meetings. If possible, do something that gets you out of breath for at least 30 minutes per day, or be a “weekend warrior” and get in longer, vigorous workouts when you can, said Bruellman.

He hopes the study will prompt policymakers to revisit physical activity guidelines and specify how much sitting is too much.

Meanwhile, Reynolds encourages young adults to take steps now that could shape their future:

“This is the time to build habits that will benefit health over the long term.”

Posted on Pain Management

Reducing daily sitting may prevent back pain

Walkable neighborhoods may pave way to less cardiovascular risk
A new study from the University of Turku in Finland showed that reducing daily sitting prevented back pain from worsening over six months. The result strengthens the current understanding of the link between activity and back pain and the mechanisms related to back pain.

The study from the Turku PET Centre and UKK Institute in Finland looked into whether reducing daily sitting could help prevent or relieve back pain in overweight or obese adults who spend most of their day sitting. The participants were able to reduce their sitting time by an average of 40 minutes per day over the six-month study period.“Our participants were quite normal middle-aged adults, who sat a great deal, exercised little, and had gained some extra weight. These factors increase the risk for cardiovascular disease and back pain,” says Doctoral Researcher and Physiotherapist Jooa Norha from the University of Turku in Finland.
Previous results from the same and other research groups have suggested that sitting may be detrimental to back health, but the data has been preliminary.

Robust methods for studying the mechanisms behind back pain
The researchers also examined potential mechanisms behind the prevention of back pain.
”However, we did not observe that the changes in back pain were related to changes in the fattiness or glucose metabolism of the back muscles,” Norha says.
Individuals with back pain have excessive fat deposits within the back muscles, and impaired glucose metabolism or insulin sensitivity can predispose to pain. Nevertheless, back pain can be prevented or relieved even if no improvements in muscle composition or metabolism occur. The researchers measured the back muscles using magnetic resonance imaging (MRI) and PET imaging based on a radioactive tracer.
“If you have a tendency for back pain or excessive sitting and are concerned for your back health, you can try to figure out ways to reduce sitting at work or during leisure time. However, it is important to note that physical activity, such as walking or more brisk exercise, is better than simply standing up,” Norha points out.
The researchers wish to remind us that switching between postures is more important than seeking the perfect posture.
Posted on Weight Loss

Weight-loss maintainers sit less than weight-stable people with obesity

Weight-loss maintainers sit less than weight-stable people with obesity
Weight-loss maintainers sit less than weight-stable people with obesity

People who are successful at weight-loss maintenance spend less time sitting during the week and weekends compared to weight-stable individuals with obesity, according to a paper published online in Obesity, The Obesity Society’s flagship journal. This is the first study to examine time spent in various sitting activities among weight-loss maintainers.

Prior findings from 2006 in the National Weight Control Registry indicated that weight-loss maintainers watched significantly less television than controls, but other sitting activities were not examined. In the current study, weight-loss maintainers did not significantly differ from controls in reported weekly sitting time spent watching television, but did differ in time spent in non-work-related time using a computer or video game.

Differences between the current study and National Weight Control Registry findings could reflect changes over the past 15 years in available electronic devices, including the rise in availability of computers and video games. Weight-loss maintainers and controls also did not appreciably differ in time spent sitting while reading or studying, traveling; or talking, texting and socializing. These could be considered more mentally active forms of sedentary behavior.

“The findings hopefully will prompt future weight maintenance intervention research testing the effects of and optimal approaches for reducing sedentary behavior, including non-work-related computer and video game usage. Future research should include objective measures of sedentary behavior and activity,” said Suzanne Phelan, Department of Kinesiology and Public Health and The Center for Health Research, California Polytechnic State University, in San Luis Obispo. Phelan is the corresponding author of the study.

Participants in the study included 4,305 weight-loss maintainers from WW (formerly Weight Watchers) who had maintained >9.1 kg of weight loss (24.7 kg on average) for 3.3 years and had an average current BMI of 27.6 kg/m2. The group of weight-stable individuals with obesity had an average BMI of 38.9 kg/m2. To gather data, the Multicontext Sitting Time and Paffenbarger physical activity questionnaires were administered.

Results revealed that weight-loss maintainers versus weight-stable individuals with obesity spent three hours less per day sitting during the week (10.9 versus 13.9) and weekends (9.7 versus 12.6). Weight-loss maintainers compared with controls also spent one hour less per day in non-work-related sitting using a computer or playing a video game during the week (1.4 versus 2.3) and weekends (1.5 versus 2.5). There were no meaningful differences between weight-loss maintainers and weight-stable individuals with obesity in the number of television sets and sedentary-promoting devices in the home (15.8 versus 14.8). Weight-loss maintainers expended significantly more calories per week in physical activity (1,835 versus 785).

“These findings are important for understanding behaviors that may enhance weight loss maintenance, and one of those may be to reduce sitting time and other modes of sedentary behavior. However, this study also showed that physical activity was associated with improved weight-loss maintenance. Thus, this study does not imply that simply standing more rather than sitting will contribute to weight-loss maintenance, but may suggest that less sitting that results in more movement is what is key to weight loss maintenance. Hence, sit less and move more,” said John M. Jakicic, PhD, FACSM, FTOS, Distinguished Professor, and Director of the Healthy Lifestyle Institute and the Physical Activity and Weight Management Research Center at the University of Pittsburgh in Pennsylvania. Jakicic was not associated with the research.

Other authors of the study include James Roake, Noemi Alarcon and Sarah Keadle of the Department of Kinesiology and Public Health and The Center for Health Research, California Polytechnic State University, in San Luis Obispo. Chad Rethorst of Texas A&M Agrilife in Dallas, Texas and Gary Foster of WW International, Inc. of New York and the Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, in Philadelphia also co-authored the study.

Posted on Patient Talk

What are the dangers of sitting still?

It’s been proven: excessive sitting is a lethal activity. That was according to Dr. James Levine, professor of medicine at Mayo Clinic. And it’s not just him — results from various studies keep on coming and they’re all pointing to your chair/couch as the culprit for bad health. Apparently, one of the most terrible things we can do everyday is to sit still, which I imagine is what most of you are actually doing right about now.

From Visually.