Counteracting sitting too much

I spend most of my day sitting. Indeed, many people spend prolonged periods of time sitting at a desk for their job or sitting on a couch at home. Studies indicate the average American may sit up to 9.5 hours daily (NYTimes), with adverse effects on cardiovascular health, metabolism, and mental health. Prolonged sitting, i.e. sedentary activity, can be defined as sitting for 8 to 12 hours or more a day. In a previous post, I described a meta-analysis of 47 studies which showed a 24% increase in all-cause mortality for those who sat for long periods of time. This increase was observed for both cardiovascular disease mortality (18% increase) and cancer mortality (17% increase).

In summary, key health risks associated with prolonged sitting include (Figure 1):

• Increased Risk of Cardiovascular Disease: Long periods of inactivity can slow circulation and promote obesity, potentially leading to high blood pressure, elevated cholesterol, and even heart disease. Studies have shown that sitting for extended hours is associated with an increased risk of heart attacks and strokes.
• Obesity and Metabolic Issues: Sitting limits the number of calories burned, which can contribute to weight gain and obesity. It’s also linked to metabolic issues like insulin resistance, which increases the risk of type 2 diabetes.
• Weakened Muscles and Poor Posture: Sitting too much weakens the muscles, particularly in the legs and glutes. These muscles support stability and movement, so a lack of strength can contribute to injuries. Prolonged sitting can also lead to poor posture, which can cause neck, shoulder, and back pain.
• Decreased Mental Health and Increased Risk of Depression and Anxiety: Extended sitting, especially when paired with isolation or screen use, has been associated with higher rates of depression and anxiety. Physical activity releases endorphins and improves mood, so sitting for long hours without breaks can impact mental well-being.

Other sitting-induced health issues include blood clots from poor circulation, increased risk for some cancers as mentioned in the first paragraph, and osteoporosis from not having bones bear weight.

To reduce the health risks associated with prolonged sitting, experts recommend incorporating a variety of strategies that promote movement and improve posture throughout the day:

• Take Regular Breaks
• Move every 30 minutes: Set a timer or use an app to remind you to stand, stretch, or walk briefly every half hour.
• Stretch often: Stretching improves circulation, reduces muscle tension, and prevents stiffness.
• Incorporate Standing and Walking
• Use a standing desk: Alternate between sitting and standing by using an adjustable desk. Start with short intervals and gradually increase standing time to avoid fatigue.
• Walk around while on calls:Taking phone or video calls while standing or walking can add movement without interrupting your workflow.
• Take short walking breaks: Walk for 5-10 minutes every hour. Walking meetings are another option if possible.
• Practice Desk Exercises and Stretches
• Leg extensions and seated marches: Strengthen your legs and keep your blood circulating by lifting each leg in a marching motion or stretching your legs out under your desk.
• Upper body stretches: Shoulder rolls, neck stretches, and wrist flexes help alleviate tension from prolonged sitting and screen use.
• Optimize Your Workspace Ergonomics
• Adjust your chair and desk height: Your feet should be flat on the floor, your knees at a 90-degree angle, and your desk height should allow your elbows to rest comfortably at your sides.
• Use ergonomic tools: A supportive chair, footrest, and adjustable monitor can encourage better posture and reduce strain on your back and neck.
• Schedule Physical Activity into Your Day
• Aim for at least 30 minutes of exercise daily: Try to get 150 minutes of moderate aerobic activity each week, along with two days of strength training.
• Integrate “mini workouts”: Add short exercises, like squats, lunges, or stretches, throughout your day.
• Use stairs instead of elevators and park further away to naturally incorporate more steps.
• Focus on Good Posture
• Sit upright: Keep your back straight, shoulders relaxed, and core engaged to minimize strain.
• Use back support: If your chair lacks support, add a cushion or lumbar support to maintain a healthy spinal curve.
• Try Micro-Movements
• Small movements like tapping your feet, standing briefly, or shifting positions can make a big difference over time, helping to keep blood circulating and muscles active.

To counteract sitting too much, people may need more than the usual amount of exercise. The standard 150 minutes of moderate exercise per week may not be sufficient if you sit for long periods. Above, one of the listed items is to aim for at least 30 minutes of daily exercise with some experts recommending 60 minutes of daily exercise for sedentary individuals.

In summary, if you sit a lot try to incorporate some of the above suggestions to be more active. Get up and walk around 5 to 10 minutes for every hour of sitting. Monitor how much you sit each day, and try to reduce the amount by 2 to 3 hours in a 12 hour day (i.e. you want to sit less than 8 hours per day). Finally, strive to obtain the recommended daily amount of exercise (or even a little bit more).

Figure 1. Sitting too much can increase the risk for obesity, cardiovascular disease, and osteoporosis (link).