Sunday, May 28

Long sitting  linked to early death

Pinterest LinkedIn Tumblr +

By Prof. Raphael Nyarkotey Obu

Some basic lifestyle changes are not favorable to our health. Studies have demonstrated the effects of long sitting, and, I examine the effect of long sitting based on science.

Effect of long sitting

Your everyday non-exercise activities, such as standing, walking, and even fidgeting, still burn calories. One review by Villablanca et al.(2015) explained that this energy expenditure is known as non-exercise activity thermogenesis (NEAT), the lack of which is an important risk factor for weight gain.

Sedentary behavior, including sitting and lying down, involves very little energy expenditure. It severely limits the calories you burn through NEAT.

Another review found that agricultural workers can burn up to 1,000 more calories per day than people working desk jobs (Levine JA, 2014).  This is because farmworkers spend most of their time walking and standing.

Increases weight loss

Studies also found the fewer calories one burns, the more likely you are to gain weight. This is why sedentary behavior is so closely linked to obesity. For instance, (Levine JA 2005), shows that people with obesity sit for an average of two hours longer each day than people with a normal weight.

Sitting linked to early death

This study should be a concern for law students and lawyers as observational data from over 1 million people shows that the more sedentary we become, the more likely we are to die early.  This is supported by (Wilmot EG, 2012; Biswas et al. 2015) study which found that the most sedentary people had a 22–49% greater risk of early death.

Another study by Pulsford et al. (2015) found that found no link between sitting time and overall mortality.   It has been argued that this study had some flaws, which likely explains why it contradicts all other research in the area.

Prolonged sitting is linked to disease.

Two studies(Wilmot EG, 2012; Biswas et al. 2015) explained that sedentary behavior is constantly connected to over 30 chronic diseases and conditions, such as a 112% increase in our risk of type 2 diabetes and a 147% increase in heart disease risk.

Some two studies (Krogh-Madsen et al. 2010; Stephens et al. 2011) also found that walking less than 1,500 steps per day, or sitting for long periods without reducing calorie intake, can cause a major increase in insulin resistance, which is a key driver of type 2 diabetes.

They held that being sedentary may have a direct effect on insulin resistance. This effect can happen in as little as one day.

Exercise doesn’t completely cut reduced your risk

Interestingly, we think regular exercise can offset all the health risks, but science says no.  For instance, Duvivier et al. (2013) study measured metabolic markers in 18 people following different exercise protocols. One hour of intense exercise did not make up for the negative effects of inactivity when other hours were spent sitting.

A previous review by Biswas et al. (2015) of 47 studies found that prolonged sitting was strongly linked to negative health outcomes, regardless of exercise levels. So you see that long sitting has a huge impact on our health irrespective of the exercise we do later.  As expected, the negative effects were even greater for people who rarely exercised.

Dealing with prolonged sitting

First, avoid sitting for extended periods. The first remedial action is to break up your sitting time by getting up and moving at least every hour, or preferably more often.
Second, shape your work environment so that it helps your posture and does not harm it. Get a desk where your computer monitor can be at eye level and invest in a good chair, so you have appropriate support. Installing ergonomic workplace equipment, such as adjustable chairs and desks, has been shown to help reduce musculoskeletal disorder symptoms. Ergonomics training sessions, which include mandatory time at standing desks, are shown to reduce both musculoskeletal and visual discomfort, which can arise from looking at screens for prolonged periods.
Third, reshape your body with appropriate exercises to restore it to its natural balance and alignment. Take front and side view photographs in a natural standing position, looking for abnormalities. From the side, your ear should be in line with your shoulder, which should be in line with your hip, which should be in line with your knee. From the front, your head should be level and facing forward, both shoulders should be even (with the dominant arm possibly lower), your pelvis should be level, your kneecaps should point straight ahead, and your toes should point forward. See the images below and compare them to yours. Even without a picture, a good quick check is to sit against a wall and see if your butt/lower back, upper back, and head can touch the wall at the same time. Make sure you don’t force yourself to do this, it should occur naturally. Chances are that you will see—or feel—opportunities for improvement.
Fourth, exercise regularly but with due care to avoid injury. It is important to understand that our bodies have natural processes built in to prevent injury, of which pain is one. Do not undertake an exercise that is painful for you, as this may cause more dysfunction. Also, swift movement without a slow warm-up can cause the muscles to tighten to prevent movement and potential injury. Always consult a physical therapist, professional fitness trainer, or athletic trainer before going into any exercise regime for the first time. 
Finally, check your progress from time to time.
Visit a chiropractor to check your spine. Your spine is a curved set of small bones. When the natural curve is changed, problems can arise. The body works as a kinetic chain, meaning everything is connected. A spine issue can cause a hip problem, a hip problem can cause a leg problem, and a leg problem can cause a foot problem.

Look at the images below of where the head is sitting about the spine. How often during the day is your neck being pulled forward, or to the side, by the weight of your head? Do you have “tech neck” from looking down at phones, tablets, or computer screens?

Therefore, the first rule of good posture is to do no harm, so start with your spine. Arrange your work environment, if you can, so that you are not holding your spine in unnatural ways, as in the images above.

The writer is a Professor of Naturopathic Healthcare, a Medical Journalist, and a science writer. President, Nyarkotey College of Holistic Medicine & Technology (NUCHMT)/African Naturopathic Foundation, Ashaiman, Ghana. Currently BL Candidate at the Gambia Law School, Banjul. E. mail:


Levine JA, McCrady SK, Boyne S, Smith J, Cargill K, Forrester T. Non-exercise physical activity in agricultural  and urban people. Urban Stud. 2011;48(11):2417-27. doi: 10.1177/0042098010379273. PMID: 22073428.

Villablanca PA, Alegria JR, Mookadam F, Holmes DR Jr, Wright RS, Levine JA. Nonexercise activity thermogenesis in obesity management. Mayo Clin Proc. 2015 Apr;90(4):509-19. doi: 10.1016/j.mayocp.2015.02.001. PMID: 25841254.

Levine JA. Lethal sitting: homo sedentarius seeks answers. Physiology (Bethesda). 2014 Sep;29(5):300-1. doi: 10.1152/physiol.00034.2014. PMID: 25180258.

Levine JA, Lanningham-Foster LM, McCrady SK, Krizan AC, Olson LR, Kane PH, Jensen MD, Clark MM. Interindividual variation in posture allocation: possible role in human obesity. Science. 2005 Jan 28;307(5709):584-6. doi: 10.1126/science.1106561. PMID: 15681386.

Wilmot EG, Edwardson CL, Achana FA, Davies MJ, Gorely T, Gray LJ, Khunti K, Yates T, Biddle SJ. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012 Nov;55(11):2895-905. doi: 10.1007/s00125-012-2677-z. Epub 2012 Aug 14. Erratum in: Diabetologia. 2013 Apr;56(4):942-3. PMID: 22890825.

Pulsford RM, Stamatakis E, Britton AR, Brunner EJ, Hillsdon M. Associations of sitting behaviours with all-cause mortality over a 16-year follow-up: the Whitehall II study. Int J Epidemiol. 2015 Dec;44(6):1909-16. doi: 10.1093/ije/dyv191. Epub 2015 Oct 9. PMID: 26454871; PMCID: PMC4690002.

Krogh-Madsen R, Thyfault JP, Broholm C, Mortensen OH, Olsen RH, Mounier R, Plomgaard P, van Hall G, Booth FW, Pedersen BK. A 2-wk reduction of ambulatory activity attenuates peripheral insulin sensitivity. J Appl Physiol (1985). 2010 May;108(5):1034-40. doi: 10.1152/japplphysiol.00977.2009. Epub 2009 Dec 31. Erratum in: J Appl Physiol. 2010 May;108(5):1034. PMID: 20044474.

Duvivier BM, Schaper NC, Bremers MA, van Crombrugge G, Menheere PP, Kars M, Savelberg HH. Minimal intensity physical activity (standing and walking) of longer duration improves insulin action and plasma lipids more than shorter periods of moderate to vigorous exercise (cycling) in sedentary subjects when energy expenditure is comparable. PLoS One. 2013;8(2):e55542. doi: 10.1371/journal.pone.0055542. Epub 2013 Feb 13. Erratum in: PLoS One. 2014;9(8):e105135. PMID: 23418444; PMCID: PMC3572053.