Many Americans repeat the same cycle each day: wake up, drive a long commute to work, sit at a desk for 8 hours, drive back home, eat dinner at the table, watch TV for a few hours, then go to bed and wake up the next morning. While this might seem like a normal day in the life of a working adult, the fact of the matter is that it is, and it involves an alarming amount of time sitting. Excessive sitting – coined the “sitting disease” by professionals – has consequences for chronic diseases and injuries such as an increased risk for heart disease, diabetes, obesity, hypertension, cardiovascular disease, certain types of cancers, depression, osteoporosis, and back and musculoskeletal pains (Levine, 2015). Just a simple Google search on excessive sitting will say that “sitting is killing” and that “sitting is the new smoking” (Fiorenzi, 2018). While there are many articles that exist to argue that sitting is not the new smoking, this catchy phrase still gives an indication of just how harmful excessive sitting can be. In fact, “sitting is the most common sedentary behavior of adults,” with more than half of the day spent sitting for most adults (Thorp et al., 2012).
Even more alarming than sitting itself is that any amount of physical activity – even meeting the recommended physical activity guidelines of 150 minutes per week of moderate physical activity or 75 minutes per week of vigorous physical activity (American Heart Association, 2018) – will not undo the harmful effects of excessive sitting. In Too Little Exercise and Too Much Sitting: Inactivity Physiology and the Need for New Recommendations on Sedentary Behavior, Hamilton et al. (2008) state that “sitting too much is not the same as lack of exercise” (p. 4) and that it results in different metabolic consequences. Dr. Brian Liem, MD from the University of Washington Sports Medicine, adds that “a lifestyle of prolonged sitting is distinctly different from a lifestyle absent of routine exercise” (Sharifi, 2018). To put in context, heart disease is consistently the leading cause of death for both men and women in the United States, with approximately 610,000 people expected to die each year (CDC, 2017). Wendell Taylor (2011) of Prolonged Sitting and the Risk of Cardiovascular Disease and Mortality indicates that even in the most physically active individuals, “there is a strong association between sitting and CVD mortality” (p. 351). Therefore, it goes to show that sitting can harmfully effect anyone – active or not.
In a large cohort study of 123,000 individuals by the American Cancer Society, it was found that women who sat more than 6 hours per day had a 40% higher all-cause death rate compared to women who sat less than 3 hours per day (Bushman, 2014), and for men, a 20% higher all-cause death rate of those who sat more than 6 hours per day compared to those who sat less than 3 hours (Bushman, 2014). Additionally, those who sat more and were less physically active had an increased death rate of 94% for women and 48% for men (Bushman, 2014). While physical activity doesn’t necessarily reduce the harmful effects of sitting, it does reduce the risk of death by a significant percentage.
Active individuals who meet the recommended physical activity guidelines but still live a sedentary lifestyle have been labeled by professionals as active couch potatoes. Dr. Elliot O’Connor, a Physical Therapist from the University of Washington Sports Medicine, states that “you can’t undo eight plus hours of sitting with a workout” (Sharifi, 2018). Hence, being physically active, but still sitting far too long. When thinking of a population that is at major risk for sitting hours on end each day, it comes as no surprise that working adults – particularly those working at sedentary desk jobs – are at a higher risk for sitting disease than any other population. As many adults spend nearly one-third of their adult life working, it also goes to prove that the workplace is a great place to target for an intervention (Bushman, 2014).
With advancements in technology in recent years, many Americans have switched from manual labor jobs to sedentary desk jobs. In fact, even the overall lifestyle of Americans has switched from active to sedentary. Instead of going to the grocery store and walking through the aisles, customers can now shop online and pick up their food to-go without even stepping foot in the grocery; retailers such as Amazon can have items delivered to a doorstep faster than taking a physical trip to the store; and more people spend their leisure time behind a screen – whether it be watching TV, on a computer, or scrolling through a phone – than ever before. There are drive-thrus and apps to have food delivered straight to your doorstep, you can stream movies on your TV instead of going to the movie theater physically, and you can even pay an Uber or Lyft a few bucks just to avoid walking a few blocks. For individuals who aren’t concerned about their health, it is easier and more enticing than ever to remain sedentary. It comes as no surprise that the rates of obesity and overweight individuals are also at their highest, with over 2/3 of Americans being overweight or obese (CDC, 2016). Sitting has many risk factors and with obesity being one of them, it can be inferred that the ease of having a sedentary lifestyle could be influencing these statistics.
The study of sitting in the workplace dates back to the early 1950s when Dr. Jerry Morris found that London bus drivers and mail sorters had higher rates of cardiovascular events than ticket collectors and postal workers (Marshall & Gyi, 2010). Bus drivers and mail sorters tend to have more sedentary jobs compared to ticket collectors and postal workers, which could be the reason that they had a higher risk of cardiovascular events (Marshall & Gyi, 2010). Since most people spend the majority of their life working and many people now at sedentary desk jobs, the workplace is a great place to address sitting disease. In a study of 21 office-based workers in the United States, it was found that sedentary time was significantly higher on work days compared to non-work days, with no difference in the amount of physical activity (Thorp et al., 2012) In addition, the proportion of time spent in prolonged sedentary bouts was significantly higher on work days than non-work days, with workers spending 77.0% of their work day – or 6.6 hours – sedentary (Thorp et al., 2012). The American Cancer Society (2018) identifies prolonged sitting as sitting in bouts of more than 6 hours. With the Thorp et al. study indicating that most workers spent 6.6 hours of their workday sedentary, it can be concluded that most people sit more than the prolonged sitting definition of 6 hours just at work alone. Since physical inactivity and sitting too much result in different ailments, it is important to realize that even the slightest changes such as transitioning posture, for example, from sitting to standing, as recommended by Occupational Health and Safety Guidelines, are effective with helping to combat sitting disease (Thorp et al., 2012).
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