Standing vs. sitting: Getting your patients to move more

We all know the dangers of a sedentary lifestyle in terms of risks for cardiovascular disease.

There is a well-established body of evidence that points to a direct connection between a sedentary lifestyle (defined by the American Heart Association or AHA as sitting for at least six to eight continuous hours per day) and higher risks of metabolic syndrome, diabetes mellitus, and cardiovascular disease.¹

According to a 2015 report released by the New Your State Department of Health, as many as 60 percent of American adults report leading a sedentary lifestyle.² In the same report, only 22 percent of Americans reported getting regular physical activity, defined as anywhere from 30 to 60 minutes of aerobic activity at least three to four times per week.

Of course, when you share these statistics with your patients, you are usually targeting those who do not get enough regular exercise.

However, a new advisory from the AHA that was published in a recent issue of the journal Circulation indicates that even people who do get in recommended exercise weekly goals may still be at an increased risk for cardiovascular disease if they remain inactive for the rest of their time.¹

Sedentary hours add up

The AHA advisory notes that the workplace is the most common environment in which people are likely to spend the majority of their time sitting down.¹

Part of this is due to the fact that the number of sedentary occupations increased from approximately 15 percent in 1960 to approximately 20 percent in 2008, meaning that a greater number of Americans were more likely to be holding down jobs that required them to sit in one location for extended periods of time. Furthermore, the total average number of sedentary hours in the U.S. has also increased from 26 hours a week in 1965 to 38 hours in 2009.¹

Meeting exercise requirements is not enough

If going by the guidelines mentioned by the New York State Department of Health, a person who exercises for an hour four days a week could reasonably reduce their number of average sedentary hours per week from 38 to 34.

Clearly, this number is still too high. The AHA advisory statement addresses some of the ways in which even those patients who do meet their weekly exercise goals can reduce their sedentary hours even further.

Taking a break from sitting

Most people will stay at their desk from when they first arrive until lunch. At that point, they may decide to stretch their legs long enough to go into the break room to fix lunch.

The AHA advisory suggests that instead, workers should consider taking short breaks during the day to take a quick lap around the office or climb a flight or two of stairs. Because it can be easy to lose track of time, setting a timer to go off every hour as a reminder can help get your patients out of their sitting rut.

One practical way of accomplishing this can be by using some of the new fitness technology that is available, either as wearable firmware or as apps for smartphones. Such technology can not only keep track of how many steps your patients take each day, but can also track heart rate, stairs climbed or store reminders of hourly step goals.

As a DC, it behooves you to encourage all your patients to be more active. However, even your active patients need reminders to move around during the entire day, rather than just during designated times for exercise.

References
Rohm Young D, Hivert M-F, Alhassan S, et al. Sedentary behavior and cardiovascular morbidity and mortality: A science advisory from the American Heart Association. Sept. 27, 2016;134:e262-79.
Physical inactivity and cardiovascular disease. New York State Department of Health. Accessed 10/3/2016.