“Just say no” were the words which fueled the anti-drug campaigns of the 1980s. Since that time, our schools and media have shifted focus to other health ailments plaguing our society. The new health wars are being waged on obesity, Type II diabetes and other “lifestyle” diseases. Today, headlines commonly link sitting to smoking and you can envision our current first lady uttering the same phrase, but it would go something like, “Just say no to the chair.” So is this our new edict? Shall we convert all of our workstations to standing desks and ditch the couch once and for all? Research on over one million people says not so fast.

Ekelund and colleagues[1] conducted a meta-analysis of 16 studies which encompassed over one million people and tracked sitting while not viewing TV (e.g. at work), sitting while viewing TV, exercise and causes of mortality over periods ranging from 2-18 years. They sought to answer the following question: If one is active enough, will this attenuate or even eliminate the detrimental association of daily sitting time with mortality? In other words, is sitting really so bad for your health if it is supplemented with consistent exercise?

The Variables

Let’s take a look at what was measured and analyzed. Researchers broke up sitting time (excluding TV viewing), TV viewing time and amount of time spent in moderate intensity activity into 4 categories, what we refer to in this summary as Level 1-4 for easy identification.

In the above table “Level 1” refers to what we would think of as the healthiest participant, someone who has lots of activity and sits very little, whereas, the Level 4 participant is expected to be the least healthy, someone who sits a lot and exercises very little. The researchers sought to find out what the interaction was between these different variables, for example, someone who was a level 4 sitter but maintained level 1 activity. Participants with health conditions were excluded from analysis, meaning all remaining participants were of normal health. All analyses were compared to the reference group of participants who were classified as the least sedentary and most active (i.e. Level 1 sitter, TV-viewer and activity).

The Results

The researchers provided a very informative graphic which is provided below.

The results can be summarized with three key findings:

1) The longest time sitting, greater than 8-hours for regular sitting, and greater than 5-hours for TV viewing, led to a higher risk of mortality.

The general trend was an increase in mortality for a more sedentary lifestyle. This is consistent with the mainstream publications which tout the evils of sitting too much. However, the important finding in this specific analysis is the second dimension or “joint association,” and that is the activity level. Although Level 4 sitting and TV-viewing was associated with higher mortality, it was heavily dependent on the level of exercise the participants engaged in. This brings us to key finding number two.

2) The increased risk of mortality associated with more sitting is heavily dependent on the amount of exercise participants engaged in.

For example, it is clear to see (and intuitive) that Level 1 exercise, leads to significantly less risk of mortality than Level 4 exercise. But what’s interesting about the data is that even Level 4 sitting and TV-viewing groups paired with Level 1 exercise were far better off than the Level 1 sitting and TV-viewing groups paired with Level 4 exercise, thus demonstrating the incredible importance of engaging in moderately intense activity. Even if you are someone who has said no to the chair or watches very little TV, if you are not challenging yourself a bit physically, those other “good” habits may be less important drivers of your long-term health. Lastly, we are lucky the researchers were able to differentiate what type of sitting their participants were doing as it leads to our third important finding.

3) Across all levels of exercise, TV-viewing time is generally associated with greater mortality risk vs. time spent sitting while not viewing TV.

The data shows that other behavioral factors may be at play while sitting. If you engage in 50-65 minutes of exercise at moderate intensity and sit more than 8 hours at work, the data set predicts you’ll have some increased mortality risk, but it would be far from the most severe. However, the data also shows that, if, instead, you watched TV for more than 5 hours a day and engaged in the behavior the participants did you’d actually be worse off at the same level of activity.

Key Takeaways

If you are trying to improve your health and reduce your risk of poor health outcomes, consider the amount of time you spend sitting and more importantly moving. The research shows the benefits of moving more, so try to get involved in 30-75 minutes of moderately intense activity every day.

What can I do about it?

If you are like the vast majority of people, you must sit while you drive, you must sit while you work and you likely want to sit down after a long day doing the former two activities. The bad news is that all this sitting may likely lead to adverse health outcomes down the road all-else equal. The good news is there is something that can be done about it. As the research we just reviewed showed, by incorporating some of the below activities into your daily or weekly schedule, you can significantly reduce your risk of getting certain “lifestyle” diseases:

Walking your dog around your neighborhood
A leisure bike ride along the beach
Gym activities: Lifting weights, treadmill, bike or elliptical machines
Volunteering your time at a nursery, food bank or other organization which requires manual labor
Playing sports with friends or in local adult leagues

The sky is the limit! Find what you love to do and do it! If pain is preventing you from enjoying some of the activities above, consider consulting your local physical therapist. Movement is key to a long and healthy life!

References

Ekelund U, Steene-Johannessen J, BrownW, Fagerland M, Owen N, Powell K, Bauman A, Lee I-M. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016; 388: 1302–10.

Work Hard, Play Hard