Sitting is Killing You

Sedentary behaviour is the topic of my PhD thesis, and as a result we discuss it quite frequently here at Obesity Panacea.  But never have I seen anything even remotely approaching the coolness of the following evidence-based infograph, which was produced by Medical Billing and Coding.  If this doesn’t clearly convey the health-impact of sedentary behaviour, nothing will.  Hat tip to @bean_syme who sent me a link to the infographic on Mashable.  You can see the full-size version here.

Enjoy!

Travis

Via: Medical Billing And Coding

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Sitting is Killing You by Obesity Panacea, unless otherwise expressly stated, is licensed under a Creative Commons Attribution 3.0 Unported License.

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34 Responses to Sitting is Killing You

  1. Amy Charles says:

    Travis,

    As a runner and writer who’s worked at stand-up desks for years, let me suggest that standing more or less still for hours on end isn’t much better. You really need to move and get the hr up, have motion happening.

    I’ve tried a number of things to break up the sedentary standing, and finally last week I put my laptop on the reading stand of my treadmill. Problem solved. I find that walking at 1.0 mph is not only unnoticeable, as far as work goes, but puts hr up about 20 bpm. (My resting hr is around 50.)

    Interestingly, I find that this doesn’t pound my feet all to hell, either. Runs after working on the treadmill actually seem easier. It’s a terrible solution in terms of carbon footprint, but otherwise I’d say it’s the way to go.

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    • Travis says:

      I think it really depends on your goal. If you want to burn calories, then the treadmill is the way to go. But simply standing all day should prevent many of the metabolic adaptations that occur with long periods of sedentary behaviour (decreased lipoprotein lipase activity in skeletal muscle, etc).

      Have you considered a self-powered treadmill? I don’t have room for a treadmill desk at home or work at the moment, but I’ve often thought that a motor-less treadmill would be an ideal option.

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  2. JerL says:

    This is great but I cringe a bit when I see, under a title “Sitting Makes us Fat” facts like sitting increased by 8% and obesity doubled. It seems to be suggesting that we can attribute a doubling in obesity to an increase in sitting of 8%. I haven’t taken the time to explore the sources but it seems to me a lot more is going on in that time period other than people just sitting more. I’d be more interested in knowing how important sitting is in causing increased obesity and mortality compared to other causes.

    It is a really cool graphic though.

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    • Travis says:

      I think you’re right to be skeptical about sedentary behaviour being the primary driver of the obesity epidemic. I think it’s one of several factors, but it’s probably not the one cause to rule them all.

      As for the mechanisms, this post from my series on sedentary physiology might be helpful. Briefly, sitting tends to make you eat more than you need, it shuts down fat and sugar uptake in your muscles (which increases the fat/sugar in your blood), and certain sedentary behaviours (TV watching in particular) exposes people to advertising and food cues, which is strongly related to weight gain in kids. But what’s interesting is that many of these mechanisms have little to do with body weight, which I personally find absolutely fascinating.

      http://blogs.plos.org/obesitypanacea/2010/12/09/sedentary-physiology-part-4-how-does-sitting-increase-health-risk/

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  3. Amy Charles says:

    Travis, I know, it seems like standing should disrupt the problems. I can testify that it just feels bad and sedentary nonetheless. There may be some improvement over sitting, but my guess is it isn’t enough. Part of the problem may be that inevitably, one ends up leaning against the standing desk and isn’t fully supporting one’s own weight. But if you’re reasonably well-conditioned, you can drift into a sedentary hr/respiration rate while standing, and you just…stay that way. I reliably gain weight when I have deadline jobs that actually have me standing at the desk for more than 4-5 hours a day.

    I suspect that with a motorless treadmill most people would simply stop walking, partly because they’d have the choice, and partly because the motion’s not so smooth. It really has to be smooth or it becomes a distraction.

    JerL, consider that people aren’t just sitting at work; they’ve got 2+ hours’ commuting while sitting, and then at home they mostly sit. I bet most Americans are putting in a good 12 hours a day on their tuchuses.

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    • JerL says:

      I have no doubt people are sitting more. My point was more epidemiological. I’m just more interested in how much obesity can be attributed to sitting relative to other things.

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  4. WRG says:

    No, Travis, I don’t find these scare-mongering, witch-hunt posters cool at all. As I recall, Health Canada’s pictures of toothless hags didn’t do much to stop people smoking either.

    Honestly, getting people moving is a very tall order. But scary, OMG posters just make some of us laugh and many of us feel bad about things that are often far beyond our control. Telling us that the recommended 30 minutes per day is just not enough–how encouraged do you think people feel about that? So many of us do our best, only to be told over and over that it’s just not enough and that WE ARE KILLING OURSELVES!!! This kind of PSA (not!) gets us nowhere.

    Also, I feel uncomfortable with the outfit that made these posters, “Medical Billing and Coding”. Are these the people who make life and death decisions on who gets reimbursed for medical costs in the States? Are these the real “death panels”? Just asking.

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  5. Franz Tafferner says:

    I think that is just bull, people are living longer than our continously walking and doing physical work ancestors. A major problem is though too much food intake. My father and grandfather both lived to be 85, in reasonably good health, both were obese, how long does one want to live? If all that walking buys you another 5 years in a nursing home, whats the point?

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  6. Evelyn says:

    Travis–what are your thoughts on using exercise-stability balls as chairs (besides the posture benefit). It would seem to offer less “sitting stasis”?

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    • Travis says:

      I think the stability balls could probably be better than sitting in a normal chair, but it’s also possible to sit on them without using many muscles for stability. Personally I use a small pedal machine that fits under my desk, which allows me to pedal at a low pace while working on my computer. I don’t use it all the time (and I wouldn’t recommend that anyone jump straight to sitting on a ball all the time either), but when I do use it I’m activating muscles in my legs and core. That’s an approach that I’ve found works quite well for me, and the machine itself only cost about $30.

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      • M says:

        It’d be great if you could provide a little more information about your pedal machine. I’ve never heard of them.

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    • Alex Caine says:

      I used a stability ball for 3 months at one of my jobs once. It was awesome…I could do all kinds of exercises while working and no one would even notice. It does look silly at first…a dude sitting on a big ball…

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  7. Jennifer says:

    I have to say, the notion that sitting is killing me sounds ridiculous. What next? Breathing? Doing the dishes? I mean, really.

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  8. Marni says:

    Yes, I noticed a decline in health when I went from being a student (and having the flexibility to study standing up or on a treadmill or to just take a 30min walk between study sessions) to having a full time desk job (and hour long commute).

    However, it’s only killing me in as much as any bad habit is killing me – like not eating enough vegetables or skipping the gym.

    It’s hard attribute doubled obesity rates to an 8% increase in sitting, when eating habits and food choices have changed as well.

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  9. Interesting comments!

    I don’t find the graphic scary – I actually found the tone a sort of charming Halloween-type approach, and in my office we all admired it for its aesthetic qualities.

    I am one of a team of 5 editors, and it’s an occupational hazard that we sit quietly, in concentration, for hours at a time. We have different ways of coping, including one of going through a succession of different chair arrangements and now agitating for a standing desk. I get up and walk around a lot – 10k steps a day or more – and I fidget, stretch, and bob my knees a lot, and use a lap surface so I can lean back part of the time. I now refuse to accept any teasing for that :) Unfortunately, I’ve been tagged with a “credibility problem” because I *don’t* sit quietly, staring at my work all the time.

    I think part of the problem for us is that as editors we are constitutionally adept at following rules, and those dozen years of schooling in which we were taught to “sit quietly” really made a mark – both in what most of us are willing to do and in what observers expect when they come to our desks.

    I’d hate to see people get hung up on whether EVERYTHING is KILLING us and think more about the balance of activity throughout the day, plus what our expectations are of the little ones we’re training in their lifelong habits.

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  10. Mitzi says:

    The graphic itself may be exaggerated, but the idea behind it is true. I have a joint condition with a very high probability of early onset, severe arthritis, so I thought becoming a microscopist would be a grand idea, so that I could sit more as my mobility decreased. Admitted to a PhD program, working hard (no time for the gym) and a few years later… wham! Chronic bursitis in one hip. Won’t go away completely, even with reinstating exercise. From now on, those long microscope sessions without a break are simply impossible. Sitting for more than an hour, or 30 minutes on a hard surface, is excruciating. Walking is fine. So I have to get up and run around a lot, which is O.K. in my field of study. Someday I’ll have a walking desk, but for now taking frequent breaks works. I tell people God gave me this problem to keep me from sitting around too much, and you confirm that moving around is better. Thanks for the encouragement.

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  11. Amy says:

    No, it’s not ridiculous. The effects just take a couple of decades to be starkly visible.

    I’m 42. A healthy bmi puts me in the 11th bmi %ile for my sex and weight. One of the ways I’ve stayed at a healthy, rather than normal, weight, is to find ways not to spend most of my time sitting, as most Americans do. I manage this despite being a non-trustifarian single mom. A priority is the freedom to stand up, walk around, move.

    It does mean building a largely diy life, and being assertive in office environments. I’ve always been willing to buy my own stand-up desk, but I’m quite firm about not working at the usual sit-all-day setup. Last I checked, you can get a decent one for about $200, will support a crt monitor.

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  12. Dava says:

    At least my retail job that requires walking around all day keeps me healthy, if not wealthy!

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  14. Melanie says:

    Hi Travis – My dissertation is an intervention to reduce SB in overwt females. I would be interested in hearing more about your project. Maybe we can share info.

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  15. It’s interesting, but not mind blowing. The overweight problem runs so deeply within our culture and it’s way beyond activity. I’m part of an exercise class (a zumba class that is high impact, high energy) for past two years. One gal started losing weight. Then another, then another. They added in a nutritional element and face book support. Hundreds of pounds have been lost. Why? Women found not only an activity they loved doing (google zumba, you’ll see), but a teacher who built a community around her clients, and then they witnessed others losing weight. The face book support, added nutritional supplements, that puts you on a cleanse and a challenge got rid of weight these folks (there are some men too) have been holding onto for years to decades. The answer is in the group think process, the culture, who you hang with and who builds your faith in what. All these woman tried dieting alone and it didn’t work for them. They could have read this article all day and stayed fat. Humans are pack animals and very influenced by the pack. They need the pack for positive change to be long lasting. This is also why home gyms are a dismal failure.

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  16. Carolg says:

    I’d love to know more why leaning back 135% is good for the spine.
    This is a first time I’ve heard backward leaning is healing.
    There are a lot of underdesk food pedalers with mixed reviews.
    Would you care to share which brand you’re happy with?
    Love these graphic posters.
    Thanks very much from one who sits way too much.

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    • Travis says:

      I’m not totally clear on that part of the infographic either – my research is more focused on the metabolic impact of sitting, rather than any impact on skeletal/back health.

      I haven’t tried many peddlers – I just bought the cheapest one I could find. It has worked well for me personally, although I would switch to a different brand if I found one that was cheaper, or one that was a bit lower (I have to sit a certain way to avoid hitting my knees on my desk with this one).

      Here is the one that I use:

      http://www.amazon.com/Drive-Medical-Exerciser-Attractive-Silver/dp/B002VWK09Q

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      • Carolg says:

        Thanks Travis for the bike info.
        So many to choose from.
        I’ll try it out.

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        • When sitting fully upright, the core will deactivate for the most part as it is no longer stabilizing the trunk, thus the spine bears the brunt of the load. When you lean back, core activation occurs, distributing body weight load off of the spine and onto the musculature. There is less direct (top) load in either the leaning forward or leaning backward position.

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  20. Barbara says:

    This totally ignores the massive increase in high fructose corn syrup consumption between 1980 and 2000, along with the “Super-Size”-ing of fast food, and all of the other things that are making us fat.

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    • Travis says:

      It doesn’t ignore it – the two effects are independent. Smoking, diet, exercise, sedentary behaviour, body weight – these are all independent factors which influence health independent of each other. Even if you have a good diet and exercise regularly, smoking is still going to increase your risk of heart disease. The evidence suggests that sedentary behaviour is similar, in that regardless of what you eat or how much you exercise, it still has an impact on your health risk.

      You can find a lot more detail on the research here.

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  21. Greg says:

    What about laying down on your back? Is that as bad as sitting?

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    • Travis says:

      The simple answer is that no one knows if one sedentary position is worse than another. Most of the things that interest me are related to metabolic health (glucose, insulin, lipids, etc) and these all seem to go haywire when skeletal muscle goes for long periods without contracting. So lying down might theoretically be worse than sitting (since sitting requires more muscle tone), but I would expect them to be pretty similar.

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