Reducing Sedentary Behaviors: Shifting Focus

In recent years I have become more and more convinced that reducing sedentary behaviors, rather than focusing solely on increasing physical activity levels, will lead to the biggest impacts on the overall physical and mental health of the populations we serve and the community as a whole.

As we are all aware of, there are a plethora of recommendations from governmental and health-minded organizations on the necessary duration, intensity, and frequency of weekly physical activity to achieve optimal health, but I believe these recommendations are falling short because they do not address all of the hours most people spend sitting and sedentary throughout the course of the day.

The unique physiology of physical inactivity makes it a stand-alone risk factor for poor health, separate from not meeting the minimum physical activity recommendations, thus necessitating research, awareness, education, and interventions specific to preventing or reducing sedentarianism, not just increasing physical activity levels.

Physical activity AND physical inactivity (sedentarianism) both change the body physiologically, but they change the body differently and so need to be handled differently. It has been much talked about in the media lately how sedentarianism contributes to a multitude of health problems, including cardio-metabolic risk markers, diabetes, obesity, cardiovascular disease, and premature mortality, yet the general dialog tends to center around being more physically active, rather than being less physically inactive. There is a difference.

Just as there were great many health care advances in combating infectious disease that came about through concerted efforts at preventing disease, rather than merely through advances in treating disease, we need to work toward similar advances in health promotion through preventing or reducing sedentary behaviors, not merely recommending people exercise more.

There is a reason the saying goes “prevention is the best medicine”. While sedentarianism is not infectious in the traditional biomedical sense, I do think it is, in its own way, infectious: sedentarianism has become the societal norm and has spread throughout all age ranges, socio-economic statuses, and geographic areas and is greatly impacting the health and vitality of a great majority of the population.

As it is becoming more and more evident that sedentarianism is in itself a health risk, particularly uninterrupted sitting, and that the diseases it contributes to are often not curable through medical intervention alone, it is crucial that we take steps toward eradicating sedentarianism through preventative measures at the same level and scale that has been successfully taken toward eradicating infectious diseases with campaigns on par with those that advocated reducing second-hand smoke exposure, wearing seat-belts, and not drinking and driving.

Such prevention measures should not solely look at increasing physical activity, as is commonly implemented now, but rather should focus on reducing sedentary and sitting behaviors throughout the day. Such efforts could emphasize increasing low-level ambulatory and standing behaviors throughout the day, rather than advocating specific bouts of “exercise”, which are likely not practical or desirable for those who could benefit most from moving more and sitting less.

One of the most successful wellness and fitness initiatives I conducted at my old department was a mileage challenge, as measured through the use of pedometers. The goal of the initiative was to get people moving more throughout their day, not necessarily "exercising" more throughout their week.

I knew the program was successful when I saw people walking during their morning and afternoon breaks, often in small groups, with larger groups taking part of their lunch hour to walk around the campus. There was also an increase in walking meetings throughout headquarters; although I didn't see them in use at our department, I know of companies that distribute cards on lanyards that said “I’m in a meeting” so people won't be disturbed during such meetings. Another great idea is standing-only conference rooms, with high-top tables and no chairs.

I believe part of the reason our mileage challenge was successful (based on feedback from participants) was that it was easy and it wasn’t “exercise” – they could do it without changing out of their work clothes and they could get in just a few minutes here and there. I think this is one of the differences between recommending more physical activity, which people equate to exercise, breathing hard, being uncomfortable, and working up a sweat, and recommending sitting less throughout the day, which people equate to things like standing and walking more, taking the stairs, and parking further away without necessarily viewing these behaviors as “exercise” or physical activity.

So much of what we do as health or movement professionals, and whether it is successful or not, depends on how people perceive the costs and benefits of the behavior that we are trying to get them to adopt.

What are the benefits of exercising more (improved mental and physical health, improved self-confidence, improved self-image)? What are the costs (time, effort, unfamiliarity, discomfort, lack of resources)? How do these costs and benefits compare to the costs and benefits of just sitting less?

If just sitting less throughout the day (thereby standing and walking more and being less sedentary overall) also leads to positive mental and physical health benefits and improved self-image and self-efficacy, but at a minimal cost (less time, less effort, more familiarity, more opportunity), could that not that appeal to more people who could benefit most? People who may have barriers, perceived or otherwise, to “exercise”? And couldn’t it also help healthy, active people stay healthy with minimal additional effort on their part?

Through an approach focused on just spending less time not sitting, which may be complimentary to physical activity promotion but must be wholly separate, in my opinion, we may be able to reach more people with more effective and sustainable lifestyle behavior changes that could result in significant long-term health benefits.

I’m not saying people shouldn’t exercise, I absolutely believe people benefit tremendously from organized bouts of physical activity.

But to do the most good, we may have to shift our focus a bit and also promote sitting less throughout the day, regardless of physical activity levels.

References

Dunstan, D.W., Howard, B., Healy, G.N., & Owen, N. (2012 ). Too much sitting - A health hazard. Diabetes Research and Clinical Practice, 97(3), 368-376. doi: 10.1016/j.diabres.2012.05.020

Hamilton, M.T., Healy, G.N., Dunstan, D.W., Zderic, T.W., & Owen, N. (2008). Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behavior. Current Cardiovascular Risk Reports, 2(4), 292-298.

Kirschenbaum, D.S. (1997). Prevention of sedentary lifestyles: Rationale and methods. In W.P. Morgan (Ed.), Physical activity and mental health (pp. 33-48). Washington, D.C.: Taylor & Francis.