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Really… Sitting Can Lead to Early Death?: A Journal Article Commentary.

Timothy Voehl, Arizona State University

Corresponding author:  Timothy Voehl E-mail: tavoehl@asu.edu

This a commentary on an interesting journal article about the unwanted effects of too much sitting, by James Levine MD., Ph.D., the Mayo Clinic, Scottsdale AZ, entitled “Sick of Sitting” (2015). According to Dr. Levine, a sedentary lifestyle leads to obesity, many chronic diseases, and elevated healthcare costs for everyone. We humans were designed to be fully upright with the ability to think and act on our feet. Except for brief resting breaks and sleep, we evolved to ambulate quickly to escape imminent danger, lest we be eaten by the marauding predators. Because of extreme advances in living, modern humans have lost touch with that former reality. Our workplaces, schools, and lives are primarily centered around a sedentary lifestyle. Dr. Levine, goes as far as referring to sitting as a sickness in this article (2015). The good news is that he proposes clear solutions to combat this disease with long-term benefits towards the whole life (physical and psychological) wellness of our populations.

Modern environments are designed to improve our convenience and efficiency while increasing sedentary sitting. Our houses are full of modern conveniences that often decrease what is known by Dr. Levine as “non-exercise activity thermogenesis” (NEAT) (2002). Likewise, work settings and schools encourage productivity at the expense of physical activity. In many workplaces, employees are discouraged from leaving their desks because it is viewed as unproductive or a waste of time, instead of the NEAT produced which Dr. Levine indicates can lead to increased productivity. Furthermore, Dr. Levine believes that communities also encourage sedentary lifestyles through polluted air and lack of easy and safe communal access for activity. Sedentary lifestyles are associated with poverty, crime, obesity, diabetes, and other poor health outcomes.

Dr. Levine points out that studies show that increasing NEAT decreases the storage of body fat, while decreasing NEAT (or staying seated) makes the body prone to it. When people increase habitual walking, they tend to burn off or metabolize excessive calorie consumption. Conversely, food over- consumption, coupled with sedentary living, causes gains of the most body fat and physical complications. Basal energy expenditure is the energy one uses at rest, but this doubles shortly after standing or walking. This can account for the differences that are seemingly insignificant for coworkers with similar duties or individuals with like circumstances. This is because those who choose to stand and walk have lower body fat and physical complications than those who sit more. Also, people who live an active lifestyle in their leisure time are more active at work. People with obesity tend to sit while walkers tend to be leaner, more active, and have fewer health complications.

In addition to lack of upright activity, Dr. Levine points out that one of the major physiological influencers of NEAT is sleep deprivation. The sleep-deprived brain and body do not allow increases in daily NEAT. However, a sleep-deprived person’s energy intake (consumption) does increase, resulting in adipose (fat) storage

The human body is miraculously designed and is composed of integrated systems dependent on proper blood flow to oxygenate and nourish tissues. Without adequate blood pressure (hypotension), blood does not flow or perfuse to all tissues adequately. Poor blood pressure occurs as a direct result of an individual’s lifestyle activity and NEAT levels. When a person is sedentary or sitting, their tissues malfunction and can die. When seated or lying down, humans’ blood pressure drops causing decreasing energy, increasing obesity, health and physiological complications, and cognitive impairment. Each of these effects can further interact with the others.

There is good news and we need not despair. Dr. Levine reports that work, school, and community environments can and are being designed to promote activity. Work environments are embracing standing, walking, and exercise gyms for employees. Schools encourage physical activity for students, with standing desk options and more spread out campuses that require walking. Communities are converting roadways for pedestrian use and increasing the availability of sidewalks and walking and biking trails. Upright postures for humans will reduce sedentary lifestyles, obesity, chronic diseases and high health care costs. This would not only help reverse the unhealthy trends of the current population, but would also promote healthy, active lives for future generations. Dr. Levine concludes by stating that sedentary science is still young and much is yet to be learned. It is clear to him that sedentary living needs to be addressed as a problem in both society-wide and individual lifestyle choices.

References

Levine, J.A. (2002). Non-exercise activity thermogenesis (NEAT). Best practice and research. Clinical endocrinology and metabolism. 16(4), 679-702
Levine, J.A. (2015). Sick of sitting. Diabetologia, 58(8), 1751-1758. Doi: 10.1007/s00125-015-3624-6