Are You Sitting Down for This?

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Originally published on January 25, 2014 by Dr. Arigo

SittingMost likely, you’re sitting at your computer (or with a tablet in your lap) as you read this. And unless you’ve been away from the news lately, you know that sitting is bad for your health. But what exactly does that mean? How did we get to be a society of sitters? How does sitting lead to poor health? And what can (or should) we do about it?

As with eating, our society has experienced a radical shift in our built and personal environments over the past 60 years. Early humans were running around on the savannah, escaping from predators or chasing food sources. They got a lot of exercise, and there was no telling when it might be time for fighting or fleeing again. So our bodies – and more importantly, our brains – evolved to preserve energy for unexpected times of need. That means that we’re set up to favor energy-saving activities when there is no need to expend energy.

Fast forward to the more recent past (1100-1800 AD). Most people worked in labor-intensive occupations such as farming. Again, lots of exercise, so sitting after a 14-hour day of harvesting allowed people to recharge. But think about today’s environment. How often are we running from predators or chasing food? How many of us work in careers that are truly labor-intensive? (Note that we all tend to overestimate how active we are. Standing as part of a job isn’t the same as labor-intensive.) And technological advances allow us to avoid even getting up to change the channel on the television. Problem: we’re built to conserve energy, and conserving energy feels good, so expending extra energy has to be deliberate. In other words, it takes effort.

This helpful graphic from the Washington Post provides a good summary of the sitting-health evidence to date. Extended periods of time spent in sedentary activities (i.e., anything done sitting or lying down, such as working at a computer or watching television) restricts blood flow to the heart and brain, and trains bones and muscles to adopt “natural” states that aren’t actually natural. For example, most of us have gotten into the habit of slouching as we sit, giving our abdomen muscles no tension or movement and repeatedly curving our spines. And with certain sedentary activities, we’re more likely to eat, and eat mindlessly. As a result, high amounts of sedentary time are associated with neck and spine problems, heart disease, cancer, diabetes, and early mortality.

Okay, so sitting is bad. Does that mean that we all have to have treadmill desks or become marathon runners (many of whom run twice per day) in order to avoid chronic problems? Should we force ourselves to stand at home all evening after a long and stressful day at work? Fortunately not, as small changes can go a long way: walking may be slightly less helpful than jogging or biking, but benefits are comparable. And there is good evidence to suggest that the biggest benefits of increasing activity come to those who start with very little.

First, one key problem is that we sit for very long periods of time without a break. Even taking a few extra two-minute walks around the office twice a day can be helpful for getting blood flowing. (NOTE: This needs to be an increase from what you normally do.) Second, many of our “relaxation” activities are sedentary, rather than active. Television show? Don’t fast forward through commercials – take the opportunity to stand, stretch, and pace the living room for a few minutes. Even better – use that treadmill or exercise bike for its original purpose as you watch, rather than using it as a coat rack. Meeting friends? Park a few blocks away and walk to/from a restaurant, or walk around the mall/street as you drink your coffee. Even better – meet for a walk instead of dinner or beverages.

Exercise that gets your heart rate up and makes you sweat will help to protect us from chronic, debilitating illness. But if you’re not ready to adopt an exercise routine, you can give yourself a gift in the same vein by setting smaller goals: “I will walk around the office for three minutes at 10:00 and 2:00 today, in addition to the other times that I get up (for lunch, etc.).” Keep it manageable and specific, and set alarms or calendar alerts to remind you. My reminders to myself say “Still sitting? Time to do yourself a favor and MOVE.”

What do you do to stay active and healthy? We all could use some additional options – share in the comments.

Read more about environmental effects on exercise, and get some additional tips, here.

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Why “The Pulse” Has My Attention

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Originally published on January 18, 2014 by Dr. Arigo

Philadelphia’s public radio station, WHYY, recently launched “The Pulse,” a weekly show devoted to “stories at the heart of health, science, and innovation.” As an academic health psychologist, Philadelphia resident, and public radio listener, I couldn’t have been more enthusiastic about this new venture. I have a schedule that doesn’t always permit tuning in to the broadcast, so podcast it is. (The wonders of modern technology! Some of it doesn’t appear to benefit the human condition in the long term, but that is for another post.)

I had very high expectations (hopes?) for this show, but also a few reservations. So much of what the media presents about science and research is simplified, sensationalized, and packaged to catch our increasingly limited attention spans. (See PhD comics for a funny and accurate summary.) Would this be an hour of the latest horrid headlines, with a few interviews edited to provide little additional information? I couldn’t help but acknowledge the possibility that “The Pulse” would not be my cup of tea.

Thankfully, my fears were unfounded, Host Maiken Scott, a behavioral health reporter for WHYY (@MaikenScott), and her team of contributors have delivered seven VERY strong episodes. Stories have included living with and recovering from traumatic brain injury; challenges to deciphering the cost of medical care and initial problems with healthcare.gov; an inside look at concussion care and prevention in youth sports; end-of-life decisions; and fights over patents on an effective treatment for blood cancer. Each of these stories has been connected to Philadelphia initiatives, issues, and concerns, and has featured interviews with people you can connect with – including the experts.

I’ll quickly note my two favorite pieces thus far. The first is a lead story honoring the 20th anniversary of the movie “Philadelphia,” which deals with the stigma of AIDS in the 1990s. I had watched this movie only a week or so before listening. Although I have an appreciation for the film and its impact, on this viewing, I found it impressively outdated and overwrought (though still full of outstanding moments). I also found myself noting something I learned from film friends a long time ago: the main character is the one who goes through a meaningful change during the film, not the one who influences him or her. From this perspective, there is no question that Denzel Washington’s Joe Miller is the main character, and I found his story much more compelling than that of Tom Hanks’s Andrew Beckett. (No offense to Tom, who I much admire, or his Oscar-winning performance in the role.) I appreciated the attention that “The Pulse” offered to the Joe Miller character, as well as the more prominent focus on the film’s extras (Philadelphia residents living with AIDS).

A second piece on “The Pulse” that really struck me was “The Spark,” a new segment on experiences that ignite passion in scientists and health professionals The first installment (January 10, 2014) included an interview with a medical ethicist, who told his story of receiving treatment for polio in the 1950s. Even as a boy, he recognized that treatment conditions (e.g., providers’ reluctance to discuss fellow patients’ deaths with children) needed improvement, and his career has been about this effort. Science provides wonderfully rewarding careers. But many of them involve long hours, underpayment, sickness (and death), unimaginable lengths and layers of red tape, and real challenges to making a difference. Despite these often-demoralizing aspects, I love my career, and identifying key moments in its development could keep me going if I ever get truly burnt out. Hearing others’ stories on this theme leaves me with a happiness and satisfaction that I’m sure amounts to an ounce (or more) of burnout prevention. I can’t wait to hear who else will be featured in “The Spark.”

“The Pulse” has my attention – I hope that it continues to spread. Follow the show @WHYYThePulse on Twitter.