Two young women friends sitting and laughing together

“Sitting is the new smoking.”

I first heard that phrase uttered by Kaiser Chief Health Information Officer John Mattison, who walked his talk by standing behind his chair during a panel discussion a few years ago, while other panelists remained seated.

And yet, Science Daily last November disputed this popular assertion:

No, sitting is not the new smoking, despite what countless newspaper articles have peddled in recent years.

That’s the consensus from an international team of researchers who have laid to rest misleading claims comparing the health dangers of sitting for long periods with smoking cigarettes.

In the latest issue of the American Journal of Public Health, researchers from Canada, the US and Australia say that while research does suggest excessive sitting (roughly more than eight hours a day) increases the risk of premature death and some chronic diseases by 10-20%, this pales in comparison to the risks associated with smoking.

And yet, even if sitting shouldn’t be placed in the same exact category as tobacco, sitting for extended periods of time during the day is a known health hazard.

For perspective, I reached out to HealthTap orthopedic physician Edward Hellman, who wrote this lengthy reply about the “sitting is the new smoking” paradigm.

Maintaining an active daily lifestyle

“Orthopedic surgeons treat disorders of the musculoskeletal system, which includes our bones, muscles, joints and spine.  The benefits to maintaining an active daily lifestyle are numerous. Regular motion and positional changes throughout the day help the joints in their lubrication and assist in the oxygenation of the articular cartilage cells.  Motion helps to maintain tone and flexibility of the muscles, reducing risk of injury. Regular loading of the bone that occurs through even simple activities like standing and walking can help the bone retain it’s strength, reducing the risk of osteoporosis.

“Prolonged sitting can have a number of negative health consequences.  Prolonged sitting can contribute to a condition known as disuse osteoporosis, in which the bone loses its strength due to failure to regularly load it.  Sitting for prolonged periods of time puts increased stress on the intervertebral discs in the spine and can be associated with an increased risk of back problems.

“Prolonged sitting can be associated with lower extremity vascular disease such as deep venous thrombosis and venous stasis disease, both of which can cause chronic swelling in the joints. Prolonged sitting can cause atrophy and contracture of the muscles, putting the person at increased risk of injury, as well as stiffness of the joints leading to swelling and pain.

Just say “no” to prolonged sitting

“In some ways, prolonged sitting has began to be considered as ‘the new smoking’ in the sense that the medical field has begun to appreciate and more fully understand the numerous medical problems that can potentially occur from sitting for extended periods of time.  Simple advice: Just say ‘no’ to prolonged sitting! Look at the times you sit for extended periods of time and make a plan to do things differently. If you spend a lot of time sitting at work, consider investing in a stand-up desk. If you watch a lot of TV or send a lot of time on the computer at home, a exercise bicycle or treadmill can be a fabulous alternative to sitting while watching a movie.”  

“Rather than sit watching your children do an activity, get out and join them. If you have to sit, make sure you are getting up and moving around every 20 to 30 minutes, even if you have to set a timer to remind you. As adults we spend a lot of time planning to do various things or investing in various things, it is time that we look at how we spend our time and resources and eliminate prolonged sitting from our lifestyle.  Let’s get moving!”

Thank you, Dr. Hellman, for describing the danger of sitting in such detail. Wearables such as the Apple Watch and Fitbit’s activity trackers may also be useful, because they nudge wearers to get out of their chairs at the intervals Dr. Hellman recommends above. At HealthTap’s offices, many desks adjust with the touch of a button from sitting height to standing height, and if your budget allows for that, consider that option as well. This flexibility helps dispel some issues about standing-only desks when they first appeared.

Lastly, if you need help determining if you’re suffering from symptoms that arise from prolonged sitting or addressing challenges associated with standing up all day, always reach out and talk to your doctor.



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Scott Mace

Writer at HealthTap. You may have read my work at HealthLeaders Media, BoardWatch, InfoWorld, or even the Village Voice if you go back far enough.

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