Sit. Stand. Stay. Good worker.

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 Example A:  The Fitbro

Businesswoman Nilofer Merchant wrote an essay for the Harvard Business Review Blog, which has gone on to become one of the most read posts on the HBR site this year,  in which she parrots the convention that sitting too much is killing us, going so far as to equate sitting with smoking. Runner’s World has inexplicably also trod this path, which will not lead us to the land of data, logic, or even common sense.

Capricious furniture vendors, imitating their wellness brethren, have grabbed the theme even though it is demonstrably untrue. Take, for example, Varidesk, which uses this YouTube video to sells its signature product, a desk that adjusts vertically. The theoretical claim, supported by nary a data point, is that workers should stand rather than sit.

On their website, the Varidesk folks also make this claim: “The VARIDESK was developed to address the negative side-effects of being seated for the majority of the working day.”

I wrote in a post on my own blog a couple of years ago that sitting was not the problem. Fitness is the problem. I also said that when we get studies that actually measure fitness, we will find that it attenuates the purported risks of sitting. It is ludicrous to believe that someone who endeavors to achieve and maintain fitness (cardiorespiratory capacity of, say 8 to 10 metabolic equivalents or METs) will somehow lose all the physiologic benefits of exercise many of which not measured by traditional risk markers, just because they sit.

Our societal messaging on physical activity and exercise is all wrong. The government’s lame philosophy, joined by groups like the American College of Sports Medicine, is that telling Americans to “exercise” is too emphatic. It will scare people. We should just tell them to be physically active, to go take a walk. Not only do Americans get too little physical activity, they get shockingly little exercise. As a result, we are manifestly UNFIT, and that is our problem.

Highly fit people live longer and have a lower rate of both heart disease and cancer, our two leading killers (both of which are strongly age-related, so being fit a point in life is not the same as achieving and maintaining fitness throughout life, even though it declines gradually with aging). In fact, they have lower rates of just about every preventable, lifestyle-related disorder you can name. Even in a population of sick people, the fitters ones do better.

This brings me to two studies recently published in the Mayo Clinic Proceedings, both of which were completely ignored by the mainstream media which no doubt realized that reporting the results would require walking back their blusterous narrative about the evils of sitting.

The first paper, unfortunately behind a paywall, concludes that health risks related to being sedentary have a great deal to do with fitness. In the second paper, which is not behind a paywall, researchers conclude that, unlike conventional wisdom, sedentary time does not increase risk for metabolic syndrome. Further, the authors conclude that, “…when taking fitness into account, prolonged sedentary time had a markedly less pronounced effect on cardiometabolic risk and adiposity.” Unlike wellness and furniture vendors, both research teams actually measured fitness with treadmill stress tests. The first paper estimated sedentary time from accelerometers. The second paper used prospective cohort and followed people for 30 years, which is about 15 times longer than the typical wellness vendor “study.”

As we shifted from an agrarian economy to an industrial, post-industrial, service, and now, information economy, each successive generation has done less physical work. Yet, lifespan grew with each cohort. If sedentary time is so deadly, why didn’t lifespan stagnate or regress when farmers became factory workers and factory workers became office workers and store clerks who then became software developers? Where’s the spike in death rates? And lifespan increased even during the time that smoking rates were rising. The reduction in lifespan that we may see with the baby boomers and Gen Xers isn’t about their sedentary time. It’s about their fitness levels.

The metabolic cost of standing is about 50% greater than the metabolic cost of sitting, but in both cases the absolute load is very small so the incremental increase in benefit is infinitesimal. Standing also causes its own set of complications that no one ever talks about. Foot, ankle, knee, hip and back pain are all consequences of prolonged standing, as are varicose veins.

I sit most of the day, sometimes in an office chair, sometimes on a stool. Sometimes I work at a lectern. I do whatever feels right. That’s a lot less important than something else I do, which is exercise every single day. If you dare to come workout with me, there is no 57 year old man who will rock your world the way I will. And then we’ll go sit down and quaff a protein shake.

Almost all your risk reduction benefit comes by getting your aerobic capacity up to the ability to do 10 METs of work. This is roughly equal to jogging at 10 min/mile (6 mph), cycling at about 15 mph, doing dance aerobics with a 10″ to 12″ step, doing martial arts, jumping rope, playing competitive racquetball, etc. Health risks go down with every increment increase in fitness from 3 METs (strolling) up to 10, after which benefits dissipate (yes, you can do too much, but that’s the last thing Americans need to worry about). See here for a full list of exercises and their METs.

You want to sit, but you are highly fit? Go on, I say, as long as you exercise every day. You want to stand, so you can be a lemming, too? Get good life insurance, I say, because the Grim Reaper will come first for you.

Vik Khanna’s new e-book Your Personal Affordable Care Act: How To Avoid Obamacare, is available now in the Amazon.com Kindle Marketplace and atSmashwords.com. Vik is THCB’s Editor-At-Large for Wellness.


5 replies »

  1. Vik,
    Your comment “…there is no 57 year old man who will rock your world the way I will…” tells me everything I need to know about you and invalidates everything else you wrote.

  2. Exercise as been one part of my life in the last 5 years. Since I´m 37 I wondering if I can do exercise everyday….

    I usually run (5 to 10 km), Swim (1km) and ride a bike (15 to 25km) – I do ofetn rotate between these 3 so I dont overload any particular muscles. I do this rotation 3 to 4 times a week.

    My questions is if I can do excerzice everyday expect on Sundays….what do you think?

    I have to add that I work 8 hours a day in front of the computer in a very demanding enveriment

  3. I agree on Vik’s book. Best five bucks you’ll ever spend.

    That Kindle download could save your life ..

    / j

  4. I am about to do a full review of Vik’s new take-no-prisoners book on my blog. I re-read much of it yesterday during my flight home from back east at my mother in law’s farm for the holidays. Even though there are a few areas regarding which I take (relatively mild) exception, I give it 5 stars and recommend it without reservation. Given its low Kindle price, it is a tremendous value. In sum:

    – Eat sensibly (w/respect to quantity and variety);
    – Don’t smoke, and minimize alcohol consumption;
    – Exercise appropriately and consistently;
    – Get enough sleep;
    – Minimize adverse stressors (including dysfunctional acquaintances);
    – Question Authority relentlessly (in particular the Received Wisdoms of Health Wonkistan);
    – Work on truly knowing yourself and work on pursuits that give you joy and meaning in life. Lose your Jones for banal trivia (e.g., soul-sucking social media and other sedentary entertainments);
    – Insure rationally against catastrophic medical misfortune, and avoid using “health insurance” as routine 3rd party intermediated pre-payment (it’s not really “insurance” anyway).

    That’s pretty much it. Not rocket science, not a panacea, but, practices that, if widely adopted, would have dramatic positive population health effects is relatively short order, at nil individual cost.