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January 22, 2014 | Volume 8 | Number 1
January 22, 2014
By Jessica McKenzie, MS
Are you sitting down? You may want to stand. Research on sedentary behaviors is revealing that sitting on the job is associated with increased health risks that are not mitigated by exercise. In other words, if you sit most of the day, even if you hit the gym before, during or after work, you are still at risk for a host of health conditions and premature death.
Sitting for long periods of time can reduce your lifespan (Dunstan, Howard, Healy, & Owen, 2012; Patel et al., 2010; Wilmot et al., 2012) and increase your risk of cardiovascular disease (Matthews et al., 2012; Wilmot et al., 2012), type 2 diabetes (Dunstan, Howard, Healy, & Owen, 2012; Wilmot et al., 2012), obesity (Chau, van der Ploeg, Merom, Chey & Bauman, 2012), cancer (van der Ploeg, Chey, Korda, Banks, & Bauman, 2012) and depression (Vallance et al., 2011).
The kicker is that even regular physical activity is not enough to protect you. Employees of all fitness levels, across occupations and organizational settings, who sit for long periods of the workday are at risk. As such, reducing sedentary time at work should be a health priority for organizational leaders.
Shift from Scientific Management
Work has changed dramatically over the past century and, for better or worse, jobs today are more sedentary than they used to be. In her book American Idle: A Journey Through Our Sedentary Culture, Mary Collins references Frederick Winslow Taylor, father of scientific management. Taylor, a productivity expert, was known for his ability to break jobs down into discrete tasks and determine the most efficient way to perform them. This process is referred to as “scientific management” and was all the rage in 1912, when (as cited in Collins, 2009) Taylor testified in front of a congressional panel. As Taylor described a laborer’s specific tasks and went into detail about piles, shovels and the best approach to shoveling piles, Congressman John Q. Tilson responded, “You have told us the effect on the pile. But what about the effect on the man?” (p 42).
The fact that work has changed since 1912 is undeniable, but the essence of the congressman’s question still rings true. What about the effect of work on employees? Sedentary jobs, long hours and work stress are a reality for many in today’s workforce, and advances in technology have made it possible to do more than ever before. However, with these advances have come less opportunity to move throughout the day. Why walk down the hall to a colleague’s office when you can send an email, text or tweet? In the long run, sitting is affecting your health and — by extension — your work and quality of life.
Active People Are Not Immune
U.S. adults spend more than eight hours a day engaged in sedentary behaviors (Matthews, et al., 2008), defined as sitting, reclining or lying down during waking hours (Mathews et al., 2008; Wilmot, et al., 2012). That is almost 60 percent of the time you are awake, spent sitting (Matthews, et al., 2008) and includes working at a desk, watching television, sitting in the car and engaging in similar activities that require only minimal energy. To make matters worse, engaging in the recommended amount of physical activity (e.g., the World Health Organization’s recommended 150 minutes a week) does not appear to mitigate the health hazards of working a desk job.
In a study that examined total sitting time and followed more than 200,000 Australians ages 45 and older for almost three years, those who sat between eight and 11 hours a day had a 15 percent higher risk of dying during those three years compared to people sitting less than four hours a day (van der Ploeg, Chey, Korda, Banks, & Bauman, 2012). Those sitting 11 or more hours a day had a 40 percent increased risk of dying during those three years (van der Ploeg et al., 2012).
In other words, if you work eight hours a day at a desk, drive an hour to work and watch a TV show before bed, you are in the “11 hours or more” range. Even so, “physical activity is still very important for health,” cautions Hidde van der Ploeg, PhD, lead researcher of the Australian study and senior researcher with the Department of Public and Occupational Health of the VU University Medical Center. In most of our daily work, sitting is the default posture and few organizations offer employees opportunities to reduce prolonged sitting time.
“The message here is if you are sitting much of the day, try to replace some of it with standing, or walking and other physical activities,” advises van der Ploeg.
Time spent sitting outside the office counts, too. A 14-year prospective study by the American Cancer Society found that women who reported sitting for more than six hours per day during their leisure time had an approximately 40 percent higher death rate than women who reported sitting less than three hours a day (Patel et al., 2010). For men who reported more sitting time, the rate was 20 percent higher than men who reported less sitting time, and the combination of sitting more and being less physically active was associated with a 94 percent increase in rate of death for women and 48 percent increase for men (Patel et al., 2010).
Watching television is the most popular leisure activity in the U.S., with adults spending an average of 2.8 hours a day watching the tube (Bureau of Labor Statistics, 2012). In a large study of U.S. adults, time spent in sedentary behaviors was found to be significantly associated with mortality, even after adjusting for age, sex, smoking, diet and physical activity (Matthews, et al., 2012). Mortality risk was 14 percent greater for those who watched three to four hours of television a day, compared to those who watched less than one hour a day (Matthews, et al., 2012).
So what is the harm in settling onto the sofa for a binge-watching session of your favorite television show? “Greater amounts of television viewing were associated with an increased risk of death, 31 percent and 61 percent greater risk for those watching five to six and more than seven hours per day, respectively,” cautioned Charles E. Matthews, PhD, lead researcher of the leisure activity study and a physical activity epidemiologist and investigator for the National Cancer Institute. “Remarkably, the increased risk associated with excess television viewing persisted even among our participants who reported seven or more hours per week of moderate to vigorous physical activity,” said Matthews.
Recent research has shown that reducing the time you sit at the office can also boost your mental health (Kilpatrick, Sanderson, Blizzard, Teale, & Venn, 2013; Pronk, Katz, Lowry, & Payfer, 2012; Vallance, et al., 2011). In a survey of more than 3,000 Australian employees, Kilpatrick, et al. found an association between occupational sitting and psychological distress, independent of physical activity (noticing a trend yet?). Mood disorders are estimated to cost more than $50 billion in lost productivity annually and result in 321.2 million lost workdays (Kessler et al., 2006), making employees’ mental health an important consideration when it comes to sedentary work.
At the opposite end of the spectrum from sedentary behavior is physical activity. In his book Spark: The Revolutionary New Science of Exercise and the Brain (2008), neuropsychiatrist John J. Ratey, MD, describes how exercise influences learning and improves the brain’s ability to process new information, and importantly, it also improves the rate of learning. Because the brain has neuroplastic abilities, the more you use it, the stronger the connections in your brain become, which can lead to enhanced performance in all areas of your life (Ratey, 2008). Physical activity also increases dopamine and serotonin levels in the brain, which can improve mood, so encouraging employees to move more, or take breaks to stand up during the day, can help boost everyone’s mood and productivity.
The findings on occupational sitting behavior are relevant to employers and organizational leaders because they highlight the importance of a dual focus on decreasing sedentary behaviors like sitting and increasing physical activity (Dunstan, Howard, Healy, & Owen, 2012; Matthews, et al., 2008; Matthews et al., 2012; Patel et al., 2010; Plotnikoffa & Karunamunib, 2012). It’s not enough to just offer employees a wellness program or onsite gym, it’s also important to promote less sitting time as part of an organization’s educational outreach and health and wellness communications.
Only 42 percent of working Americans say their organizations promote and support a healthy lifestyle (American Psychological Association, 2013). The answer to less “sit time” may lie in integrating strategic movement into the flow of your day. Seeking out opportunities to be active during the workday can range from taking the stairs instead of the elevator to placing your folders away from your desk so that accessing them requires you to get up and move. The good news is that expensive equipment and extensive regimens are not required to prevent the negative effects of prolonged sitting.
Even small changes can make a big difference. But to be effective, efforts require at least three levels of support: environmental, organizational and individual (Healy, et al., 2013). This multi-level approach, also called an “ecological approach” is more effective than individual-only approaches and in addition to the environmental, organizational and individual levels can also take into account community, policy and the interaction between each of the levels (Owen et al., 2011; Plotnikoff & Karunamuni, 2012). The examples that follow are approaches that can guide organizational leaders and employees in their efforts to reduce occupational sitting.
Time for a Micro-Break
In Tom Rath’s latest book Eat Move Sleep (2013), he discusses the benefits of having short “bursts” of activity built into your work routine. Rath cites findings from an 18-year study of 3,263 San Francisco longshoremen (Paffenbarger, Gima, Laughlin, & Black, 1971). In this study, the work activity of one particular job, cargo handlers, attracted special attention because of the intense energy expenditure demanded. Cargo handlers, who burned an average of 925 calories per workday more than other longshoremen, also had a coronary death rate 20 percent lower than their less active counterparts. The evidence suggests that adding activity to your everyday work can help improve your health.
A systematic review of the literature found support for short activity bursts helping people reach suggested physical activity levels and that promoting physical activity by targeting people at work was effective (Barr-Anderson, AuYoung, Whitt-Glover, Glenn, & Yancey, 2011). Short bouts of activity can help you reach your physical activity goals and have the added benefit of breaking up the work day. “Workers in sedentary jobs can benefit from periodic standing, stretching and conscious awareness of proper breathing,” suggests Christopher J. L. Cunningham, PhD, UC Foundation Associate Professor of Industrial-Organizational and Occupational Health Psychology at The University of Tennessee at Chattanooga.
“These activities can be utilized in just about every work environment, and sedentary workers who have more autonomy over their actual work schedules have more alternatives and options than workers who do not have such autonomy,” says Cunningham. Simply giving employees flexibility can help them discover creative solutions to recharging during their workday.
“Given the recent evidence on the health risks associated with prolonged sitting, more workplaces are introducing solutions such as sit-stand workstations or standing meeting rooms, which allow workers to alternate sitting and standing throughout the day,” according to van der Ploeg, the lead researcher of the Australian study on sitting behavior. In a small sample study, findings showed that sit-stand desks reduced sitting time by 66 minutes per day at work, reduced upper back and neck pain by 54 percent and improved employee mood (Pronk, Katz, Lowry, & Payfer, 2012).
In another study, researchers found that even more effective than using sit-stand desks alone, adding goal-setting, feedback communication and self-monitoring components to the organization’s efforts decreased employees’ sit time by 89 minutes per day (Neuhaus, Healy, Dunstan, Owen, & Eakin, 2104).
So even if you don’t have a sit-stand desk, stand up at your worksite while you’re on phone calls, do calf raises behind your desk where you won’t disturb anyone — whatever works for you to add movement to routine activities throughout the day. Also, if you’re stuck at a regular desk, try replacing your desk chair with a stability ball for a few hours a day for some variety and an opportunity to strengthen your core while you work.
Brief stretches during the workday can provide relief. “A shift in attentional focus can be restorative, especially likely when the worker has the autonomy to choose when and how to do this,” suggests Cunningham. “Physical movement and stretching help to loosen and relax tension in the body, and changing physical orientation and movements can also interrupt repetitive movements and positions, the strain from which can lead to musculoskeletal disorders over time.”
Set up reminders to stretch throughout the day. Short, frequent breaks from computer work have been shown to benefit employee productivity and well-being, especially when accompanied by stretching (Henning, Jacquez, Kissel, Sullivan, & Alteras-Webb, 1997).
When you consider a typical day at the office, it’s easy to see how the time you spend not moving can add up. Myanna Duncan, PhD, C.Psychol., of the Biomedical Research Unit at Loughborough University in England conducts a number of workplace intervention studies aimed at breaking up extended periods of sedentary behavior during the day. “Excessive sitting impacts our body’s metabolic system. If we are just sitting, we are not burning as many calories compared to if we are standing. And the muscle activity required for standing seems to trigger important processes related to the breakdown of fats and sugars in the body.”
Duncan’s advice? “If you can stand for 10 minutes every hour during the day, try and do so. Add a sticky note on your desk as a reminder,” suggests Duncan. Also, walking doesn’t require special skills or equipment and most employees are able to increase the amount they walk each day. Duncan adds that taking breaks to walk more, or “adding more steps” can also help.
Have a look at this resource, Walking Works Wonders from Loughborough University.
Other strategies include optimizing the work environment for movement, encouraging employees by creating a wellness message like “Sit Less, Move More” and suggesting employees add calendar reminders or apps as a prompt to get up and stretch. The Mayo Clinic has a few visual desk stretches that can be used throughout the day. Schedule a walk-and-talk or stretching session with a co-worker instead of grabbing lunch or coffee and wear comfortable shoes into and leaving the office so you can take more steps comfortably during your commute. Try reading while you are using the gym treadmill, add steps and use a pedometer or heart rate monitor to track your progress.
Take the Stairs
“Take the Stairs” campaigns can be effective. At the environmental level, employers should ensure stairwells are accessible, labeled and well-lit. At the organizational level, managers can lead by example and encourage employees to take the stairs with them. For individuals, make it a priority to take the stairs instead of the elevator. Employers can post easy-to-read signs near elevators as reminders, and encourage employees to set goals. For example, you may set the goal to take the stairs when going between floors and save the elevator for longer trips. Before you know it, you’ll be taking the stairs all the time, and saving electricity, as well.
A program aimed at encouraging inactive employees at a hospital in Switzerland to take the stairs instead of the elevator improved their fitness, body composition and blood pressure after just 12 weeks (Meyer et al., 2010). At the headquarters of the American Psychological Association in Washington, D.C., stairs are easily accessible, signs are posted and employees are encouraged by their colleagues to take the stairs, a message that has been intermittently reinforced by the organization’s deputy CEO handing out cash rewards to random employees in the stairwells, rewarding their healthy steps. It is one thing to say you’ll take the stairs more often, but when your organization supports that effort, it can make all the difference.
The Take Home Message
Prolonged sitting is a modifiable health risk. Workplaces are an ideal location to influence health because employees spend much of their waking hours there and are influenced by organizational norms. Even small changes in the work environment can help employees make healthier lifestyle and behavior choices. Reminders can prompt employees to stand periodically and take more micro breaks. Managers can be supportive by modeling healthy behavior, encouraging employees to adjust their workspace to accommodate integrated movement throughout the day and suggesting standing or walking meetings. Be sure to consider individual differences in employee needs, preferences and abilities and communicate that activities are optional, as not every activity will be a good fit for all employees. However, educating employees about the benefits of increased movement throughout the workday can help employees be healthier and more productive on and off the job.
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