Blog | Wednesday, August 15, 2012

Health, by the seat of our pants

News comes that sitting is killing us. Well, actually the news is really that not sitting could help save us; the fact that sitting is killing us was yesterday's news. Less sitting could extend our lifespan, and more importantly, our healthspan.

But either way, the point is this: We are getting to ill health by the seat of our pants. We'll see about turning those trousers inside out before we're through.

The context here is largely a matter of common knowledge at this point. Exercise is good for us, and we get too little of it. While the particular benefits of exercise, in its various forms, to weight loss are fodder for frequent, and in my opinion, largely futile, debate, the value of exercise to health is all but indisputable. Physical activity is the vital, conditioning work of the human animal. We were meant for it, and we need it.

But alas, we are getting less and less. Just this week comes news that more and more schools, in the face of epidemic childhood obesity and diabetes, are cutting physical education, rather than expanding it. And this despite the fact that good physical activity programming during the school day preserves or enhances academic performance, rather than interfering with it, and confers additional benefits in the bargain. In the case of our own research, findings suggest that if routine "recess" is used to treat rambunctiousness, less Ritalin is needed to treat ADHD!

Exercise has been squeezed out of the average day for adults and kids alike. And in the absence of dedicated wellness programming, there is less and less on-the-job physical activity as well.

At one point, this might have left us with a square peg/round hole dilemma: Do without exercise, or free up a big block of time every day to make room for it? The trends in schools, workplaces, and our society at large suggest that this dilemma gets the better of us.

Fortunately, we have long since come to recognize that just about any way of fitting in exercise is a good way. It needn't be in one long bout, and we needn't all make the Olympics team. Brief bursts of exercise that add up to a reasonable dose (20-30 minutes) over the course of the day will do just fine, as will moderate intensity.

The news about sitting is the icing on this cake. Getting to sedentariness by the seat of our pants increases risk for chronic disease, and shortens our lives. Specifically, the evidence on this front is that sitting for eight hours a day is associated with an increase in all-cause mortality risk of 15 percent at any given age, and sitting for 11 hours a day is associated with a 40 percent increase.

Merely getting off the seats of our pants more often confers the promise of the opposing benefits: less chronic disease, longer life expectancy. The study just published in the British Medical Journal suggests a potential gain in life expectancy of two years, on average, from reducing total daily sitting to less than three hours.

Such studies, and others like them, expand the realm of relevant physical activity options. Suddenly, just standing up qualifies.

And this notion, that just getting off the literal seat of our pants more often could have implications for life expectancy and vitality, invites some reflection on the figurative meaning. The expression "flying by the seat of our pants" apparently owes its origins to the early days of aviation, when instinct and feel mattered as much or more than high-tech instrumentation. If early pilots could establish that kind of connection with an airplane, perhaps the rest of us could at least manage it with our own bodies.

If you are stiff or sore after hours at a desk, it may be time to get up, walk around, stretch out a bit. If you are feeling sluggish, feel your productivity declining, need something to boost your energy, a walk might be a far better solution than an energy drink. As for standing: We can stand from a chair; we can stand from a couch; and we can even stand from a pew!

And we can do more than just stand up, even if we only have a few minutes free at a time. Colleagues and I have developed a free physical activity program for kids in school (or at home), and another for adults at work, that allow for intermittent, brief bursts of high-quality physical activity throughout the day. There are options for converting work at a desk from a sitting to a walking activity for those so inclined. And there are ways of adding physical activity that are as much about having fun as they are about finding health.

If the modern day is a round hole, and conventional approaches to exercise are a square peg, we certainly can muster the resourcefulness to whittle the peg, or drill a new hole. Many, my colleagues among them, have already done just that.

If just standing more and sitting less can add years to life and life to years, then we owe a lot of ill health to the seats of our pants. The solution is for us each to incorporate strategies into our daily routines that allow us to get up and move about, at least a little, at least intermittently. It's not aviation science, and no complex instrumentation should be required. I think, in fact, we should all be able to get there, by the seat of our pants.

David L. Katz, MD, FACP, MPH, FACPM, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care. He is a board certified specialist in both Internal Medicine, and Preventive Medicine/Public Health, and Associate Professor (adjunct) in Public Health Practice at the Yale University School of Medicine. He is the Director and founder (1998) of Yale University's Prevention Research Center; Director and founder of the Integrative Medicine Center at Griffin Hospital (2000) in Derby, Conn.; founder and president of the non-profit Turn the Tide Foundation; and formerly the Director of Medical Studies in Public Health at the Yale School of Medicine for eight years. This post originally appeared on his blog at The Huffington Post.