Health Optimization In The Workplace

The Risks of Being Sedentary in the Office

Health Fitness Productivity Discussion Paper

Carol Ewing Garber, Ph.D., FAHA, FACSM, author of the American College of Sports Medicine's (ACSM) new guidelines on quantity and quality of exercise for adults, states it as it is; sitting for long periods of time is not just a bad habit, it is harmful to your health. Research shows long intervals of physical inactivity during the day raise your risk of developing heart disease, diabetes, cancer and obesity. The field of inactivity physiology is new and the numbers vary, but the message is clear. Our lifestyles behind a desk and computer are putting our health at risk. According to Dr. Emmanuel Stamatakis, who led a study out of the University College London, published in the January 18, 2011, issue of the Journal of the American College of Cardiology, whether you spend time in front of a computer or a television screen for four or more hours a day you are 125 percent more likely to suffer a major heart problem than those who spend two hours or less. Further analysis of the data suggests that two or more hours of screen time per day may increase the odds for a cardiac event. He goes on to say Our one hour exercise routine during non-work hours cannot reverse the damage done by working 9-5 on our computers. ACSMs overall 2011 recommendations are consistent with the 2008 Physical Activity Guidelines for Americans, which states that most adults should engage in at least 150 minutes of moderate-intensity exercise each week. Many of us have worked to diligently follow these guidelines, working our 8-10-12 hour days and faithfully putting in roughly an hour of exercise at least three times per week. We all need to take note... there is now scientific evidence that it is not how much time we spend moving that needs to be monitored, but the amount of time that we are not moving. It is our sedentary time that is key and predictive of our overall health. Consider the following points, the second of which is a new advisory mentioned in the ACSMs 2011 paper:

Though exercise protects against heart disease, it is still possible for active adults to develop heart problems. All adults must be able to recognize the warning signs of heart disease, and all health care providers should ask patients about these symptoms. Sedentary behavior sitting for long periods of time is distinct from physical activity and has been shown to be a health risk in itself. Meeting the guidelines for physical activity does not make up for a sedentary lifestyle.

It is no longer enough to consider whether an individual engages in adequate amounts of weekly exercise, said Garber, who is an associate professor of movement sciences at the Teachers College of Columbia University. We also need to determine how much time a person spends in sedentary pursuits, like watching television or working on a computer. The evidence is clear that sitting for long periods of time adversely affects health. Sitting for long periods of time actually increases the risk of obesity, diabetes, heart disease and an early
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death. In other words, regardless of whether or not you exercise vigorously, sitting for long periods is dangerous. Our one hour exercise routine during non-work hours cannot reverse the damage done by sitting from 9:00 to 5:00 in front of our computers. So what is it about sitting, or being sedentary, that makes it so dangerous? One of the dangers is the documented physiologic change that occurs with long periods of sitting; without movement, muscles significantly reduce the uptake of plasma (blood) and the electrical activity in the muscles drops, which leads to harmful metabolic changes. The most immediate and dangerous change is the suppression of the activity of lipoprotein lipase, a heart healthy enzyme. Lipoprotein lipase is the enzyme responsible for breaking down fats in the blood. It is the reduction of this enzyme that poses the greatest risk for cardiac events, diabetes, increased abdominal fat and metabolic syndrome. It follows that with lower levels of lipoprotein lipase the fats in our blood accumulate, leading to a host of health issues. Dr. Stamatkiss research suggests that prolonged sitting can cause up to a 90% reduction in lipoprotein lipase. Other deleterious effects include a significant drop in calorie-burning rates (to about one per minute) as well as a drop in insulin effectiveness which can increase the risk of developing Type 2 diabetes. In the European Heart Journal, Dr Genevieve Healy, a research fellow at the School of Population Health, The University of Queensland, Australia, recently published a study that looked at the links between the total amount of time spent sitting down and the breaks in sedentary time. Dr. Healy studied various risk indicators for heart disease, metabolic diseases such as diabetes, and inflammatory processes that contribute to atherosclerosis. The results were startling and a rude wake up call for those of us who spend time in moderate to vigorous activity. Prolonged periods of sedentary time were associated with worsening indicators of cardio-metabolic function and inflammation. These indicators include waist circumference, insulin resistance, lower levels of HDL (the good cholesterol), higher levels of Creactive protein (an important marker in inflammation) and triglycerides. Dr Healy states: "The benefits of regular participation in moderate-to-vigorous intensity exercise are well accepted scientifically and by the general public. However, the potential adverse health impact of prolonged sitting (which is something that we do on average for more than half of our day), is only just being realized. Our research highlights the importance of considering prolonged sedentary time as a distinct health risk behavior that warrants explicit advice in future public health guidelines. In particular, the findings are likely to have implications for settings where prolonged sitting is widespread, such as in offices. In her conclusion she states "Prolonged sedentary time is likely to increase with future technological and social innovations, and it is important to avoid prolonged periods of sitting and to move more throughout the day. Reducing and regularly breaking up sedentary time may be an important adjunct health message, alongside the well-established recommendation for regular
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participation in exercise. While further evidence of a causal nature is required, less sitting time would be unlikely to do harm. It would, at the very least, contribute to increased overall levels of daily energy expenditure and could help to prevent weight gain."

Solution: There is no possible way to get the benefits of physical exercise without moving
your body. Nobody can exercise for us, there is no magic pill and all of the plastic surgery in the world cannot do for us what an active, non-sedentary lifestyle can. The literature tells us that the hour at the gym before or after work does not counter the effects of sitting all day. So, what to do? Some people have developed desks at which you stand to do your work. Others have built desks on their treadmills and slowly walk while they work. Inspired by his son to get more physical exercise, yet faced with 10 to 12 hour days at the computer, Bryan Wassom of Pleasanton California took a different approach. While his weight gain was the impetus to get moving, Bryan was unaware that he was the poster child for a sedentary life. He was experiencing almost all of the health risks caused by a sedentary lifestyle: elevated blood pressure, high cholesterol and of course there was the abdominal fat (a major marker of metabolic syndrome) that he wanted to lose. His medical conditions were treated as separate and distinct problems by his physician without regard to his sedentary time. He was put on statins (medications to lower cholesterol), began running more in the mornings and was a vegetarian for 3 years. It wasnt until he solved his weight problem that he began to understand the totality of his situation and the effect on his health. To solve the weight problem, Bryan built a full size desk around his recumbent exercise bike, the combination of which he calls ActivOffice. He now rides an average two and three quarters hours a day each day that he is in his office, and most often, those 2.75 hours are spread across his entire work day. In the nine months since he started riding in October 2011, his total number of riding hours equates to more than 275 hours of exercise that he would not otherwise have had access to. In aggregate, Bryan has ridden more than 5,000 miles during this 9 month period of time. To put that into perspective its the equivalent of riding from San Jose California to Jacksonville Florida to New York City to Chicago and then on to Minneapolis. Not bad since he was able to exercise while also being productive in his sales career, take care of his familys financial matters, and work on his digital photography hobby (which happens to involve a lot of computer time). During the nine month period in which the data was recorded, Bryan averaged approximately 50 miles per day that he was in his office. He was able to ride the exercise bike 101 days out of the

190 working days that were available during the nine month period --- the balance of the 89 days were travel days which took him out of his office.

Miles Per Day

120
100 80 60 40 20 0
Aggregate Total = 5,031 Miles Aggregate Avg. = 49.81 Miles / Day
Bryan also recorded his time riding his ActivOffice exercise desk during the 101 days discussed in this paper. The data shown in A2 is a graphical representation of those hours. His methodology is as follows. A set is defined as the period of time he rode the exercise desk before stopping, and it ranges from 3 minutes to 160 minutes. There is no boundary for a set --it is simply based on what his work day permitted. Each time the bike is idle for more than five minutes, the computerized monitoring system shuts off. Any time Bryan stopped riding for more than five minutes, he would enter the data for the set into a journal, including the miles ridden and the calories burned. The following graphs reflect the amount of time and miles that he rode each day. His office days typically consist of phone calls, e-mails, conference calls, paperwork, and most of his activities can be conducted while he is pedaling. When he is not pedaling, he often stands at the side of his desk to prevent being sedentary. The desk height lends itself well to working in a standing position.
A1

Hi = 102 Miles in One Day Low = 10 Miles in One Day Miles Per Day

Bike Per Day LowTime = 35 Minutes

7.00 6.00 5.00 4.00 3.00 2.00 1.00 0.00
Aggregate Total = 16,638 Min = 277 Hrs. Aggregate Avg. = 2.74 Hours / Day
To understand the effect that the exercise desk has had on Bryans metabolic health, lets take a look at the before and after pictures of his weight and his blood chemistry by reviewing the information on the following pages. As one would expect, his weight dropped as the number of calories burned exceeded the number of calories consumed. With the exercise desk, it was easy to burn calories well beyond those he consumed on his regular diet.

Hi = 6 Hr, 13 Min Low = 35 Min Column1

Weight Prior to ActivOffice

Weight
200 190 180 170 160 150 Age 18 Age 30 Age 40 Age 50 Age 56

Weight

A3

The trend in A3 is not unusual in North America. There are certainly exceptions, but young people typically enjoy vigorous health and trim physiques prior to entering the work world. As we age and take on more responsibility, we become much more sedentary and our metabolism slows which causes increased weight and a variety of health issues which accompany physiques with which we are typically less than pleased. After nine months of regular exercise the with ActivOffice exercise desk, Bryans weight chart now shows a much healthier trend (graph A4).

Weight With ActivOffice

Weight
195 190 185 180 175 170 165 160 155

Weight

A4

At 6 foot 2 inches tall, Ideal Weight Charts recommend that Bryan weigh 164 pounds to 178 pounds, numbers he thought were long behind him. In October of 2011, prior to developing the ActivOffice exercise desk, Bryan weighed 194 pounds. As of the date of this paper, his current weight is174 pounds, a loss of 20 pounds in 9 months. His results suggest a solution to the weight gain most people living a sedentary lifestyle experience. With the ability to optimize his time by riding while working, he is able to burn a substantial number of calories (graph A5). His focus now is being certain he eats enough calories to support his activity!

Calories Burned

3000.00 2500.00 2000.00 1500.00 1000.00 500.00

Hi = 2824 Calories Low = 300 Calories

Column1

0.00
Aggregate Total = 126,920 Calories Aggregate Avg. = 1256 Calories / Day

A5

Metabolic Benefits
The benefits to Bryans metabolic health cannot be overstated. His total cholesterol has dropped 16% (from a high of 220mg/dl in 2010 to 185 mg/dl); LDL, the bad cholesterol, has dropped 21% (from 131 mg/dl to 103 mg/dl); triglycerides have dropped 32 % (from 57 mg/dl to 39 mg/dl); and his HDL, the good cholesterol, has increased 54% (from 48 mg/dl to 74 mg/dl). Once his LDL is below 100 mg/dl, Bryans doctor plans to take him off of his cholesterol medication. The following graph illustrates how much closer his blood levels are to optimal standards.

250 200
Total Cholesterol

150 100 50 0 Optimal 2009 Feb-12 Jun-12

Triglycerides HDL LDL

To summarize, Bryan had gained approximately 25 pounds over a 30 year period of time. His cholesterol levels were increasing with every passing year. Attempts to manage his weight and high cholesterol by exercising on a regular basis were unsuccessful and it became impossible to offset the negative effects caused by the number of sedentary hours he spent in his office. Below are Bryans overall results after riding the exercise desk for more than 275 hours over a period of 9 months and a distance of more than 5,000 miles. Weight: Down from 194 to 174 = 20 Pounds lost. (While Eating / Drinking Anything He Wanted)

Cholesterol: Total cholesterol down from 220 mg/dl to 185 mg/dl LDL down from 131 mg/dl to 103 mg/dl Sedentary Office Hours: Down by 275 Hours Inadequate Levels of Exercise: PROBLEM SOLVED.

Other: Sleeping, Digesting, Thinking, Moving, and Feeling BETTER. Substantially More Energy. There are a variety of ways to incorporate movement, activity and exercise into your workday, but it may take some creative thinking and changes to your routine or your office layout. We strongly encourage you to consider ways to minimize your sedentary hours.

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