What’s the problem with excessive sitting?
The proportion of older adults is increasing globally. Persons over age 60 may account for a quarter of the UK population in 2050. Older persons spend a disproportionately large amount of time in sedentary behaviors, such as sitting, which predict increased risk of worse health.
Lots of daily sitting predicts increased risks of premature death, cardiovascular disease, type 2 diabetes, dementia, and loss of muscle mass and strength for older adults. If you’re looking to die early, perhaps from heart problems, suffer from diabetes and dementia, and end up with muscle wasting (sarcopenia), keep on sitting. Otherwise, keep reading.
Adverse effects of low muscle mass
Canadian and American researchers reviewed evidence for the negative effects of low muscle mass. The studies included hospitalized patients undergoing surgery; patients with cardiovascular disease or chronic obstructive pulmonary disease; outpatients with cancer or liver diseases; and older persons in long-term care facilities. Overall, low muscle mass predicted shorter survival, worse physical function, more surgical and post-operative complications, longer lengths of hospital stays, and poorer quality of life. Effective interventions that promote greater muscle mass could help stem the rise of medical care expenses and improve the quality of life, especially of older persons.
Can interventions reduce sitting time and increase moving time?
Researchers in the UK conducted a systematic review of intervention studies that aimed to decrease sedentary behaviors and to trade sitting time for more active behaviors. The interventions lasted from 2-8 weeks. Overall, the studies showed that interventions might reduce sedentary behaviors by reducing sitting time in favor of standing or walking. Objectively measured activity suggested that an intervention could induce 50 minutes of additional daily walking time. Alas, the 6 studies in the review had poor methodological quality with large differences in procedures among them. Whether or not decreasing sedentary behavior actually improves measures of physical health remained unknown (but keep reading).
Can interventions help older adults with excess weight and health conditions build muscle mass?
Older adults with overweight or obesity and medical conditions spend a lot of time in sedentary behaviors, such as sitting. Unfortunately, such individuals have considerably higher risk of diminished health. Researchers developed a pilot study to determine if a cognitive behavioral theory-based intervention would reduce sitting time, increase walking and standing times, and improve measures of overall health. The 36 participants had an average age of 71 years and had either overweight or obesity. The 8-week intervention included 5 phone calls, mostly about 20 minutes long, from health coaches with individual participants. The health coaches used motivational interviewing to help participants identify goals and figure out how to achieve them.
At the end of the 8-week intervention, participants modestly but significantly reduced sitting time by 27 minutes per day and significantly increased standing time by 25 minutes per day. In addition, participants significantly increased device-measured light activity (21 minutes per day) and moderate-vigorous physical activity (4 minutes per day). Overall physical function and gait speed increased significantly. This promising, relatively low-intensity intervention (a bit more of 2 hours of phone calls per participant) led to modestly less sitting and more standing and more movement activity for older, overweight or obese persons with medical conditions.
Can interventions reduce sedentary behaviors and improve health measures?
Physically inactive people typically have high levels of sedentary behavior, which predicts increased risks of poor health. Greater amounts of physical activity can reduce the amount of daily sedentary behavior. A recent systematic review and meta-analysis of 18 studies (nearly all randomized controlled trials) studied whether interventions designed to reduce sedentary behavior would be effective for people with medical conditions. Effective interventions included self-monitoring, motivational counseling, social motivation, and either a cell phone app or access to a website. Positive effects of the interventions were most pronounced for patients with type 2 diabetes, overweight, and obesity. On average, intervention groups significantly reduced daily sedentary behavior by 64 minutes more than the control groups. Plus, intervention groups significantly increased both daily walking time (27 minutes) and step counts (1,976) compared to the control groups. Finally, the intervention groups significantly reduced blood sugar levels (HbA1c by – 0.17 percent), body fat (-0.66 percent), and waist circumference (-1.52 cm) compared to the control groups. Thus, multi-component interventions can help people with medical conditions sit less and move more and improve several measures of better health.
Can interventions reduce sitting and lower blood pressure?
Less sitting time and shorter bouts of sitting predict lower risk of hypertension, a leading cause of cardiovascular disease. A new study investigated whether a six-month intervention designed to reduce sitting time would reduce systolic blood pressure. Researchers with the Kaiser Permanente Washington Health Research Institute recruited 283 participants (average age 69 years) who were randomized to either the intervention group or an equal contact time control group. Members of the intervention group received up to 10 coaching sessions (2 in person and 8 by phone), a study workbook, a wrist-worn fitness band, feedback from the fitness band, and a tabletop standing desk. Members of the control group received 10 health coaching contacts.
After 6 months, participants in the intervention group significantly reduced their average daily sitting time by 32 minutes more than the control group. As sitting time decreased, standing time increased significantly. The intervention group significantly reduced systolic blood pressure by 3.5 mm Hg more than the control group. That level systolic blood pressure reduction was similar to that found in studies using increased exercise or improved diet. Interventions may help older Americans reduce their sitting time, reduce their systolic blood pressure, and reduce their risk of cardiovascular disease.
What to do
Sitting all day long as you age won’t do you any good. To the contrary, sitting less and moving more will likely reduce your risks of chronic conditions and improve your health and quality of life. If you’re a senior and have Medicare Part B supplemental insurance, you may qualify for a free gym membership. Head to the gym and ask a trainer show you how to use the training equipment. I visit my local YMCA twice a week and spend a little more than an hour each time doing resistance, flexibility, and balance exercises. I sometimes do resistance exercises with hand weights in my back yard. I feel better each time I exercise, plus I know that I’ll be able to do the things I enjoy far more and longer than I otherwise would.
