A recent report in Medscape pointed out that the total time we spend sitting has a direct relationship with early death.

Yes, and I am sitting as I type this. Am I suicidal or what?

Here is the link. If you aren’t signed up with Medscape, you will have to create a login and a password. The great thing about Medscape is that it is free, and you don’t get any unwelcome emails, just announcements. I am signed up in the psychiatry category, but I do get all their notices, not only psychiatry.

Here is the teaser paragraph from Medscape:

“Prolonged sitting was associated with higher mortality from all causes, as well as increased incidence of cancer, cardiovascular disease, and type 2 diabetes, even among people who exercise regularly, according to a meta-analysis published in the January 20 issue of the Annals of Internal Medicine.”

Glad I subscribe to Medscape, as I don’t read Archives of Internal Medicine.

This is a meta-analysis, analyzing 39 studies of time sitting versus risk of illness.

Here is a paragraph from the study on the hazard ratios:

“Sedentary lifestyle was linked to a hazard ratio (HR) for all-cause mortality of 1.240 in the meta-analysis (95% confidence interval [CI], 1.090 – 1.410). Further, sedentary behavior was associated with an increase in cardiovascular disease mortality (HR, 1.179; 95% CI, 1.106 – 1.257), cardiovascular disease incidence (HR, 1.143; 95% CI, 1.002 – 1.729), cancer mortality (HR, 1.173; 95% CI, 1.108 – 1.242), cancer incidence (HR, 1.130; 95% CI, 1.053 – 1.213), and type 2 diabetes incidence (HR, 1.910; 95% CI, 1.642 – 2.222).

The increased risk for all-cause mortality was most pronounced among people with lower levels of physical activity, the authors found. The relative risk for sedentary behavior for all-cause mortality among those with high levels of physical activity was 30% lower than for those with low levels of physical activity. The hazard ratio for those who exercised frequently was 1.16 (95% CI, 0.84 – 1.59) compared with a HR of 1.46 (95% CI, 1.22 – 1.75) for those who did not.”

I have read the Wikipedia entry on Hazard Ratios and can explain it simply as this: A Hazard Ratio of 2.0 means the experimental group has twice the chance of having a disease as the control group. So, from the paragraph above, cardiovascular disease risk is roughly 18% higher from prolonged sitting. All cause mortality is 24% higher for a prolonged sitting group.


Many of my readers are mental health professionals. Here’s a juicy fact for you. Women who sit seven hours a day or more are 47% more likely to develop major depressive disorder.

The good news is that frequent exercise reduces your HR from 46% risk rise to only 16% rise. So you reduce your risk by a very nice amount by frequent exercise, perhaps 30 minutes a day.

But outside of this study, I do need to mention some good news. There is a good amount of evidence that there are some good alternatives when we have to sit for our jobs. Five minutes an hour of activity, even walking at a mile pace, will reverse the damaging effects of sitting.

You could create a “standing desk” where you raise the desk up and do your work while on your feet.(Link goes to images.google.com search for “standing desks.” But that isn’t an ideal solution. Continuous standing or sitting is not good; the body needs to shift and change. Nurses and retail sales people are well known for the damage that standing continuously does. 

You can get up and stretch / walk / exercise lightly every hour or two. Do some yoga every hour.

You could sit on an exercise ball instead of a regular chair. John F. Kennedy had a very bad back; his physician made him sit in a rocking chair for the slight but useful exercise. (Doesn’t that date me to the Cretaceous?) 

On the other hand, six hours of uninterrupted sitting robs you of the benefits of an hour of exercise.  In other words, if you exercise, you have to get up and move once an hour in order to retain the great health benefits from the exercise. 

Many of my readers are therapists and coaches, and we do in fact sit. That’s what I’ve done for 40 years. If I could start over again, I would take a five minutes break between each patient and do some yoga or squats or stretches, and so on. I think I would also replace my regular office chair with an exercise ball.

(I recall thinking when I was starting out that I wished I could sit on a stationary bicycle during therapy sessions, or perhaps do sessions from a treadmill. But I realized how silly that was and didn’t.)

Our bottom line: If you want to live longer, try something to avoid prolonged sitting. If you are a therapist, try to exercise, even mildly, once an hour for a few minutes. If you coach or teach people, pass this along to students, clients, and patients.

Now I am going for a walk. Want to join me?