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Sit Less to Move More ~ Maureen Ashe, PhD

 Abundant evidence exists extolling the benefits of physical activity, and specifically to include more exercise into daily life. Despite this, ample data highlights that many people are inactive [1 2], sedentary, [3], and the group who are most at risk are older adults.

Fortunately, evidence suggests that health behaviours adopted earlier at midlife reduce the risk for developing chronic disease [4]. Prevention strategies to increase physical activity in middle-aged can result in downstream benefits across many domains such as increased fitness, enhanced social engagement, and a positive impact on quality of life.

The question remains: how do we implement sustainable solutions for people to uptake and adhere to a physically active lifestyle? One possible solution is to “re-engineer energy expenditure” [5] back into our lives through activities of daily living and utilitarian walking.

Photo by “AlmaGamil_Philippines”. Used with permission. All rights reserved. Source: flickr

Photo by “AlmaGamil_Philippines”. Used with permission. All rights reserved. Source: flickr

Recently the science [6] and epidemiology [7 8] of sedentary behaviour has emerged in the literature and mass media, challenging previous terminology used to denote someone who did not engage in physical activity. Historically people have used the words sedentary or inactive interchangeably. Guidelines published in 2012 by the Sedentary Behaviour Research Network [9] propose that inactivity is defined by an individual not meeting current recommendations for physical activity, ie, not meeting 150 minutes per week of moderate to vigorous physical activity (MVPA).

In contrast, sedentary behaviour refers to waking activities in a sitting or reclining posture, which are low in energy expenditure defined by less than or equal to 1.5 metabolic equivalent of task (MET) [9].

For some older adults, it may be insurmountable to tackle 150 minutes per week of MVPA at least in the beginning. In contrast, it may be easier to suggest that an activity program begins by simply sitting less throughout the day. If watching TV, have standing breaks during the commercials (or even reduce total TV time altogether!); wash the dishes by hand instead of loading up a dishwasher; and/or walking to the local mailbox or store.

A feasibility study by Gardiner and colleagues [10] highlighted that a brief behavioural intervention for older adults 65 years plus resulted in a three percent reduction in sitting time over a two-week period. An interesting detail of this study was that the sitting time reduction was replaced by a two percent increase in light activity and a one percent increase in MVPA.

Starting with reduced sitting time is a potential way towards increasing physical activity. The science of sedentary behaviour and physical activity, although distinct, still operate collectively when taking a full day approach to active living and health.

Recently, Robinson [11] coined the term “stealth intervention” to describe his behavioral programs designed to tackle the obesity epidemic. He posits interventions such as traditional dancing or raising awareness of food-related environmental issues provide positive health benefits, without actually setting the long-term goal of improving health. Does this make reducing sedentary behaviour a stealth intervention?

For older adults, and especially those with mobility challenges, a “Sit Less to Move More” strategy may be an optimal approach to slowly adopt physical activity, and especially exercise, as a way of life.

Maureen Ashe is an Assistant Professor in the Department of Family Practice at the University of British Columbia, and an investigator at the Centre for Hip Health & Mobility in Vancouver, Canada. Her research interests include investigating older adults’ physical activity and sedentary behaviour patterns and the influence on mobility. More recently, she expanded her focus to include the role of the built and social environments on older adults’ community participation.

References:

1. Troiano RP, Berrigan D, Dodd KW, et al. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 2008;40(1):181-8 doi: 10.1249/mss.0b013e31815a51b3[published Online First: Epub Date]|.

2. Ashe MC, Miller WC, Eng JJ, et al. Older adults, chronic disease and leisure-time physical activity. Gerontology 2009;55(1):64-72 doi: 10.1159/000141518[published Online First: Epub Date]|.

3. Matthews CE, Chen KY, Freedson PS, et al. Amount of time spent in sedentary behaviors in the United States, 2003-2004. Am J Epidemiol 2008;167(7):875-81 doi: kwm390 [pii] 10.1093/aje/kwm390[published Online First: Epub Date]|.

4. Willis BL, Gao A, Leonard D, et al. Midlife fitness and the development of chronic conditions in later life. Arch Intern Med 2012;172(17):1333-40 doi: 10.1001/archinternmed.2012.3400[published Online First: Epub Date]|.

5. Stein J. Stay moving, not still. Exercise slows aging and makes us feel better. Los Angeles Times. Los Angeles, 2009.

6. Hamilton MT, Hamilton DG, Zderic TW. Exercise physiology versus inactivity physiology: an essential concept for understanding lipoprotein lipase regulation. Exerc Sport Sci Rev 2004;32(4):161-6 doi: 00003677-200410000-00007 [pii][published Online First: Epub Date]|.

7. Owen N, Bauman A, Brown W. Too much sitting: a novel and important predictor of chronic disease risk? BJSM 2009;43(2):81-3 doi: bjsm.2008.055269 [pii] 10.1136/bjsm.2008.055269[published Online First: Epub Date]|.

8. Proper KI, Singh AS, van Mechelen W, et al. Sedentary behaviors and health outcomes among adults: a systematic review of prospective studies. Am J Prev Med 2011;40(2):174-82 doi: 10.1016/j.amepre.2010.10.015[published Online First: Epub Date]|.

9. Sedentary Behaviour Research Network. Letter to the editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab 2012;37(3):540-2 doi: 10.1139/h2012-024[published Online First: Epub Date]|.

10. Gardiner PA, Eakin EG, Healy GN, et al. Feasibility of reducing older adults’ sedentary time. Am J Prev Med 2011;41(2):174-7 doi: 10.1016/j.amepre.2011.03.020[published Online First: Epub Date]|.

11. Robinson TN. Stealth interventions for obesity prevention and control: motivating behavior change. In: Dube L, Bechara A, Dagher A, et al., eds. Obesity Prevention: The Role of Brain and Society on Individual Behavior. New York, NY: Elsevier, 2010.

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