How to combat sedentary behaviour or the ‘sitting disease’?

Sedentary behaviour has reached the status of a global health epidemic. According to the World Health Organisation (WHO), approximately 2 million deaths a year are directly linked to this phenomenon. Also known as the sitting disease, a sedentary lifestyle is typified by people who spend at least six hours a day in a seated, reclined, or lying posture, and who lack sufficient physical activity. Regular physical activity is preventive in the onset of a wide range of conditions. Not only does it serve the body with health benefits, it also bolsters our mental form, helps to maintain a healthy weight, and contributes to our overall well-being.According to Ms Koh Hui An, Senior Physiotherapist, Ng Teng Fong General Hospital (NTFGH), sedentary behaviour is defined as simply “taking fewer than 5,000 steps a day, on a weekly average.” She described the condition as being prevalent and even commonplace amongst those that she has immediately observed. “Just by asking the people around us or the patients that we work with, we noticed that an average desk-bound person walks less than 3000 steps a day. For people working from home, the daily average further decreases by another 350 to 400 steps,” continued Ms Koh. You’re going to want to stand for what we’re about to share with you: sedentary behaviour is a public health risk. •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• •••••••••••••••••••••••••••••••••••••••••• Source: World Health Organisation steps a day is considered sedentary behaviour a yearare directly linked tosedentary lifestyles Approximately spend at least8 hours per day sitting down Approximately Increases likelihood of health problems >8 hours a day Increases fatal cardiovascular risks by at least 45 % hours a day On average, Singaporeansare awake this period of We should be moving for at least Any bodily movement produced by skeletal muscles that requires energy expenditure •Prolonged sitting•Bad posture •Non-ergonomic support •Chronic back pain •Compression of the spinal disc Studies show links between sedentary behaviour and lung, uterine and colon cancer What causes a sedentary lifestyle? While technologies and modern living have created more conveniences, they have also nudged us into increasingly passive postures; a large percentage of our domestic and professional lives now revolve around sitting and staring at various screens for hours on end, often with few intermissions to allow for physical movement. Although this doesn’t sound like dangerous behaviour, the truth is that inactivity, especially over prolonged periods, makes us sitting ducks for a litany of health problems. These range from the physical to the mental – and may even result in early mortality.The COVID-19 pandemic has also exacerbated physical inactivity due to global lockdowns and the resultant limited opportunities for incidental physical activities.“During Singapore’s circuit breaker period, a significant reduction in overall physical activities was recorded in Singaporeans aged 21 to 40 years old, who took approximately 4,000 steps on a typical day,” said Ms Koh. “This is the equivalent to spending an additional 40 minutes a day in a lying or sitting posture.”While it is too soon to record the true effects of the pandemic on sedentary behaviour, Dr William Kristanto, a consultant at the Division of Cardiology at NTFGH, added: “Working from home may [have increased] sedentary behaviour, as the physical activity associated with commuting to work has been reduced.” How much do I need to move? In a Canadian study, which followed over 17,000 participants for an average of 12 years, researchers showed a significant association between daily sitting time and cardiovascular health. “Compared with people who reported sitting almost none of the time, those that reported sitting almost all of the time had a 54% higher risk of dying from all-cause and cardiovascular diseases,” said Dr Kristanto. Another Australian study showcased the risks behind the phenomenon we know as being a ‘couch potato’. "When compared with those who reported watching television less than two hours per day, individuals who watched television for four or more hours per day experienced a 45% and 80% increased risk of all-cause and cardiovascular disease mortality, respectively,” shared Dr Kristanto. Aside from its strong ties to cardiovascular fitness, prolonged sitting also contributes to an increased risk in developing high blood pressure and diabetes mellitus, as well as weight gain and fat accumulation that can lead to metabolic syndrome.Your muscles and spine can also suffer the adverse effects of sedentary behaviour. “These muscles are important for walking and stabilisation. When they are weak, you are more likely to get injured,” Dr Krisanto explained. He added, “Prolonged sitting, especially coupled with poor posture and non-ergonomically designed chairs, may lead to poor spine health resulting in compression of spinal discs and chronic back pain.”And physical inactivity has even more dire consequences. “Emerging studies suggest a possibility that sedentary behaviour increases the risks of developing lung, uterine, and colon cancers,” said Dr Kristanto. In addition to these debilitating physical conditions, a sedentary lifestyle also has adverse effects on mental health, as it is a risk factor for anxiety and depression. So how much movement is necessary to keep these health problems at bay? “People who have a weekly exercise plan and are achieving the global recommendation of 150 minutes a week of moderate-intensity physical activities, may reduce their risk of cardiovascular diseases and associated mortality,” said Ms Koh. Learning to incorporate short periods of movement and exercise into your daily routine, whether at the office or while working from home, is critical in countering the long hours we spend sitting or lying down. “A little something goes a long way. Heart diseases are contributed by long-term exposure to risk factors, so every chance of physical activity would help to mitigate those risks,” said Dr Kristanto. And if you need even more motivation to get moving, try to incorporate more enjoyment into your routine, as it plays a big part as a natural motivator. “Physical activity includes any bodily movement, be it a structured routine, frequency, intensity and time specific, or not,” said Ms Koh.“Ultimately, the key to increasing overall participation in physical activity is to select activities that we find joy in doing, to sustain the behaviour.” can result in Obesity Type 2 diabetes Cancer The harmful effects of sedentary behaviour Premature death Cardiovascular diseases Moderate-intensity activities The more energythe activity requires, the more you will burn such as walking at a faster pace Exercise at 64 % – 76 % of your maximum heart rate* *Calculate by subtracting your age from 220. At least 150 – 300 minutesa week Brisk walking ~5.6 km/hr Set reminders to walk every 30-45 minutes Minimize and break up prolonged periods of sitting Walk or cycle to work Invest in astanding desk or workstation Use the stairs instead of the elevator Taking a walk during your lunch break

In consultation with Dr William Kristanto, Consultant, Department of Medicine, Division of Cardiology, NTFGH and Ms Koh Hui An, Senior Physiotherapist, Department of Physiotherapy, NTFGH.

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