January 16, 2023
By Dr. Joel K. Kahn
This article addresses what I call sederericide (killing oneself by excessive sitting).
I am a cardiologist addicted to standing. I use a standing desk when I see patients at my office. I use a standing desk at home. When we used to go to conferences I was always the guy in the back of the room pacing back and forth rather than sitting. When we use to fly I was the guy by the exit row standing and squatting. Are you that attorney with the same issue?
We can all blame James Levine, M.D., Ph.D., of the Mayo Clinic. He has shown the health risks of prolonged inactivity and sitting. His research showed that even small movements contributed to health and prolonged sitting contributed to disease and even early death. He explained in 2014:
Excessive sitting has been linked to more than 2 dozen chronic diseases and conditions including cardiovascular disease, diabetes mellitus, obesity, hypertension, hyperlipidemia, back pain, ankle swelling, and deep vein thrombosis. Of concern, going to the gymnasium after work does not offset the harm of sitting, and excess sitting harms lean and obese people alike. Studies, thousands of them, drill down to the same point: sitting is lethal.
Or to quote the title of Dr. Levine’s 2014 book, Get Up! Why Your Chair is Killing You and What You Can Do About It.
How did Dr. Levine identify the health risks of prolonged inactivity? About 15 years ago he had research subjects wear underwear with multiple sensors in them to track their activity. He observed that obese individuals moved less compared with thin people during an average day. It was not gym time but small motions like standing, shaking legs and walking to the water cooler. He called these motions NEAT or non-exercise activity thermogenesis. It helps to burn calories when you are active, even if it is just standing and fidgeting.
Subsequently, researchers have found that each hour of sitting per day is associated with an increased hardening of heart arteries, a sign of aging. These small, daily and consistent movements, NEAT, were more preventive of heart aging than even prolonged time in the gym! The lead author of the study summarized the findings as “how much you sit every day may represent a novel, companion strategy (in addition to exercise) to help reduce your cardiovascular risk.” Heart disease joins other diseases linked to excessive sitting including diabetes mellitus, high blood pressure, obesity, cancer, and dementia. Even 30 minutes of sitting has been found to raise the “bad” LDL cholesterol, blood pressure, blood sugar and inflammation levels along with lower levels of mental alertness.
So what are we to do? The amount of activity needed to improve the response to prolonged sitting is small; even light walking two out of every 20 minutes can improve blood sugar metabolism. Standing 5-10 minutes and hour, combined with some squats or walking in place, can overcome most of the detriment of prolonged sitting.
What is an attorney to do? How about start reading. depositions standing or even on a slow-moving treadmill. Take phone calls standing or moving around.
And, please, read Labor and Employment Lawnotes while pacing like a trapped tiger.
Editor’s Note: Joel Kahn, MD, FACC, is a practicing cardiologist and a clinical professor of medicine at Wayne State University School of Medicine. His books include Lipoprotein(a): The Heart’s Silent Killer; Your Whole Heart Solution, Dead Execs Don’t Get Bonuses; and The Plant Based Solution. See www.drjoelkahn.com.
“NEVER STAND UP WHEN YOU CAN SIT DOWN. AND NEVER SIT DOWN WHEN YOU CAN LIE DOWN.”
Winston S. Churchill (1874-1965)
This quote comes from historian and writer Paul Johnson, who met Churchill in October 1946 when Johnson was about to go to Oxford. In his great book, Churchill (2009), Johnson writes (at 5):
Churchill was capable of tremendous physical and intellectual efforts, of high intensity over long periods, often with little sleep. But he had corresponding powers of relaxation, filled with a variety of pleasurable occupations, and he also had the gift of taking short naps when time permitted. Again, when possible, he spent his mornings in bed, telephoning, dictating, and receiving visitors.
In 1946, when I was seventeen, I had the good fortune to ask him a question: “Mr. Churchill, sir, to what do you attribute your success in life?” Without pause or hesitation, he replied: “Conservation of energy. Never stand up when you can sit down, and never sit down when you can lie down.” He then got into his limo.
Most of us are not Churchill-like-hardworking, courageous, brilliant and able to conduct business in bed, aided by short naps. We ought to follow Doctors Kahn’s and Levine’s advice.
– John G. Adam
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