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How much do sedentary people really need to move? It’s less than you think

<p>People who spend much of their day sitting may need to move around less than we thought to counteract their sedentary lifestyle, new research shows.</p> <p>Our research, published today in the <a href="http://www.onlinejacc.org/content/73/16/2062">Journal of the American College of Cardiology</a>, found about 20-40 minutes of physical activity a day seems to eliminate most health risks associated with sitting.</p> <p>That’s substantially lower than the one hour a day <a href="https://bjsm.bmj.com/content/early/2018/06/05/bjsports-2017-098963">a previous study</a> has found.</p> <p>We spend almost all our waking day sitting, standing, or moving. The health impact of each one of these can be complex.</p> <p>For example, too much standing can lead to <a href="https://bjsm.bmj.com/content/52/3/176">lower back problems</a> and even a <a href="https://academic.oup.com/aje/article/187/1/27/4081581">higher risk of heart disease</a>. But sitting for too long and not moving enough <a href="https://jamanetwork.com/journals/jama/fullarticle/2712935">can harm our health</a>.</p> <p>Then there are people who sit for many hours and also get in reasonable amounts of physical activity. For example, someone who has an office job but walks to and from work for 20 minutes each way and runs two to three times a week easily meets <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/ti-18-64years">the recommended level of physical activity</a>.</p> <p>While we know moving is better than sitting, what is far less clear is how much of a good thing (moving) can offset the harms of a bad thing (sitting).</p> <p>That’s what we wanted to find out in our study of almost 150,000 Australian middle-aged and older adults.</p> <p>We followed people enrolled in the <a href="https://www.saxinstitute.org.au/our-work/45-up-study/">45 and Up Study</a> for nearly nine years. We looked at links between sitting and physical activity with deaths from any cause, and deaths from cardiovascular disease such as heart disease and stroke, over that time. We then estimated what level of moderate-to-vigorous physical activity might offset the health risks of sitting.</p> <p>This kind of activity is strenuous enough to get you at least slightly out of breath if sustained for a few minutes. It includes brisk walking, cycling, playing sports or running.</p> <p><strong>What we found</strong></p> <p>People who did no physical activity and sat for more than eight hours a day had more than twice (107%) the risk of dying from cardiovascular disease compared to people who did at least one hour of physical activity and sat less than four hours a day (the “optimal group”).</p> <p>But it wasn’t enough just to sit less. People who did less than 150 minutes of physical activity a week and sat less than four hours a day still had a 44-60% higher risk of dying from cardiovascular disease than the optimal group.</p> <p>We also calculated the effect of replacing one hour of sitting with standing, walking, and moderate and vigorous physical activity.</p> <p>Among people who sit a lot (more than six hours a day) replacing one hour of sitting with equal amounts of moderate physical activity like strenuous gardening and housework, but not standing, was associated with a 20% reduction in dying from cardiovascular disease.</p> <p>Replacing one hour of sitting with one hour of vigorous activity such as <a href="https://bjsm.bmj.com/content/51/10/812">swimming, aerobics and tennis</a>, the benefits were much greater, with a 64% reduction in the risk of dying from cardiovascular disease.</p> <p><strong>What does it all mean?</strong></p> <p>The great news for people who sit a lot, including sedentary office workers, is that the amount of physical activity needed to offset the health risks of sitting risks was substantially lower than the one hour a day <a href="https://bjsm.bmj.com/content/early/2018/06/05/bjsports-2017-098963">a previous study</a> found.</p> <p>Even around 20-40 minutes of physical activity a day - the equivalent of meeting the <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/ti-18-64years">physical activity guidelines</a> of 150 to 300 minutes a week – seemed to eliminate most risks associated with sitting.</p> <p>For people who sat a lot, replacing sitting with vigorous physical activity was better than replacing it with moderate activity; and replacing sitting with moderate activity or walking was better than replacing it with standing.</p> <p><strong>What’s the take-home message?</strong></p> <p>Our study supports the idea that sitting and exercise are two sides of the same <a href="https://bjsm.bmj.com/content/early/2018/07/10/bjsports-2018-099640">health “coin”</a>. In other words, enough physical activity can offset the health risks of sitting.</p> <p>Should we worry about sitting too much? Yes, because sitting takes up valuable time we could spend moving. So too much sitting is an important part of the physical inactivity problem.</p> <p>We also know only <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-2736-3">a minority of adults</a> get enough physical activity to offset the risks of sitting.</p> <p>For those who sit a lot, finding ways to reduce sitting would be a good start but it is not enough. The most important lifestyle change would be to look for or create opportunities to include physical activity <a href="https://bjsm.bmj.com/content/early/2019/02/15/bjsports-2018-100397">into our daily routine</a> whenever possible.</p> <p><strong>How to widen our activity “menu”</strong></p> <p>Not everyone has a supportive environment and the capacity to create opportunities to be active. For example, lack of time and physical activity being low on people’s list of priorities are the main reasons <a href="https://www.mdpi.com/2075-4663/5/3/47">why inactive adults</a> don’t exercise. Also, many do not have the motivation to power through a strenuous workout when they are juggling many other life challenges.</p> <p>There are no known remedies to a lack of time or low motivation. So, perhaps we need to add new approaches, beyond exercising and playing sport for leisure, to the “menu” of physical activity options.</p> <p>Incidental physical activity like active transportation – think <a href="https://bjsm.bmj.com/content/52/12/761">walking fast</a> or cycling part or all of the way to work – or <a href="https://bjsm.bmj.com/content/early/2019/02/15/bjsports-2018-100397">taking stairs</a> are great ways to become or stay active without taking much extra time.</p> <p><em>Written by Emmanuel Stamatakis, Joanne Gale and Melody Ding. Republished with permission of </em><a href="https://theconversation.com/how-much-do-sedentary-people-really-need-to-move-its-less-than-you-think-114824"><em>The Conversation</em></a><em>. </em></p>

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The easy-peasy guide to exercise as you age

<p>Sitting and lying down are classified as “sedentary” behaviours. You can be sedentary while watching television, driving your car or even whilst sitting down at a table with your laptop.</p> <p>Leading integrative cardiologist <a href="http://www.drrosswalker.com/" target="_blank"><strong><span style="text-decoration: underline;">Dr Ross Walker</span></strong></a> warns that “Physical inactivity as a result of a sedentary lifestyle can lead to something known as ‘disuse syndrome’, which may include conditions and illnesses such as premature ageing, obesity, cardiovascular vulnerability, musculoskeletal fragility, and depression”. In fact, every additional hour a day you spend sitting is linked to doubling the risk of being disabled.</p> <p>The simple way to avoid becoming sedentary is by making sure that the level of activity you are doing is sufficient. You may think that simply going for a long stroll from the couch to the biscuit aisle at the corner shop will do the trick. However, Dr Walker explains that this isn’t quite enough.</p> <p>“Low intensity exercises such as gardening and walking are definitely great to include into your daily routine, but you should not rely on these alone to alleviate risks associated with a sedentary lifestyle.”</p> <p>To ensure that you are getting enough exercise, Dr Ross advises that you need to incorporate a “moderate intensity” activity into your daily routine, for at least 30 minutes. Absolute moderate intensity has been defined by the Victorian government health guidelines as any activity that expends three-and-a-half to seven calories per minute.</p> <p>Here, we breakdown some ways that you can ensure you meet this target, and ones that don’t pounding the pavement. The <a href="http://wellness.illinois.edu/iWalk/intensity.html" target="_blank"><strong><span style="text-decoration: underline;">Illinois Wellness Centre</span></strong></a> has suggested some activities that are not normally what we think of as moderate exercise, but can be used to expend the necessary calories.</p> <p>Since calorie expenditure will vary according to different individual’s fitness levels, we also share easy ways that you can measure your exertion, to make sure you are hitting the level you need to. These methods from the <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/exercise-intensity" target="_blank"><strong><span style="text-decoration: underline;">Victorian Government's Better Health Channel</span></strong></a> make it a whole lot easier than you might think.</p> <p><strong>1. Go for a walk and talk in the park</strong></p> <p>Walking is a great way to improve and maintain your overall health, especially when done a tad more vigorously. Grab yourself a walking buddy and head down to your nearest oval, park, or even just a quiet street. Or, talk on the phone (as long as you are in a safe area). To make sure you are exercising at moderate intensity, use “the talk test” to monitor your exertion by taking note of these simple signs:</p> <ul> <li>If you can talk and sing without puffing at all, you’re exercising at a low level.</li> <li>If you can comfortably talk, but not sing, you’re doing moderate intensity activity. This is where you want to be!</li> <li>If you can’t say more than a few words without gasping for breath, you’re exercising at a vigorous intensity.</li> </ul> <p><strong>2. Do the housework</strong></p> <p>Doing the housework can be a real bother, but it can also do you a world of good. Next time your dusting, vacuuming or just generally tidying, you can take you pulse to help you turn chores into exercise. Taking your pulse at regular intervals lets you know whether you are exercising within your target heart rate range. You can do this easily by locating the radial pulse on your inside wrist. Take your pulse before you start cleaning and then again when you’ve been cleaning for about five to 10 minutes. Continue taking your pulse at regular intervals.</p> <p><strong>To take your pulse:</strong></p> <ul> <li>Put the first three fingers of one hand against the inner wrist of the other hand just below the thumb.</li> <li>Lightly press your fingers into the hollow next to the tendon on the thumb-side – your artery lies just beneath the skin.</li> <li>Using a watch with a second hand, count your pulse for 15 seconds. Multiply this figure by four to get your beats per minute. (For example, 31 pulse beats over 15 seconds equals a pulse rate of 124 beats per minute.)</li> </ul> <p>Your heart rate target range may need to be professionally recalculated to take your health and general fitness into account, but the general rule is as below. Always remember that medications and environmental factors can affect this, and read all the info on the <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/exercise-intensity" target="_blank"><strong><span style="text-decoration: underline;">Better Health Channel</span></strong></a> to find out exactly how to use this method in detail.</p> <ul> <li>Age 60 to 65: 80 to 112 beats per minute</li> <li>Age 60-plus: 78 to 109 beats per minute</li> </ul> <p><strong>3. Play with the grandchildren</strong></p> <p>Running around after the little ones in the back yard can be healthy as well as fun, if you keep your calorie expenditure in the right zone. Next time you’re tickling, picking up or playing with toy trucks, take a moment to measure your activity using the exertion rating scale. To keep within a moderate intensity, aim to experience the exercise signs three to seven in the chart below.</p> <p><img width="500" height="418" src="https://oversixtydev.blob.core.windows.net/media/29069/exertion-table_500x418.jpg" alt="Exertion Table" style="display: block; margin-left: auto; margin-right: auto;"/></p> <p><em>Chart from</em> <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/exercise-intensity" target="_blank"><strong><em><span style="text-decoration: underline;">Better Health Channel.</span></em></strong></a></p> <p>What ways do you exercise that don’t feel like work? Let us know in the comments below.</p> <p><strong>Related links:</strong></p> <p><a href="/health/body/2016/08/how-to-take-care-of-your-heart-in-cooler-months/"><strong><em><span style="text-decoration: underline;">How to take care of your heart in cooler months</span></em></strong></a></p> <p><a href="/health/body/2016/01/cardiologist-tips-for-better-heart-health/"><em><strong><span style="text-decoration: underline;">5 tips from a cardiologist for better heart health</span></strong></em></a></p> <p><a href="/health/body/2016/07/secrets-for-a-healthy-heart-after-60/"><strong><em><span style="text-decoration: underline;">5 secrets for a healthy heart after 60</span></em></strong></a></p>

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