Sedentary behaviour and your health

It might seem strange to hear the average working week in Australia has reduced by 2 hours per week however, that doesn’t mean people are working less, it purely represents a shift from productivity to outcome based performance measurements. Tied together with the development of new technologies and the introduction of flexible working options including working from home, it means workers days are stretched longer, they are available more of the time and are working more hours they don’t register. Ultimately this leads to more sedentary behaviour at work.

Interestingly, the first occupational study looking at health outcomes in those who were physical active at work versus those who weren’t was published way back in 1951. The Morris paper looked at the rates of coronary heart disease (CHD) in bus drivers compared to ticket conductors and it was no surprise to see bus drivers had a higher incident of CHD compared to ticket conductors. To confirm these findings Morris and Crawford then compared the risk of heart attacks between postmen and government clerks and found a similar result; government clerks more often suffered heart attacks than postmen.

Fast-foward to 2019 where we now know that sedentary behaviour is associated with higher blood pressure, total cholesterol and poor cognition and academic performance. It is also strongly associated with all cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes, metabolic syndrome along with being moderately associated with ovarian, colon and endometrial cancer.

Time to get moving!

As Morris showed in his studies, workers who were more active had lower incidents of cardiovascular disease (CVD) and this rings true today. In 2018 the Physical Activity Guidelines Advisory Committee Scientific Report highlighted the importance of physical activity which is linked to improved sleep, cognition, minimizing weight gain, reduced risks of depression, anxiety, dementia, colon, breast, bladder, endometrial, oesophagus, stomach, kidney and lung cancer as well as reduced risks of chronic preventable diseases like high blood pressure, type 2 diabetes and cardiovascular disease. There is also low grade evidence indicating sit to stand desk (ie. being more active) reduces low back pain in office workers.

Breaking up sedentary behaviour doesn’t need to be difficult, it might involve introducing a sit to stand desk to help modulate posture throughout the day, getting up from the desk and walking around the office at regular intervals, it could include exercising during the lunch break and for the extremely busy people think about replacing your car commute to work with a ride or run. Whatever it is you chose to break up your sedentary behaviour with, it is important that you are reaching the minimum guidelines for physical activity – 150 minutes of moderate to vigorous activity per week.

The American College of Rheumatology and the American College of Orthopaedic Surgeons recommend opioids such as Tramadol as a front line intervention for knee osteoarthritis (OA), either on their own or in association with NSAID’s.

This paper looked at the 1 year all cause mortality risk associated with knee OA and the use of opioids (Tramadol and Codeine) compared to NSAID’s. Over 1 year the risk of all cause mortality was higher in those who used opioids compared to NSAID’s. This presents a strong case that opioids shouldn’t be used to treat knee OA. However, it must be pointed out that this paper didn’t confound for risks such as cardiovascular disease, diabetes, obesity etc which are commonly seen in patients with knee OA and can be associated with all cause mortality. Therefore further research is required to better understand these results.

Having said that, there is good evidence that supports the use of exercise therapy for improvements in pain and function associated with knee OA. Therefore a more appropriate front line intervention would be to avoid opioids and to utilise exercise therapy and NSAID’s when needed to treat knee OA.

In 2017, I wrote an article for The Australian Chiropractor outlining the importance of exercise as medicine and the role chiropractors can play in prescribing exercise therapy to their patients.

The article can be found on pages 10 and 11 in the November 2017 issue of TAC.

TAC November 2017

150 mins per week of moderate to vigorous intensity exercise is all it takes to reduce the risks of chronic preventable diseases like cardiovascular disease, high blood pressure, obesity, diabetes and certain cancers like bowel and breast cancer. Lets stop sitting and lets start moving.

 

Pandemic of Physical Inactivity.

Hot off the press, is the 2018 Physical Activity Guidelines Advisory Committee report, building on the evidence for exercise training and health benefits from 2008.

It has been well documented that exercise is beneficial in the prevention of chronic diseases like cardiovascular disease, type II diabetes, obesity and certain cancers such as breast and colon. This update now extends those benefits to include: improved sleep quality, better cognitive function, assisting in the treatment of depression and anxiety disorders, reducing fall rates in the elderly, helping to prevent more cancers including, kidney, stomach, breast, lung and bladder.

There has never been a better time to start exercising.

2018 Physical Activity Guidelines Advisory Committee Scientific Report

Exercise for the prevention of chronic diseases such as cardiovascular disease, type II diabetes, obesity, etc are well known. There is a growing body of evidence that shows exercise is important in the treatment of cancer patients. The rate at which this evidence is growing has led the American College of Sports Medicine to rethink their guidelines for patients undergoing cancer treatment, as those who exercise during cancer treatment are more likely to beat cancer.