Too Much Sitting and Metabolic Risk—Has Modern Technology Caught Up with Us?
Too Little Exercise, Too Much Sitting, and Cardio-metabolic Health—Where to From Here?
The research agenda on too much sitting includes developing a broader understanding of the health consequences of prolonged sitting time and examining what follows from changes in these behaviors. This will require implementing and evaluating innovative interventions to change sedentary behaviors in transport, domestic, community, and occupational settings. Such studies will include controlled intervention trials to better understand the acute and chronic cardio-metabolic consequences of sitting for prolonged periods. This evidence will greatly assist in understanding the causal nature of how too much sitting affects health and will be necessary to inform potential new public health and clinical guidelines in relation to sitting time.
Additionally, there is now consideration being given to environmental, policy, regulatory, and educational interventions to reduce prolonged periods of sitting time in workplaces. Policy and regulatory approaches will require the relevant workplace consultation approaches, and educational interventions will most likely involve innovative uses of information technology, particularly email and websites, to inform and motivate individuals. Such initiatives will need to be carefully evaluated to determine whether they have the expected benefits, or whether there might be harm associated with them. Such interventions and careful evaluations will be required to further build on the evidence base now available on the cardio-metabolic correlates of sedentary behavior.
Public Health Policy Implications
In public health, there is a long history of large-scale behavioral change initiatives that have had significant impacts on whole populations.29 For example, since the publication of landmark documents on smoking and health in the 1960s, there have been remarkable reductions in smoking prevalence in developed countries. These have resulted from a plethora of inter-related social, environmental, and policy changes, all fundamentally based on knowledge about the health consequences of tobacco use.
For public health initiatives aimed at increasing physical activity and reducing sedentary behavior, there are many allies in sectors other than health. For example, transportation and urban planning experts are now proposing changes to transport systems and the physical and functional layout of urban areas, including higher street connectivity (allowing multiple walking or bicycle routes to destinations), more mixed land use (providing multiple local destinations such as retail, food outlets, and other services), and population density (with more people making local services and businesses more viable), as well as related public policy initiatives that will act to promote higher rates of walking and bicycle use as alternatives to the use of private motor vehicles.35 Potentially, the accumulation of additional evidence on the health impacts of sedentary behaviors may help to persuade workplace health and safety bodies to seriously begin to address the potential implications of prolonged unbroken sitting time in the workplace.
- Haskell WL, Lee IM, Pate RR, et al., Circulation, 2007;116(9):1081–93.
- Bauman A, Allman-Farinelli M, Huxley R, James WP, Obes Rev, 2008;9(Suppl. 1):119–26.
- Healy GN, Dunstan DW, Salmon J, et al., Diabetes Care, 2007;30(6):1384–9.
- Hamilton MT, Healy GN, Dunstan DW, et al., Curr Cardiovasc Risk Rep, 2008;2:292–8.
- Owen N, Leslie E, Salmon J, Fotheringham MJ, Exerc Sport Sci Rev, 2000;28(4):153–8.
- Pate RR, O’Neill JR, Lobelo F, Exerc Sport Sci Rev, 2008;36(4):173–8.
- Dunstan DW, Salmon J, Owen N, et al., Diabetologia, 2005;48(11):2254–61.
- Healy GN, Dunstan DW, Salmon J, et al., Med Sci Sports Exerc, 2008;40(4):639–45.
- Sugiyama T, Healy GN, Dunstan DW, et al., Int J Behav Nutr Phys Act, 2008;5:35.
- Lanningham-Foster L, Nysse LJ, Levine JA, Obes Res, 2003;11(10):1178–81.
- Brownson RC, Boehmer TK, Luke DA, Annu Rev Public Health., 2005;26:421–43.
- United States Department of Labor, American Time Use Survey – 2007 Results. Available at: www.bls.gov/tus/ (accessed March 4, 2009).
- Hamilton MT, Hamilton DG, Zderic TW, Diabetes, 2007;56(11): 2655–67.
- Bertrais S, Beyeme-Ondoua JP, Czernichow S, et al., Obes Res, 2005;13(5):936–44.
- Cameron AJ, Welborn TA, Zimmet PZ, et al., Med J Aust, 2003;178(9):427–32.
- Dunstan DW, Salmon J, Healy GN, et al., Diabetes Care, 2007;30(3):516–22.
- Dunstan DW, Salmon J, Owen N, et al., Diabetes Care, 2004;27(11):2603–9.
- Gao X, Nelson ME, Tucker KL, Diabetes Care, 2007;30(3):694–700.
- Brown WJ, Williams L, Ford JH, et al., Obes Res, 2005;13(8):1431–41.
- Hu FB, Leitzmann MF, Stampfer MJ, et al., Arch Intern Med, 2001;161(12):1542–8.
- Hu FB, Li TY, Colditz GA, et al., JAMA, 2003;289(14):1785–91.
- Howard RA, Freedman DM, Park Y, et al., Cancer Causes Control, 2008;19(9):939–53.
- Blanck HM, McCullough ML, Patel AV, et al., Obesity (Silver Spring), 2007;15(6):1578–88.
- Bassett DR Jr, Mahar MT, Rowe DA, Morrow JR Jr, Med Sci Sports Exerc, 2008;40(7 Suppl.):S529–36.
- Balkau B, Mhamdi L, Oppert JM, et al., Diabetes, 2008;57(10): 2613–18. 26. Ekelund U, Griffin SJ, Wareham NJ, Diabetes Care, 2007;30(2):337–42.
- Healy GN, Wijndaele K, Dunstan DW, et al., Diabetes Care, 2008;31(2):369–71.
- Healy GN, Dunstan DW, Salmon J, et al., Diabetes Care, 2008;31(4):661–6.
- Hamilton MT, Healy GN, Dunstan DW, et al., Curr Cardiovasc Risk Rep, 2008;2(4):292–8.
- Owen N, Bauman A, Brown W, Br J Sports Med, 2009;43(2):81–3.
- Brown WJ, Bauman AE, Owen N, Br J Sports Med, 2009;43(2):86–8.
- Sallis JF, Owen N, Physical Activity and Behavioral Medicine, Thousand Oaks, CA: Sage, 1999.
- Trost SG, Owen N, Bauman AE, et al., Med Sci Sports Exerc, 2002;34(12):1996–2001.
- Sallis JF, Owen N, Fisher EB. In: Glanz K, Rimer BK, Viswanath K, eds., Health Behaviour and Health Education: Theory, Research and Practice, 4th edn., San Francisco: Jossey-Bass, 2008:465–82.
- Saelens BE, Sallis JF, Frank LD, Ann Behav Med, 2003;25(2): 80–91.