Prolonged Sedentary Behavior is Harmful Even if You are Physically Active
Physical activity is the cornerstone of our atmasvasth quest to live long healthy. It is also important along with being physically active, to consciously reduce time spent being sedentary.
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Bhavin Jankharia
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Physical activity (PA) has long been recognized as a cornerstone of living long, healthy. Since I started Atmasvasth in 2020, I have extensively documented how movement is crucial for wellbeing.
In the last 3 years, we’ve seen that “moving” improves healthspan and lifespan, helps with blood pressure control, improves white matter function, offsets the downsides of reduced sleep and reduces the rate of cognitive decline and the chance of falls and fractures.
We have noted that any physical activity is better than none, there is no age barrier to start being active, though the earlier you start the better…it is important to continue to be active throughout life. The sweet spot is 30-45 minutes of brisk walking a day (4000 steps), though the more you walk and the brisker you walk, the better it is. Running has added benefits and the better the cardiorespiratory reserve (CRF), the longer and better we live. Strength training is equally important and mixing walking/running with strength training gives the best results. In the end, any physical activity, including stairs climbing helps.
In March 2024, I updated two physical activity guidelines based on 2023 literature and made two statements.
The first was in the first update article.
Bhavin Jankharia
PA is the “magic pill,” guaranteed to increase our healthspan and lifespan. New data from 2023 and early 2024 clearly shows that MPA, MVPA and VPA can improve blood pressure control, blood sugar control, reduce the incidence of some forms of cancer, attenuate the downsides of poor sleep, reduce falls and falls related fractures and reduce deaths associated with dementia.
The second update article concluded.
Bhavin Jankharia
Any activity is better than none.
Concentrating the PA during the weekend is as good as working out evenly during a week.
Strength or resistance training should be part of the PA schedule.
4000 steps per day remains a sweet spot, though benefits accrue even at 2000 steps per day (20 mins of brisk walking).
A crucial question remains: Can regular exercise offset the negative effects of prolonged sitting or lounging around? Many of us – whether radiologists, office workers, or programmers – spend most of our day seated. We might wonder if our dedicated exercise time (like a daily 30-45 minute walk or alternating between running and strength training) can counteract long periods of inactivity. Put simply: Is it enough to be physically active, or do we need to both exercise regularly AND minimize our sedentary time?
A recent JACC study [1] has tried to answer this tough question. Ezimamaka Ajufo and colleagues looked at 89,530 UK Biobank people who wore accelerometers for 1 week to assess SB and PA levels.
The study's findings were striking. The researchers identified a critical threshold of 10.6 hours of daily sedentary time for cardiovascular mortality. Combined with the standard recommendation of 150 minutes per week of moderate-to-vigorous physical activity (MVPA), they found:
- People who were both inactive AND highly sedentary faced the highest mortality risk (solid blue arrow), compared to those who were both active AND less sedentary (dashed green line).
- Those active but highly sedentary (>10.6 hours/day) (dashed blue line) had elevated risk between the inactive/sedentary and active/not sedentary groups.
This reveals a crucial insight: regular exercise, while vital, cannot fully counteract the negative effects of prolonged sitting and lounging.
Let's break this down into practical terms. In a typical day:
- 7 hours of sleep
- 1 hour of dedicated exercise
- 8 hours at a desk job
- 1-hour commute
- Several hours of relaxation
Even with a solid exercise routine, most of us exceed the 10.6-hour threshold of sedentary time. The solution isn't to abandon our desk jobs or evening relaxation, but to find ways to incorporate more movement throughout the day.
A standing table helps cut out the sedentariness of sitting all the time. If you raise your table on and off and stand to work, that helps. Other strategies include walking around the house or office a little more, or getting up to stretch now and then and perhaps doing a couple of squats. The key is to break up long periods of sitting with brief moments of movement. However done, it is a good idea to be conscious of the fact that you should not be sedentary for more than 10 hours a day.
What does this mean for you and I? While physical activity remains the cornerstone of our atmasvasth quest to live long, healthy, it's only part of the equation. We need a two-pronged approach:
- Maintain regular physical activity through structured exercise.
- Actively reduce sedentary time throughout the day.
This might require a shift in how we think about movement. We need to see movement as an integral part of our entire day, rather than viewing it as just our daily workout. While other health factors matter...not smoking, staying vaccinated, managing high blood pressure and high blood sugar...how we move (or don't) has emerged as a fundamental determinant of our health.
The takeaway? Don't just exercise...move more, sit less, and break up those inevitable periods of sitting with small bursts of activity.
Footnotes:
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