Evidence supporting moving more and sitting less
Introduction
Early recognition of the health benefits associated with adopting a physically active lifestyle predates formalized scientific efforts by multiple millennia.1 Perhaps, a true appreciation for the powerful effects physical activity (PA) confers on one's health did not occur until a greater proportion of individuals took on physically insufficient/sedentary lifestyles, largely as a consequence of industrialization or “Westernization”. In addition to optimizing the efficiency of mass-producing materials, Westernized civilizations continually seek innovative methods of decreasing the energy expenditure required for travel, work, and entertainment. In the 1950's, Morris and colleagues provided compelling evidence of the health consequences associated with sedentarianism and the benefits of PA in the work place when comparing employees with active or sedentary job tasks within an organization.2,3 Moreover, societal and technological advancements have contributed to reductions in time spent performing physically demanding home management tasks and a shift toward higher screen times, which appears to have contributed to an increase in obesity; a prominent risk factor for developing cardiovascular disease (CVD) and diabetes.4
With a growing proportion of the general population facing multiple barriers to becoming physically active, studies have and continue to seek optimal doses and types of activity necessary to mitigate the numerous health consequences associated with physical inactivity and a sedentary lifestyle. However, for many sedentary individuals, performing levels of PA recommended for substantial health benefits5 may initially be perceived as being unobtainable and may instead deter them from becoming physically active due to an all or nothing mentality. While there are numerous contributing factors for this mentality, a prominent reason may be associated with consistent messaging exclusively touting the health benefits achieved with 150–300 min of moderate intensity or 75–150 min of vigorous intensity aerobic PA. As a consequence, less emphasis is placed on the significant and clinically meaningful benefits acquired when transitioning from a sedentary state to a more physically active lifestyle, albeit below the aforementioned ideal PA recommendations. Accordingly, this paper will provide an overview of evidence supporting the health benefits of a new approach to PA messaging and counseling - moving more and sitting less.
Section snippets
Moving in context of the aerobic PA guidelines
Early editions of PA recommendations developed by professional organizations such as the American Heart Association6 and American College of Sports Medicine7 were largely built on small randomized controlled trials.8, 9, 10, 11, 12, 13 Although larger epidemiology studies identified the general benefits of moving more compared to a less active or sedentary lifestyle, developing precise recommendations based on findings from self-reported PA data was difficult. Accordingly, prominent figures in
Time efficient modes of PA
It is widely recognized that a lack of time during the work week is a commonly cited barrier preventing many individuals from regularly participating in structured PA.22 Accordingly, individuals looking to become physically active may only do so during weekends. Initial observations from the Harvard Alumni Health Study provided support for the potential protective effects of completing recommended volumes of activity in one or two sessions during the weekend.23 Those using the weekend to
Health implications of a sedentary lifestyle
Over recent decades, considerable evidence has highlighted the significant and broad health consequences and increased risk of CVD and all-cause mortality31 associated with a sedentary lifestyle. Self-reported sedentary time data from the National Health and Nutrition Examination Survey identified that roughly 70% of Americans spend six or more hours sitting per day32 and the risk for mortality with higher amounts of sitting time (ST) is independent of leisure time PA.33 More concerning is the
Practical considerations for promoting PA
An impressive PA campaign was launched in concert with the 2018 PA Guidelines that sought to not only increase awareness of the updated PA guidelines but to also provide resources that would facilitate their adoption. Though the overarching objective of the campaign is to get all Americans to perform 150 min of moderate or 75 min of vigorous PA and two days of muscle strengthening activities per week, resources (health.gov/moveyourway) also aim to encourage individuals to engage in any volume
Conclusion
Physical inactivity and high sedentary time continue to be significant issues that drive the development of noncommunicable diseases in developed countries. Consistent and continually emerging empirical evidence highlights the significant and clinically meaningful health changes that can occur when previously sedentary individuals engage in PA levels well below the nationally recommended guidelines. Provided that many Americans are faced with barriers that limit their ability to perform
Disclosures/conflicts of interest
None.
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