Evidence supporting moving more and sitting less

Abstract

High levels of sedentary time and physical inactivity independently contribute to the development of noncommunicable diseases and premature mortality. Engaging in at least 150 min of moderate or 75 min of vigorous physical activity (PA) is globally recognized as conferring substantial health benefits. However, setting these distinct thresholds and promoting them may have inadvertently created perceptions among the general public that an all or nothing phenomenon exists. Yet, the PA guidelines and a growing body of evidence highlights the robust health benefits associated with becoming more active from a previously sedentary lifestyle, even if the volume of PA performed is below current ideal recommendations. Practitioners providing PA recommendations are encouraged to initially highlight the benefits of moving more and sitting less rather than initially setting lofty, perhaps unachievable, PA goals for inactive individuals. Taking this approach may increase the likelihood of adopting a more physically active lifestyle and ultimately progressing to meet the PA guidelines.

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.