A lot of media attention is given to the effects of prolonged sitting on health status. The impact of prolonged sitting and sedentary work is so big that sitting has been named the new smoking.
Many studies have elaborated on the impact of daily lengthy sitting episodes from musculoskeletal problems to weight gain to metabolic syndrome to diabetes, cardiovascular disease, depression, cancer and early death.
Humans are not meant to sit down for extended periods of time. Our ancestors would stand and walk for hours on end hunting, gathering, fishing, working the fields…. only sitting down to eat or to rest after hours of hard work.
Our present morphology is designed to walk upright and be physically active. Modern times and automation lead to increased sitting times and diminishing physical motion: sitting at desks, public transport, sitting in cars (and parking as near the entrance of the building to access), stepping into the lift, long distance plane travels, are just some examples.
Our muscles and skeleton are not being used as they should which leads to major health concerns. In fact, inactivity and sedentary lifestyle lead can be classified as a health hazard.
Some consequences of prolonged sitting.
Sitting down for longer periods significantly impacts pressure on the spine. When sitting behind a desk, poor posture causes shoulder and neck muscles to become tense and in turn strain the lower spine and leads to reduced flexibility, misalignment and weakening of muscles. This will also impact the bones, leading to increased proneness to osteoporosis1.
A recent study4 explored the association with sitting and the occurrence of musculoskeletal disorders through inflammatory cytokines and low-level inflammation.
During the COVID-19 pandemic a high prevalence of physical discomfort was reported by home office workers5, confirming the impact on the musculoskeletal system.
Lengthy sitting leads to vascular dysfunction of the veins of the lower limbs2. This can cause serious problems such as formation of blood clots and deep vein thrombosis. Findings of a study published in the European Journal of Preventive Cardiology, Jan.20, 2022 showed that prolonged television viewers (> 4hours/day) were 1,35 times more likely to develop deep vein thrombosis compared to non-viewers. That is why it is not a good idea to binge-watch your favourite tv series for hours!
Moreover, prolonged and uninterrupted sitting significantly increases systolic blood pressure and mean arterial pressure, especially in younger people3.
Weight gain and diabetes
When sitting down for longer periods, energetic pathways are disrupted which will impact the glucose metabolism and negatively impact proper functioning of all metabolic processes. The implications are decreased insulin sensitivity, increased fat storage, weight gain, obesity, low grade chronic inflammation, metabolic syndrome and type 2 diabetes. Regular exercise is a necessary component in prevention and treatment of type 2 diabetes.
Besides the risk for developing blood clots (see vascular problems), prolonged sitting affects good overall functioning of the blood vessels and the superficial layer of arteries (known as the endothelium). According to a recent study, sedentarity behaviour is associated with some type of endothelial dysfunction and can lead to chronic, low-grade blood vessel inflammation, which in turn contributes to the development of atherosclerosis and cardiovascular disease12.
Cognition and mental health
Research has shown that prolonged sitting negatively affects emotional wellbeing. Moreover, sitting for excessive periods of time leads to declined executive function, memory and attention. More research is necessary on the mechanisms, but it is thought that the negative impact of prolonged sitting on complex metabolic and vascular functions in turn lead to declined mental performance6,7.
How much sitting is considered prolonged sitting?
Prolonged sitting is considered to be sitting for extended periods of time, usually defined as sitting for more than between 2,5 and 4 hours at a stretch, such as during travelling. This is based on several studies8 and reviews of the literature on the topic. The exact definition of prolonged sitting can vary and depends of the study population and the context.
Conclusion and recommendations
Desk-based teleworking from home and digital leisure time have a massive negative impact on health, so much so that it has become a global concern. Looking for ways to curb the consequences of this decline in overall health is very important.
- It is recommended, over and over again, to break up sitting sessions with frequent (every 30 minutes for at least 5 minutes) breaks to counteract the negative effects.
- Incorporating regular brisk walking or short weight bearing exercise during the course of the day is an excellent way to improve metabolic responses9,10,11.
- Even when sitting down while watching a movie for example, it is a good idea to have a small ball and place it underneath your feet, rolling the ball around with your feet whilst enjoying your movie!
Disclaimer: Content should never be used as a substitute for medical advice from your doctor.
- Paterson C, Fryer S, Zieff G, et al. The Effects of Acute Exposure to Prolonged Sitting, With and Without Interruption, on Vascular Function Among Adults: A Meta-analysis. Sports Med. 2020;50(11):1929-1942. doi:10.1007/s40279-020-01325-5
- Paterson C, Fryer S, Stone K, Zieff G, Turner L, Stoner L. The Effects of Acute Exposure to Prolonged Sitting, with and Without Interruption, on Peripheral Blood Pressure Among Adults: A Systematic Review and Meta-Analysis. Sports Med. 2022;52(6):1369-1383. doi:10.1007/s40279-021-01614-7
- Dong Y, Jiang P, Jin X, et al. Association between long-term static postures exposure and musculoskeletal disorders among university employees: A viewpoint of inflammatory pathways. Front Public Health. 2022;10:1055374. Published 2022 Dec 1. doi:10.3389/fpubh.2022.1055374
- Garcia MG, Aguiar B, Bonilla S, Yepez N, Arauz PG, Martin BJ. Perceived Physical Discomfort and Its Associations With Home Office Characteristics During the COVID-19 Pandemic [published online ahead of print, 2022 Jun 27]. Hum Factors. 2022;187208221110683. doi:10.1177/00187208221110683
- Chandrasekaran B, Pesola AJ, Rao CR, Arumugam A. Does breaking up prolonged sitting improve cognitive functions in sedentary adults? A mapping review and hypothesis formulation on the potential physiological mechanisms. BMC Musculoskelet Disord. 2021;22(1):274. Published 2021 Mar 12. doi:10.1186/s12891-021-04136-5
- Baker R, Coenen P, Howie E, Williamson A, Straker L. The Short Term Musculoskeletal and Cognitive Effects of Prolonged Sitting During Office Computer Work. Int J Environ Res Public Health. 2018;15(8):1678. Published 2018 Aug 7. doi:10.3390/ijerph15081678
- Kett AR, Milani TL, Sichting F. Sitting for Too Long, Moving Too Little: Regular Muscle Contractions Can Reduce Muscle Stiffness During Prolonged Periods of Chair-Sitting. Front Sports Act Living. 2021;3:760533. Published 2021 Nov 3. doi:10.3389/fspor.2021.760533
- Duran AT, Friel CP, Serafini MA, Ensari I, Cheung YK, Diaz KM. Breaking Up Prolonged Sitting to Improve Cardiometabolic Risk: Dose-Response Analysis of a Randomized Cross-Over Trial [published online ahead of print, 2023 Jan 12]. Med Sci Sports Exerc. 2023;10.1249/MSS.0000000000003109. doi:10.1249/MSS.0000000000003109
- Chauntry AJ, Bishop NC, Hamer M, Paine NJ. Frequently Interrupting Prolonged Sitting With Light Body-Weighted Resistance Activity Alters Psychobiological Responses to Acute Psychological Stress: A Randomized Crossover Trial [published online ahead of print, 2022 Aug 25]. Ann Behav Med. 2022;kaac055. doi:10.1093/abm/kaac055
- Dempsey PC, Sacre JW, Larsen RN, et al. Interrupting prolonged sitting with brief bouts of light walking or simple resistance activities reduces resting blood pressure and plasma noradrenaline in type 2 diabetes. J Hypertens. 2016;34(12):2376-2382. doi:10.1097/HJH.0000000000001101
- Vandercappellen EJ, Koster A, et al. Sedentary behaviour and physical activity are associated with biomarkers of endothelial dysfunction and low-grade inflammation—relevance for (pre)diabetes: The Maastricht Study. Diabetologia. 2022. 65,777-789