"Sitting is the new smoking. It increases your risk of disability, heart disease, and cancer." — Dr. James Levine
Introduction | Circulatory Health | Musculoskeletal Health | Metabolic & Weight Implications | Mental Health | Sleep Quality| Steps & Solutions | Final Thoughts | Takeaway Points | References | Disclaimer
Introduction
Our increasingly sedentary lifestyles may have unintended consequences for us. Sitting for extended periods of time, whether at work, in the car, or at home, has serious physical and mental health implications. According to research, sitting for more than seven hours per day[1][2] raises the risk of cardiovascular disease, musculoskeletal issues, metabolic imbalances, and even mental health problems. Little changes to our lifestyle habits, though, can have a big impact; they break up protracted periods of inactivity and improve circulation, flexibility, and mood. Little changes like standing up more often, stretching, or choosing active commuting options help offset these effects and inspire a better, more balanced lifestyle.
Prolonged Sitting and Circulatory Health
Sedentary lifestyles have serious implications for cardiovascular health. People who spend more than seven hours a day sitting have an increased risk of developing cardiovascular disease (CVD) and CVD-related mortality[3][4].
An inactive lifestyle promotes a range of vascular effects that contribute to the prevalence of CVD in sedentary individuals.
"Strong predictors of CVD, such as conduit arterial stiffness and reduced endothelium-dependent dilation (ie, flow-mediated dilation), have been well documented in physically inactive men and women."[5]
Here are some direct effects of insufficient daily movement on cardiovascular health:
increased numbers of the proatherogenic small, dense LDL (sdLDL) cholesterol particles and triglycerides[6][7], which have been linked to the development of coronary artery disease (CAD), peripheral artery disease (PAD), cerebrovascular disease (stroke), and myocardial infarction (heart attack).
a reduced production of nitric oxide (NO)[8][9] leads to arterial stiffness and narrowing, both of which are key features of endothelial dysfunction. Endothelial dysfunction is associated with hypertension, atherosclerosis, coronary artery disease (CAD), and heart failure.
a reduced production of antioxidant enzymes such as superoxide dismutase (SOD), glutathione, and catalase[10][11] leads to oxidative damage to the inner artery lining and the development of atherosclerosis, coronary artery disease (CAD), hypertension, stroke, and heart failure.
increased platelet aggregation and elevated blood coagulation factors[12][13] make blood thicker, promoting the risk of myocardial infarction (heart attack), stroke, deep vein thrombosis (DVT), pulmonary embolism (PE), and atherosclerosis.
The repercussions for cardiovascular health due to insufficient physical activity can be damaging and incapacitating. The proper functioning of the heart and arteries plays a crucial role in determining our overall vitality and longevity, allowing us to fully enjoy our lives. Nonetheless, there are additional aspects of well-being, including our muscles and joints, that a sedentary lifestyle fails to promote.
Sedentary Lifestyle Impacts Musculoskeletal Health
Our muscles and joints are responsible for our ability to move. When they become tight and stiff, or lose their flexibility, we experience reduced mobility, pain, and overall discomfort. Sedentary behaviors reinforce these negative effects. Sitting on a chair or couch for a long period of time, or frequently during the day, causes a lot of strain on our spines, lower back, and hip muscles.
Researchers have identified sitting position as a contributing factor to spinal disc degeneration [14][15].
These changes to the anatomy of the spine reduce its flexibility and may cause the adjacent vertabrae to lose proper alignment, increasing the risk of inflammation, pain, and nerve compression.
Muscular problems, such as lower back pain and hip and hamstring tightness, are also very common in people who spend many hours sitting down. Sitting for long periods—especially with poor posture—can disrupt weight distribution and put extra strain on the lower back muscles. Studies show that prolonged sitting causes lower back muscles to become stiff[17][18] and, therefore, sore.
Furthermore, sedentary behavior puts a lot of pressure on our pelvis, especially if we slouch and don't provide our back with lumbar support. Misalignments in pelvis position lead to hamstring and hip flexor muscle tightness[19][20]. When tight, these muscles reduce our range of motion, promote poor posture, and contribute to spinal problems.
The effects of a sedentary lifestyle on our muscles and spine can quickly become problematic and disruptive. Such a position can lead to disc problems, muscle tightness, loss of flexibility, and pain. But the ramifications do not stop there—the lack of physical activity promotes also poor metabolic and weight management outcomes.
Metabolic and Weight Implications of Sedentary Behavior
Inappropriate physical activity and a sedentary lifestyle translate into low energy expenditure. Those of us who drive or have desk jobs are prone to burning fewer calories than those working in different environments. If we do not spend the energy that we consume with our food, our bodies store it as fat.
Extra glucose from carbohydrates is turned into triglycerides[21][22] and accumulates as adipose tissue.
Likewise, higher-than-required protein consumption causes the development of adipose tissue. The body converts protein that it doesn't use for muscle maintenance and repair into glucose[23][24] and stores it as fat.
The extra fat we consume is directly stored in expandable fat cells. Large fat deposits arise[21][25] due to an abundance of dietary fat compared to a low energy expenditure.
Finally, an inactive lifestyle affects insulin action[26][27]. In response to elevated blood glucose levels, the pancreas increases insulin production to store glucose in fat tissue. Moreover, lack of physical exercise lowers the insulin sensitivity of the cells absorbing glucose. To control blood sugar, the pancreas must thus work even more and generate more of this anabolic hormone.
These mechanisms reveal how sensitive our bodies are to an excess of food and insufficient daily physical activity. The aforementioned circumstances have a direct impact on our health. They cause weight gain, obesity, and the development of metabolic syndrome and its associated diseases, which include type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), dyslipidemia, and cardiovascular disease (CVD).
"[...] greater time spent sedentary increased the odds of metabolic syndrome by 73%, thus encouraging people to limit their time spent sitting could reduce the risk of metabolic syndrome."[28]
The physical aspects and effects of prolonged sitting are not the only ways in which a lack of movement affects our health. Excessive sitting also harms our mental health, which is another major concern.
The Effects of Prolonged Sitting on Mental Health
Another important element of our overall health is our mental well-being. There are multiple links between our physical activity levels and mental health. Movement promotes brain activity and neuroplasticity—the production of neurotransmitters like endorphins, dopamine, and serotonin—while also having anti-inflammatory effects. Therefore, sedentary lifestyles impact all these processes and contribute to:
Furthermore, studies have shown that even modest reductions in sedentary behavior can improve mental health and prevent the emergence of mental health problems.
"[...] our data suggest that decreasing daily sedentary time by 60 min may prevent or significantly attenuate the negative effects of sedentary time on mental wellbeing."[29]
Porlonged sitting can have lasting effects on our mood, stress levels, self-esteem, and brain health. However, there are steps we can take to reduce the risk of health complications.
Sedentary Lifestyle and Sleep Quality
As we continue to explore the effects of prolonged sitting on human health, it is necessary to shift our focus to sleep. Sleep is an essential component of our well-being that involves a wide range of processes and mechanisms during which our bodies and minds reset, heal, detoxify, and prepare for daily functioning. Therefore, quality sleep every night is essential to our health. However, lack of physical activity and everyday movement disrupts our sleep patterns. Extended periods of sitting can result in a variety of sleep-related consequences:
insufficient feelings of fatigue and tiredness by the end of the day, which may cause difficulty falling asleep[39][40].
the disruption of circadian rhythm[41][42] occurs due to inadequate daylight exposure, which we obtain through spending time outdoors.
nighttime restlessness, which occurs due to poor blood circulation related to lack of movement[47][48].
As a result, we observe that healthy sleep requires adjustments to our lifestyle habits. It also necessitates the acknowledgement that both sedentary behavior during the day and lack of quality sleep at night contribute to a range of health problems.
"[...] low TPA [total physical activity]-poor sleep group and high SB [sedentary behavior]-poor sleep group had the highest risk for overall cancer, breast cancer, and lung cancer. Adherence to a healthier activity pattern was associated with a lower risk of cancer among individuals regardless of genetic strata."[49]
Even if our professional obligations force us to spend long hours sitting behind a desk or driving a car, lifestyle modifications can positively impact our well-being. Most busy and schedule-bound people can incorporate simple, effortless fitness strategies to increase their physical activity levels.
Practical Steps and Solutions to Incoporate More Movement
If you find yourself sitting for extended periods, there are quick strategies and practices that can help you get some movement in, in addition to traditional methods like workouts, gym visits, and sport classes. You can implement these tips anytime and anywhere, giving your body and mind a boost of fresh energy.
Set a movement timer: Every 30 to 60 minutes, stand up, stretch, or walk quickly—even a little loop around your workspace counts.
Try a standing desk: Consider using a standing desk to reduce the stress of prolonged sitting by alternating between sitting and standing positions.
Walk your meetings: If at all possible, schedule meetings while walking or standing for phone calls to stay involved and active.
Make commuting active: If you can, walk or bike your way to work; else, park further away to add a few extra steps.
Use breaks to move: To re-energize lunch or shorter breaks, fit a quick workout, some yoga, or a stretch routine.
Equip your desk: Try adding a balance pillow or board, or an inflatable sitting cushion to engage your core and maintain motion even while seated.
Track your steps: Aim for 5,000–10,000 to keep on top of your activity and use a fitness tracker to meet daily step goals.
Taking mindful walks: Short, mindful walks are a good option to get some daylight, which boosts energy and mood.
Take the stairs: Choose the stairs rather than elevators to increase daily mobility.
Move during screen time: You can watch TV or use screen breaks, walk in place, stretch, or perform basic exercises.
Do quick bodyweight exercises: Fit in squats, lunges, or calf raises throughout the day. They are easy to do anywhere and anytime.
Regular streches: Every couple of hours, gently stretch your neck, back, hips, and legs to keep flexible and avoid stiffness.
These strategies are very helpful in counteracting the effects of prolonged sitting, but they may not be sufficient to meet all of the requirements for daily physical activity. If your lifestyle is mostly sedentary, incorporating a workout session or participating in your favorite sports class will be necessary to safeguard your health.
Final Thoughts
Long hours of sitting clearly affect our bodies and minds. The negative effects of insufficient physical activity impact all aspects of our well-being, from cardiovascular to musculoskeletal and mental health. Fortunately, there are ways to prevent and reduce the harmful effects of our lifestyle habits. Even a few small changes can significantly improve our health. Regular movement and basic changes in daily habits, such as stretching at your desk, taking walking breaks, or choosing active seating, can offset many of the negative consequences of a sedentary lifestyle. Staying active all day doesn't call for big life changes; rather, it requires a few deliberate choices that sum up to improved physical and mental health.
Takeaway Points
Sitting for an extended period increases your risk of developing heart disease by stiffening the arteries and slowing blood flow.
Physical inactivity increases dense LDL cholesterol and reduces nitric oxide, both of which are associated with serious heart problems.
A sedentary lifestyle strains muscles and joints, especially the spine, leading to discomfort, stiffness, and even spine degeneration.
Sitting all day encourages fat storage, weight gain, and metabolic problems, increasing the chances of conditions like diabetes.
Long periods of sitting can hurt your mental health, raising the risks of anxiety, depression, and slower cognitive function.
Not moving enough can disrupt your sleep, making it harder to fall asleep, stay asleep, and feel well-rested due to poor circulation and reduced melatonin.
Simple changes—like standing more, taking regular breaks to move, and stretching—can help combat the downsides of sitting too much.
References
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