Prolonged Sitting is the New Smoking

What to expect this week:

Sitting feels good. It relieves our lower bodies of the weight they typically bear while we walk around. But, feeling good and what is actually good for you are two different things. There are plenty of things in this world that bring about short-term pleasure at the expense of long-term consequences.

Smoking is an example of this. The buzz people get from a cigarette gives them a satiating feeling - a feeling of comfort and enjoyment. However, the duration of that buzz only lasts for a few minutes. Add up a bunch of those short moments of euphoria and you’ve put yourself at risk for cancer and other debilitating diseases.

Similarly, sitting can give us that momentary feeling of physical relief. Yet, if you continue to spend too much time sitting, it too can lead to debilitating disease - and even increase your risk of mortality.

Although industrialized people may not live lives that are as physically demanding as our ancestors’, we can still enjoy a nice relaxing seat now and again. We just can’t make a habit out of sitting for extended periods. The purpose of this video is to bring awareness to that very fact and highlight some ways we can mitigate the problem.

Enjoy!

Housekeeping:

• One thing I’m excited to share with you guys this week is that the background music for my videos is now being created by yours truly. I’ve always loved making music and so I’m proud to say that I’m putting it to use through Evolve.2. This week marks the first video using my own music rather than some stock audio, and going forward, all future videos will too!

• If a fitness regimen based around evolutionary principles sounds like something you’d be interested in, email me at [email protected] and I can help you formulate a plan!

Links to my e-Courses

• The Bare Minimum - FREE

• The Adaptive Scholar - $5

Prolonged Sitting is the New Smoking (Why You Should Stand)

In the first half of the 20th century, smoking was perceived as a signal of “cool” status. Some health professionals at the time even argued that cigarettes have health benefits. However, once we applied the methods of science to test the relationship between smoking and medical complications, the evidence was clear: smoking has a direct, causal relationship with a multitude of cancers and cardiovascular problems [1].  

We were ignorant to those problems and who knows how many lives were lost as a result. 

There is yet another cultural norm with serious negative health implications, which is much more widespread, and has also been largely ignored - sitting. It’s something that seems harmless and everyone does it to some degree. But, we now have evidence showing that it can be detrimental to one’s health, especially over prolonged periods.

So much of what we do today is done in a seated position, with a 90-degree angle in our hips and knees. Eating, driving, working, and watching TV are just some of the activities that people engage in while sitting. When added together, these can amount to large portions of our waking life. This is quite concerning considering that sitting for each of these, as well as total sit time, is an independent risk factor for type 2 diabetes and cardiovascular disease [2].

Both of those morbidities can reduce our overall quality of life, and result in a large economic burden associated with medical treatments, but sitting can also increase your risk of an early death.

A study out of Australia showed that prolonged sitting, especially for 8 or more hours per day, increases your risk of all-cause mortality, even independent of your physical activity levels [3]. This has been further supported by a more recent study showing that physically active people aren’t immune to the acute effects of prolonged sitting. They still show changes in blood pressure and increased arterial stiffness after 2 hours of sitting [4]. 

Researchers believe that many of these blood flow issues that arise from prolonged sitting are due to that 90-degree bend in the hips and knees. A team out of the University of Nebraska at Omaha said [5], 

Following up with, “we hypothesize that the ‘bent artery’ morphology associated with the seated position is a major initiator of sitting-induced changes in vascular function.”

Aside from vascular issues, the bent position of sitting is also linked to chronic pain. One study looking at three different sitting positions showed that a forward-leaning sitting posture is especially prone to triggering lower back pain [6]. A paper published in American Family Physician notes how prolonged sitting and rising from a seat can aggravate hip pain, especially for those suffering from hip impingement [7].

We are not adapted to these positions - sitting at right angles. In fact, humans are specifically adapted to standing upright. This is partly why sitting is so incongruent with our health. 

Adaptations for Our Upright Posture

Our bodies are not designed to sit for long periods of uninterrupted time. Humans evolved very specific adaptations to support our vertical posture, which helped us walk bipedally and eventually run for long stretches of time. The earliest evidence of this comes from fossils in Chad, suggesting that proto-humans were transitioning from arboreal to land living 7 million years ago (MYA) [8]. Then, by maybe 4 (MYA), and definitely by 2 (MYA), humans were vertically oriented bipeds. 

Species like Homo habilis and Homo erectus were navigating the savannahs of Africa and exploring new lands in Eurasia with an upright posture. There were many adaptations needed to make this full transition, but four, in particular, were very important [9]. Let’s start from the bottom.

First, our feet are shorter and have a more distinct arch than the feet of our ape relatives. These shorter, stiff-arched feet are more energetically efficient for walking and running on two feet, acting like springs propelling us forward.

Second, our hip and waist morphology is unique. Our waists are taller and narrower than chimps’. 

says paleoanthropologist Daniel Lieberman.

Third, we have an S-shaped spine. The C-shaped spine of other apes places their upper torso slightly forward, in front of their hips. Because we have two curves in ours’ (the lumber and thoracic), our upper bodies sit directly atop our hips. This makes for a more stable upright posture.

Fourth, the connection between that S-shaped spine and our skulls is unique. Known as the foramen magnum, this part of the skull is the entrance for the spinal cord, allowing it to connect to the brain. In many primates, the foramen magnum is set towards the back of the skull. This makes sense if you are walking or climbing on all fours because it allows you to look foreward. However, if you stand on two feet, you want that foramen magnum to be on the bottom of your skull to look in front of you. Or else you’d constantly be looking up.

Note how two of the locals for chronic pain due to sitting are exactly where our bodies have adapted to bipedality - the hips and lower back.

So these are the anatomical adaptations that suggest we should be spending more time in a standing, upright posture, but what about behavioral evidence?

In the West, We Sit WEIRD

Don’t modern hunter-gatherers sit? And haven’t they always? You may think that if the answer is yes (which it is) then that suggests sitting is something we should be better adapted to. But it is more nuanced than that. First, hunter-gatherers don’t sit in industrially created chairs that put us in that typical right-angle position. This means that they are more likely to spend time kneeling, sitting on the ground, or in a full squat [11].

Second, they don’t stay seated as long. People in the West often sit for 40+ minutes at a time, whereas hunter-gatherers stand up and move around every 10-15 minutes [12]. This will be a key point when discussing how to combat the negative effects of sitting later in this article.

Just for perspective, let’s also take a look at physical activity from a broader standpoint. Researchers have recently looked into the evolution of steps - how many are taken in a day by different primate species. Roughly speaking, as you progress through species that are more closely related to humans, you see an increased amount of steps taken per day [13]. Hunter-gatherers take the most, ranging from 10,000 to 18,000.

However, people in industrialized societies have step counts that fall back closer to those of chimps and bonobos, sometimes as low as 5,000 steps per day. The researchers also showed how this more ape-like walking habit associated with modern culture is linked to greater risks of cardiovascular problems compared to people living in hunter-gatherer communities. 

Presumably, as our species shifted from its more traditional lifeways, much of our physical activity time was replaced with sitting. As of 2008, Americans spent up to 7.7 hours per day seated, and oftentimes more [14]. This number has likely gone up since the rise of social media use during our leisure time. 

Solutions to the Sitting Problem

The solutions to this problem are numerous, and some are quite creative.

First and foremost, simply don’t sit continuously for long periods of time. Of course, many people work at a desk for up to 8 or 9 hours per day, but I doubt your office has rules against briefly standing up or going to the bathroom. Multiple studies have now shown that breaking up bouts of sitting with standing breaks or walk breaks can significantly improve various cardiometabolic health markers such as glucose, insulin, and triglyceride levels [15]. 

Second, consider swapping your old work desk for a standing desk. It’s been shown that there is “a significant increase in caloric expenditure in subjects that were standing at a standing classroom desk compared with sitting at a standard classroom desk,” [16].

One study even found that employees who use standing desks are more productive [17]. If you find that most of your work-from-home day is spent seated, it might be time to consider changing up your workspace.

Lastly, we can look to fix the sitting problem from an organizational level. Schools and business should consider reorganizing their work environments to accommodate these concerns. One study looked at “active workstations” for both adults and children. This included the standing desks discussed previously, as well as treadmill and cycling desks. 

They found “decreased sitting time, increased energy expenditure, a positive effect on several health markers, no detrimental effect on work performance,” associated with these active workstations [18].

A more artistic approach to this has been termed “The End of Sitting”, which is an architectural style of designing workspaces to allow people to work in all sorts of positions. There are no chairs or tables, only surfaces of various angles. It's like an office jungle gym of productivity. 

A 2015 study looking into the influence of this type of design on human behavior found that “83% of participants worked in different non-sitting postures at different locations, giving rise to locomotion,” [19].

A final important tip is to reduce the amount of time spent sitting outside of work, during your leisure time. Make sure you're staying physically active. Try to make up for those steps we’re no longer taking. Rucking can be a great way to do this by adding a little more resistance than normal walking. You can watch my video on rucking here.

References:

[1] Doll, R. 1998. “Uncovering the effects of smoking: historical perspective.” Statistical Methods in Medical Research 7(2):87-117.

[2] Henschel, B., et al. 2017. “Time Spent Sitting as an Independent Risk Factor for Cardiovascular Disease.” American Journal of Lifestyle Medicine 14(2):204-215.

[3] van der Ploeg, H., et al. 2012. “Sitting time and all-cause mortality risk in 222 497 Australian adults.” Archives of Internal Medicine 172(6):494-500.

[4] Paterson, C., et al. 2024. “The effect of cardiorespiratory fitness and habitual physical activity on cardiovascular responses to 2-hours of uninterrupted sitting.” Journal of Applied Physiology. 

[5] Pekas, E., et al. 2023. “Prolonged sitting and peripheral vascular function: potential mechanisms and methodological considerations.” Journal of Applied Physiology 134(4):810-822.

[6] Waongenngarm, P., et al. 2015. “Perceived body discomfort and trunk muscle activity in three prolonged sitting postures.” Journal of Physical Therapy Science 27(7):2183-7.

[7] Kuhlman, G., and Domb, B. “Hip impingement: identifying and treating a common cause of hip pain.” American Family Physician 80(12):1429-34.

[8] Daver, G., et al. 2022. “Postcranial evidence of late Miocene hominin bipedalism in Chad.” Nature 609, 94–100.

[9] Bramble, D. and Lieberman, D. 2004. “Endurance running and the evolution of Homo.” Nature 432:345–352; Lieberman, Daniel E. 2014. The Story of the Human Body: Evolution, Health and Disease. New York, NY: Vintage Books.

[10] Pontzer, H. “Economy and Endurance in Human Evolution.” Current Biolology 27(12):R613-R621.

[11] The Brain Doctor: "Popular Treat Now Considered Deadlier Than Smoking!" - David Raichlen

[12] Harvard Professor: REVEALING The 7 Big LIES About Exercise, Sleep, Running, Cancer & Sugar!!!

[13] Raichlen, D., and Lieberman, D. 2022. “The evolution of human step counts and its association with the risk of chronic disease.” Current Biology 7;32(21):R1206-R1214.

[14] Matthews, C., et al. 2008. “Amount of time spent in sedentary behaviors in the United States, 2003-2004.” American Journal of Epidemiology 167(7):875-81.

[15] Loh, R,. et al. 2020. “Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Blood Glucose, Insulin and Triacylglycerol Measures: A Systematic Review and Meta-analysis.” Sports Medicine 50(2):295-330; Buffey, A., et al. 2022. “The Acute Effects of Interrupting Prolonged Sitting Time in Adults with Standing and Light-Intensity Walking on Biomarkers of Cardiometabolic Health in Adults: A Systematic Review and Meta-analysis.” Sports Medicine 52(8):1765-1787.

[16] Reiff, C., et al 2012. “Difference in caloric expenditure in sitting versus standing desks.” Journal of Physical Activity and Health 9(7):1009-11

[17] Garrett, G., et al. 2016. “Call Center Productivity Over 6 Months Following a Standing Desk Intervention.” IIE Transactions on Occupational Ergonomics and Human Factors 4(2-3): 188-195.

[18] Torbeyns, T., et al. 2014. “Active workstations to fight sedentary behaviour.” Sports Medicine 44(9):1261-73.

[19] Withagen, R., and Caljouw, S. “'The End of Sitting': An Empirical Study on Working in an Office of the Future.”Sports Medicine 46(7):1019-27.

Fuel Song Suggestion

The Fit Fuel song suggestions are hand-picked by yours truly to elicit the motivation (and possibly aggression) needed to initiate or persist through a grueling workout. They consist of heavy, brutal guitar riffs and gruesomely guttural vocals. Additionally, I timestamp what I believe to be the best riff of the song - one that will kick your nervous system into overdrive when approaching a personal record (PR).