DON’T BE AN ACTIVE COUCH POTATO
Although it sounds like an oxymoron, it is indeed possible to be an active couch potato. Many people exercise 30 or more minutes daily, but succumb to the comfort of the chair or couch for most of the rest of the day. Although regular exercise is well known to help prevent type 2 diabetes, heart disease, unwanted weight gain, and some cancers, it’s rarely enough to overcome an otherwise sedentary lifestyle. The activities of your workday and leisure time matter quite a bit.
Why Are We So Sedentary?
It seems that each decade in recent history brings us more labor-saving devices. We have remote controls to turn on and off the TV and the sprinkler system, adjust the temperature of the house, and light a gas fireplace. We drive to work instead of walking. I find research articles online instead of walking through the library stacks. I load my dishwasher instead of scrubbing my dishes. And I grind coffee in a noisy electric machine instead of using a hand crank. If I’m hungry while driving to work, I don’t even have to get out of the car to order, receive, and eat food. Our lives are filled with tools of convenience. But with these conveniences come some disadvantages. While I’m not willing to give up my collection of remote controls, wash dishes by hand, pull the plug on my coffee grinder, or hang up my car keys, I do acknowledge how time-saving and labor-saving devices can potentially harm my health by making me less active, and I look for ways to defeat the draw of inactivity.
How Inactivity Harms
Recall from Chapter 4 that there are three components that combine to make up the total number of calories that you burn each day. Only the physical activity component is greatly within your control. And this portion of the total consists of physical activity for the purposes of getting exercise (like a morning jog or water aerobics class) and activities of daily living as big as walking your dog, tiling your floor, and raking leaves to as little as folding laundry, walking to pick up a ringing phone, and nervously tapping your foot.
Body Weight
It’s easy to see that if you spend your days tied to a desk and a computer that you’ll burn fewer calories than the worker hauling boxes, trimming trees, or transporting hospital patients by wheelchair. Likewise, if you spend your evenings cleaning house, folding laundry, or playing basketball, you will burn more calories than your friend who is nearly lulled to sleep on the coach by the sound of the TV.
Several years ago, physician and researcher James Levine and his colleagues published research findings suggesting that non-exercise activity plays a large role in body weight regulation. Non-exercise activity thermogenesis (NEAT) refers to the calories burned during movement that is not exercise simply for the purpose of exercise. It’s the calories burned when standing, walking to the mailbox, sweeping the floor, letting the dogs in and out, repairing a backyard deck, planting a garden, and so on. Some people burn a lot of calories through non-exercise activity. Others, not so much. Week after week and year after year, these calories that are either being burned or not can make a significant difference to your weight and your health.
For 10 days, Levine and colleagues measured the movements of 20 volunteers who described themselves as couch potatoes. None were gym-goers or participated in exercise for the purpose of being physically active. The researchers fitted 10 lean participants and 10 participants with mild obesity with devices that measured their posture and movements twice every second. On average, the participants with obesity sat for an additional 2 hours per day compared to the lean participants. According to the researchers, if the individuals with obesity had copied the non-exercise activities of the lean subjects, they would have burned an extra 350 calories daily, enough to make significant differences in their weights over time. So even without purposeful exercise, the leaner subjects burned more calories because of their NEAT-enhanced behaviors like standing, fidgeting, and moving during daily activities.
Beyond Body Weight
Sedentary behavior is any activity other than sleeping that occurs in a sitting or reclining posture and burns little calories. High amounts of sitting and other sedentary behaviors are associated with poorer health outcomes, even among regular exercisers. In one study, healthy, physically active adults who watched the most TV had larger waist sizes, higher blood pressure levels, and worse blood glucose levels. Researchers find links between the amount of sitting and the risks of developing type 2 diabetes, heart disease, and some types of cancer. In general, as sitting increases, so do the risks of disease and death.
The reasons may be related to weight as described above, but also to other metabolic problems. For example, even among healthy volunteers with normal blood glucose levels, cutting daily steps from more than 10,000 to less than 5,000 for a mere 3 days led to greater blood glucose spikes after eating. Some scientists speculate that prolonged inactivity leads to the suppression of some muscle enzymes, which may result in worsening cholesterol and triglyceride levels. Additionally, when we fail to contract our muscles, less glucose exits the blood to enter the muscle cells.
Take Movement Breaks
Interestingly, taking small breaks from sitting or other sedentary behavior is beneficial. The American Diabetes Association recommends avoiding long periods of sedentary behavior. The Association advises us to break up long periods of sitting with 3-minute breaks every half hour to improve blood glucose control. If you have a sitting job, it may take some creativity to find ways to be less sedentary. In those 3 minutes, you could walk to the bathroom and back, walk in place, do pushups against the wall, do lunges and squats, or any activity that suits you.
Identify Your Patterns of Activity and Sedentary Behavior
Adults under age 60 years of age spend about 6–8 hours daily in sedentary behavior. Older adults are sedentary 8.5–9.6 hours each day. There are many cues to sitting—chairs in a waiting room, desk chairs, or comfy TV chairs. Certainly, we are influenced by the company we keep. If we spend time with sitters, we too are likely to be sitters. But if our friends and family take walks, shoot hoops, dance, and participate in other active leisure-time activities, we are more inclined to do the same.
People often tell me that they are so busy during the day—even if their busyness is a type of sedentary busyness—that they don’t have energy left at the end of the day to do anything active. They are drawn to the chair immediately after finishing their daytime chores and stay there until bedtime. Isn’t it odd that sitting all day is tiring? I find this when I travel by car or plane and when I’m stuck in a doctor’s waiting room for a couple of hours. I’ve also seen, fortunately, that just a little bit of activity spurs on interest in more activity. When my clients fight the lure of the chair to take a walk or do something active, it nearly always results in so many positive effects that some form of activity eventually becomes the preferred behavior. Isn’t it interesting that we can fight fatigue by being active?
Spend some time thinking about why and how you engage in sedentary activities. If you have a pedometer or an accelerometer-type fitness tracker, you can learn your baseline activity levels fairly simply. Strap on your device and let it measure your movement. Keep a record for a few days to a week. If you find that you’re not active enough, set a SMART goal to increase your daily steps by 500 or 1,000. Once that pace is comfortable, add another 500–1,000 steps to your daily goal. Aim to eventually accumulate at least 10,000 steps daily. Many devices don’t identify periods of activity and inactivity, so looking at the total steps per day may not help you break up periods of sedentary behavior. A tracking sheet like the one on the next page can help you. You can use the blank Activity/Inactivity Record in Appendix B on page 281.
In the example, a woman tracked her activities for a full day and made a note of the amount of active or standing time. Each activity block in which she was active for less than 3 minutes in a 30-minute period is circled. While it isn’t feasible or even smart to be active while driving to and from work or while eating dinner, there are four activity blocks that are ideal for her to take active breaks. She is inactive during three long blocks of time while working at her desk and again for 2 hours while relaxing with the TV or a book before bed. With this awareness, she can make goals for active breaks both during the workday and at home. After brainstorming solutions, she might choose several of the following ideas. More ideas are in the next section.
Activity/Inactivity Record
Record your activities throughout the day. Make note of when you stand, walk, or otherwise engage in activity. Keep records for a few days, including both weekdays and weekends. Identify each block of time in which you are inactive, defined as less than 3 minutes of activity in a 30-minute period.
At work:
• Stand up each time she sips water, coffee, or tea
• Stand up each time the phone rings
• Walk to coworkers’ desks instead of calling or emailing
• Set a timer to remind her at regular intervals to do toe raises, squats, and pushups against the wall
At home:
• Relax with active activities instead of sedentary activities
• Walk, play active videogames, play catch with the kids
• Walk, stretch, squat, or lunge during TV commercials
• Stand during TV credits
• Walk for 3 minutes after reading one chapter
Boosting NEAT
Depending on what you find from your activity assessment, you may want to engage in more active leisure-time activities like taking a ballroom dance class, gardening, or leisurely riding your bike after work. Or you may want to focus on breaking up sedentary behavior with short bouts of movement. Or perhaps you’ll do both. If you are very inactive, it’s probably wise to start with breaking up excessive sitting. Then move on to active leisure activities, and finally, move on to planned exercise.
Try some of these ways to be less sedentary.
• Use a treadmill desk. This is my favorite strategy. In fact, I’m writing the majority of this book while walking 1.5 miles per hour. Fortunately, I have ample space in my home office. I completely get that most people don’t have this option.
• Greet visitors to your office. I do this in my patient office. I bring each patient from the waiting room to my office at the start of our appointment time and walk each person out at the end. This ensures that I get up from my desk regularly.
• Use the stairs instead of the elevator.
• Walk to the bathroom farthest from you.
• Ask coworkers to join you for a walk-and-talk meeting.
• Walk the long way to a coworker’s desk or to the office kitchen.
• Talk to coworkers in person instead of using the phone and emails.
• As you move from one type of task to another, take a 3-minute activity break.
• Do squats, toe raises, or wall pushups while reheating your coffee.
• Let your dog in and out instead of asking a family member to do it.
• Walk in place or do sit-ups during TV commercials.
• Take 3-minute walk or dance breaks after 30 minutes of reading, studying, paying bills, and other sitting activities.
• Watch TV while using a hula hoop, treadmill, or stationary bicycle.
• Take the dog for a walk.
• Play with your kids or grandkids or even with your neighbor’s kids.
• Carry items upstairs or from the car one at a time.
• Walk while talking on the phone.
• Park far from the entrance of a store, office, or friend’s home.
• Walk the golf course instead of riding.
• Walk on the beach or toss a Frisbee instead of sitting.
• Choose a different family outdoor activity every weekend. Try hiking, biking, visiting a farmer’s market, walking on the beach, playing croquet, swimming, roller skating, visiting a petting zoo, etc.
• Take a 15-minute walk after eating.
Makes Cues to Be Active
Just like we have cues to sit, you can use cues to get yourself more active. If you want to use your stationary bike or treadmill at home, get it in working condition and move it to a room where you’ll both see it and use it. If you spend your days at home, lace up athletic shoes to make movement more comfortable and more likely. If you want to be active after work, dress in athletic clothes once you get home. Schedule a dance class or a walk with a friend, so you know that someone is expecting you. If you want to add a few minutes of exercise into your day, simply spreading out a yoga mat or moving hand weights onto the floor earlier in the day might do the trick.
Be Empowered
• Commit to limiting sedentary activities.
• Assess your leisure-time and work-time sedentary behavior by using a step counter or the Activity/Inactivity Record in Appendix B (on page 281), or both.
• Select five ways to break up sedentary behavior at home and work.
• Select at least one active leisure activity to replace an inactive leisure activity.