Cycling CME

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Active CME:  Combining Continuing Medical Education (CME) and Bicycle Touring for the Healthcare Provider

Stop All The Sitting!

There have been studies for decades detailing the health risks of inactivity. Physical inactivity alone is identified as a major risk factor for poor health and increases the risk of multiple chronic diseases. Being inactive increases your risk of diabetes, hypertension, osteoporosis, colon and breast cancer and cardiovascular disease, to name a few.

These studies have led to a call to action to increase physical activity. Campaigns such as “Exercise is Medicine”, “Let’s Move”, and “Everybody Walk” have promoted the importance of physical activity both personally as well as a globally. However, recent studies have illustrated that an isolated block of exercise each day may not be the only answer. Studies began to appear that specifically correlate sitting with poor health. As they say, sitting has become the new smoking.

Illustrating this, a more recent study by Katzmarzyk, and then a meta-analysis by Chau, demonstrated the importance of decreasing our sitting time. Katzmarzyk et al looked at 17,000 Canadians and demonstrated a dose-response association between sitting time and mortality from all cause and CVD, which was independent of leisure time physical activity. Chau et al looked at multiple studies with a total of almost 600,000 patients and again showed that higher amounts of daily total sitting time was associated with greater risk of all-cause mortality.

So, we are not really surprised that sitting all day is not good for us. The human body is clearly designed for movement and movement uses energy. We know that we use energy with all our activities, not just exercise. Therefore, we need to promote less sitting and add more motion to our daily lives. These ideas have led to many innovative studies and interventions.One study in Minnesota showed improved scores, less stress, less frivolous movement when students were encouraged to move around the classroom. One of the authors of this study, Dr. James Levine, director of the Mayo Clinic Obesity Solutions Initiative, and inventor of the first treadmill desk, calls for a paradigm shift: Make standing and moving the norm and decrease sitting in all walks of life.

We have several options both personally and while promoting activity to our patients. Simple ideas such as purposefully moving regularly from your desk, even setting an alarm as a reminder to get up and moving, can be helpful. Stand up to field phone calls. Change your desk to be able to alternate sitting and standing during the day. If you are very ambitious, look at a treadmill desk for the ultimate desk workout.

Even though I am moving throughout most of my day in the clinic, I have made several changes to my lifestyle related to this issue: I have changed my desk chair to a Swiss Ball, I often read while on my stationary bike and I frequently stand while dictating medical records.

Again, we are made to move and we should apply this personally and impart this information to our patients. Let’s daily encourage our patients to remember: Avoid sitting when possible and be a body in motion.

Cycling CME

References:

Chau JY, et al.  Daily Sitting Time and All-Cause Mortality:  A Meta-Analysis.  PLoS One 8(11)

Katzmarzyk PT, et al.  Sitting Time and Mortality from All Causes, Cardiovascular Disease, and Cancer.  Med. Sci. Sports Exerc., Vol 41, No. 5, pp.  998-1005

www.juststand.org - Interesting site reviewing research related to standing versus sitting; vendors of standing desks

www.mayoclinic.org/documents/mc5810.../doc-20079082  Dr. James Levine discusses “NEAT” – Non-Exercise Activity Thermogenesis

http://time.com/sitting/ - Easy educational link for our patients

Continuing Medical Education