Why Cardiologists Call Sitting the “New Smoking”

In this country, we sit for at least 8 hours each day, adding up to a yearly total of about three full months camped out 24-7 on the old rear end.

This sheer volume that how much most of us sit, combined with the pitfalls of fast food the western diet, has created a rogue wave, where one factor builds on top of another, to create a huge problem.

It’s gotten so bad that some cardiologists are now calling sitting the new smoking – but the numbers are showing that sitting might even be worse than smoking. Shocking to me as a physician, studies have shown that the death rates are higher for people who sit all the time than for people who smoke. It’s mind-blowing, but the data is clear: The more you sit, the sooner you die.

How can this be?

Well, the position of sitting is bad-we didn’t evolve to be sitting in chairs. When we sit, our muscles weaken, the spine stiffens, our circulation is restricted, brain function slows and even our bones weaken because we are not weighting them – but these reasons just scratch the surface of why sitting is killing us.

The core of the problem is that the western diet is full of simple carbohydrates, processed foods in things like white flour, that fill our bloodstream with fast-burning fuel that the body treats exactly like sugar. To deal with the flood of fuel, our bodies send out the blood stream’s delivery truck for energy – a hormone called insulin.  

But because we are sitting and burning minimal energy, our muscles don’t need the fuel, so these delivery trucks drive around our bodies causing unnecessary wear and tear on both the highways where they drive (our blood vessels) as well as on the delivery trucks themselves.

While sitting, our muscle cells don’t need the fuel, so this sugar bombards the great energy warehouse in our gut, where the liver quickly converts the sugar into fat and stores it.  This extra fat stored around our organs is particularly dangerous.  We call this the hot fat-the internal or visceral fat. We all don’t like the fat we can see on the outside, but as a doctor that cares about you it is the fat on the inside – the hot fat – that is linked to cancer, diabetes, heart attack and Alzheimer’s.

But that’s still not the worst of it.

After a while, the cells stop answering the door for the deliveries, even if they need the energy.

Would you continue to answer the door for the delivery guy if he kept bringing you things you didn’t order and don’t need?

On top of that, the garage for these energy trucks, an organ called the pancreas, sends out less and less trucks, even when we need the energy. The result is that our bloodstream is flooded with sugar that lacks its delivery vehicle – further damaging our blood vessels. Think of it as a highway covered with boxes and no delivery truck to take them to their destination. When this happens, other vehicles in the bloodstream start having problems too.

In our bodies, this highway disaster is usually called diabetes, but variations on this disaster cause a heart attack or stroke, and can even cause brain disease.

We like to name diseases, but it’s not like you’re perfectly healthy and then suddenly you have diabetes or a heart attack. Instead, it’s a slow decline of function that eventually reaches a point that we can give it a name. The other thing that kills you from sitting is that you leave work in a brain fog and get hit by a car – death by all causes increases as we sit more. Isn’t that incredible? By sitting more your chances of getting in an accident actually increase?

But the damage that happens while we sit is mostly due to how we burn energy. When we’re moving rather than sitting, our muscles need the energy so the traffic jam of sugar delivery is less pronounced, but even in athletes a high sugar, high carbohydrate diet is eventually damaging to the heart. Our bodies did not develop to handle the sheer volume of carbohydrates and sugars available to us now, so even top athletes should avoid too much of it.

Our bodies are happiest with a regulated delivery so the fuel trucks are emptied at a rate that matches the needs of the receiving cells. This is where vegetables, whole grains and fiber come into play. These foods are broken down and distributed at a rate that prevents rush hour traffic jams from happening.

In my opinion, excessive sitting is, indeed worse than smoking. Not because smoking is good, but because our lifestyle and culture force us to sit. A lot.

Kids in school are required to sit much of the day. When I was in school we had two recesses and PE every day – now many schools have PE once a week and one short recess each day. The rest of the time? The kids sit.

Most of our professions are now sitting-based. People have told me they are afraid to get up for fear of being fired. Computers don’t help, because they allow us to do even more while sitting down. We drive home – more sitting. Then we go home and sit down to watch TV and eat dinner.

To avoid and minimize the damage from sitting:

-Get up about every half hour during work and explain to your boss that your doctor told you you’ll work better if you get up frequently. If you’re a boss, get your workers to stand up and move around every half an hour – they’ll think more clearly and get more done anyway.

-Get an exercise ball at your desk instead of a chair and if possible use a standing work station to alternate with sitting down. Over the course of a day, using a standing desk burns about 300 calories over a seated work position. But too much standing isn’t good either, so variety is the key. Go for a walk to make phone calls, sit to do certain tasks and stand to do others.

-Try a beginner yoga class to keep your body in proper alignment. Make exercise a part of your life almost daily.

-Change careers. If there is no alternative but to sit without ever getting up in your place of work, do what it takes to change careers. If you don’t your job will literally kill you.

-Optimize your diet – a high vegetable and healthy fat diet that is low in sugar and carbohydrate will offer some protection against the damage of sitting.

I’d go so far as to say doing anything as much as we sit is probably bad for our health.

Mark Menolascino MD, MS, ABIHM, ABAARM, IFMCP