We have made tremendous strides in preventing and treating cardiovascular disease. In a single decade, death from coronary heart disease and stroke has decreased by 30 percent and 35 percent, respectively, thanks to advanced therapies and treatments, anti-smoking efforts and early detection and treatment of risk factors such as hypertension and high cholesterol. Nonetheless, heart disease remains the No. 1 cause of death for both men and women. It is the most costly disease today, both in terms of medical expenses and lost productivity. 

We can do better. The American Heart Association’s 2020 Impact Goal is to improve the cardiovascular health of all Americans by 20 percent, while reducing deaths from cardiovascular disease and stroke by another 20 percent.  The strategy to achieve this goal is to increase the number of Americans with ideal cardiovascular health or “Life’s Simple 7.”  These 7 metrics are: maintenance of a healthy weight, getting sufficient physical activity, following a healthy diet, not smoking, preventing diabetes, and controlling cholesterol and blood pressure. Today, less than one percent of U.S adults meet the criteria for ideal cardiovascular health.

The Dangers of Sitting

How does sitting play into these numbers? According to the World Health Organization, physical inactivity is now the fourth leading risk factor for mortality, estimated to account for six percent of deaths, or 3.2 million deaths globally per year. Evidence shows that lack of exercise and “too much sitting” are risk factors for diabetes, heart disease, cardiovascular death, some cancers and even all-cause mortality. What this means is that exercise may not fully counteract the harmful effect of high levels of sedentary behavior throughout the day (more research needs to be done in this area). For these reasons and more, sitting has been dubbed “the new smoking.” 

Caloric intake in this country remains too high and certainly contributes to obesity; paradoxically, caloric intake in the U.S. over the last couple of decades has remained the same even while obesity rates continue to climb. It is the dramatic reduction in total physical activity and energy expenditure that is the major contributor to this continual rise in obesity (and with it, diabetes and poor cardiovascular health). 

Look around and you’ll see that sitting is quite common in modern society. Consider drive-thru windows for coffee, banking and food; escalators and motorized walkways; computers, email, online shopping (including groceries); and transportation time (how many of us know somebody making the commute between Milwaukee and Chicago every day?). Today, we don’t even have to walk to the mailbox to get our mail – we can do it all from our chair.

Find Ways to Reduce Sitting

Exercise and fitness will always be important. In fact, cardiorespiratory fitness is one of the strongest, if not the strongest, predictor of good health and longevity. It is currently recommended that adults obtain at least 150 minutes per week of moderate-intensity exercise (brisk walking counts!) and performed in periods of at least 8-10 minutes.  In addition to exercise, efforts to reduce sedentary behavior are necessary. There are many easy ways to reduce sitting time:

  • Take the stairs instead of the elevator.
  • Reduce “screen” time. Get up and pace while talking on the phone. Break up prolonged periods of sitting with a short walk or some stretching. Even standing is better than sitting!
  • Consider a pedometer, or step-counter – research shows that people tracking their daily steps are motivated to do more. 

Today, 70-80 percent of occupations are considered “sedentary.” If you have a sedentary job, do not plant yourself in front of the TV when you get home. Instead, take a walk outside. I strongly encourage the development of workplace wellness programs – organize walking meetings at work. Become the advocate to reduce sitting at your place of work. Communities need to step up too, and make neighborhoods easier and safer for foot traffic. 

Start today to take a break from sitting. Now that you have read this article, go take a walk. Your heart will thank you.

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About the Author

Jacquelyn P. Kulinski, MD is a cardiologist at the Froedtert & the Medical College of Wisconsin Heart and Vascular Center. Board certified in internal medicine and cardiology, among other board certifications, and she is particularly interested in general cardiology with a focus on prevention, particularly lifestyle behaviors such as diet and physical inactivity. Dr. Kulinski’s specific research interest is in sedentary behavior as an emerging and adverse cardiovascular risk factor.

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