Is too much sitting killing Indian Americans? Are you having problems sleeping at night, controlling your weight, or managing your blood sugar, pressure, or cholesterol? If you are a white collar worker, you are probably sitting too much and for too long.  And this may be the greatest health hazard you face.

The human body is a product of millions of years of evolution. It was never meant to be sedentary. New science is revealing that being immobile and sitting at the same place for hours has dire consequences.

If you are an average Indian American, your usual day begins with sitting at the table eating your breakfast, then sitting in your car, bus or train going to work. At work, you will sit at your desk for eight hours and then return home while sitting in a motorized vehicle. You will have dinner while sitting, and then watch television while relaxing on a couch. Some may go for a run or lift weights for an hour at the gym. In total, the average Indian American is sitting more than nine hours in a day. This is an all-time high in recorded history.

Now, there is a vast amount of data linking a physically active lifestyle to lower rates of morbidity and mortality. Decades earlier, this connection was not studied or understood. In 1949, it was  Professor Jerry Morris who made a significant discovery linking exercise to heart health. He studied the heart attack rates among drivers and conductors on London’s transit system. Even though drivers and condutors were drawn from similar backgrounds and social status, drivers had a statistically significant difference in heart attack rates that adversely affected them.  After his study was published in the Lancet in 1953, recommendations for exercise have become mainstream and widely followed all over the world.

Health organizations recommend  around one hour of exercise a day. The American Heart Association and American College of Sports Medicine call for a minimum of 30 minutes of moderate to intense physical activity five days a week or 20 minutes of vigorous intense physical activity three days a week. But new research reveals that one hour of activity is not enough to mitigate the harms of 23 hours of inactivity. This new finding is revolutionizing how we think about exercise.

The association between sitting and mortality is dose dependent; the more you sit, the less you live. This is independent of leisure activity or baseline BMI (body mass index) so that no matter how much exercise we get or how healthy our food choices are, the dangers of prolonged sitting will still cause harm.

Studies have shown that even four hours of sitting changes your metabolism and sitting is especially harmful for women. Women who sit for more than six hours per day have a 40 percent increased all-cause death rate compared to those sitting less than three hours per day. This association is not affected by the amount of physical activity women receive.

If we look back in history, until very recently, humans have always been moving. In the beginning, we were all hunter-gatherers, and we used to forage for food. Then the economy switched to pastoral, agricultural and after the industrial revolution, things began to change rapidly as fossil fuels and electricity replaced physical labor. In this digital age, almost everything can be done seated. Although tools and technology changed our environment, our body has not had time to evolve. Scientists and anthropologists conclude that the human body has not changed much over the last 40,000 years.

Most Indian-Americans are white collar workers. They may argue that the kind of work that they do demands that they sit to focus and concentrate. They may say, “Deep thinking and contemplation requires the meditative stillness of sitting.” This may seem like a valid argument, but even this argument does not stand up in the light of scientific research. The brain has enormous plasticity. It can produce new neurons and make new synaptic connections throughout life. Scientists have found that a protein called Brain Derived Neurotropic Factor (BDNF) plays an important role in brain function. It improves memory, attention, mood and concentration. We produce more of this protein when we exercise and move. Therefore, moving more may not only make us healthier, it may also make us smarter.

Now, the challenge becomes how to create circumstances where we can coax our bodies to move. We see that the market has responded to our need to increase movement with many creative fitness gadgets that make it easier for us to exercise.

One such innovation is the Standing desk, which makes you stand and work, and the Treadmill desk, which makes you walk and work. As companies are becoming aware of the cost of sitting and the sedentary life, some are offering standing and treadmill desks for their employees.

As a practicing Indian American psy chiatrist I had to spend a lot of time sitting and listening to people’s stories, and then documenting them. As my practice got busier, I began to develop back and neck pain from prolonged sitting. And then there was the weight gain, despite my eating healthy and exercising regularly. It made me rethink the way in which I structured my day.

I made changes to my schedule. I placed a small table on top of my desk and converted it into a standing desk. I try to do all my reading, typing and writing while standing. When I get tired I sit down and take rest, then I will stand again and continue. Some of my coworkers saw me make this change, and now they have also put a small platform over their desk in order to use the computer keyboard while standing. Many of us suffered from back, neck and wrist pain in the past and we have seen this disappear after we changed our posture from sitting to standing.

I strongly encourage everyone to have a standing desk or make one. There are inexpensive DIY options as well. You can make a workable standing desk using a box or stool over the regular desk. A spare treadmill or standing cycle can be placed under the desk. Pedometer smart phone apps are available that will record all steps and movements of the day.

Seek all opportunities to move. While you are working, get up and move every 15 minutes. Use a pedometer or a fitness tracker. A mundane activity like walking and moving can become fun and competitive once you measure and compare with family and friends. I wear a Fit-bit Charge and try to do the recommended 10,000 steps per day. Stand while you talk on the phone. Some offices are holding standing and walking meetings. I got rid of the copier and printer in my office. This forces me to walk down the hallway to get papers. I stopped bringing bottled water and now use a recyclable mug. Every time I get thirsty, I walk to the common area to refill my water.

Prolonged sitting increases the risk of death from all causes, including cardiovascular diseases, irrespective of a person’s BMI, leisure activities, and exercise.

The solution is simple—move. Make use of fitness gadgets and tools available to make you less sedentary. Make a personal commitment to stand more, move more, and sit less. Keep a daily activity log noting your position at each hour. Try to find more opportunities to move rather than sit. It has been established that we  become healthier, happier, and smarter as we move more. As you finish reading now, you may stand up, and ponder what Nietzsche meant when he said “Only thoughts reached by walking have value.”

Dr. Panchajanya Paul, MD, ABIHM, ABPN, is an American Board certified  Child, Adolescent, and Adult Psychiatrist. He is a diplomate of the American Board of Integrative and Holistic Medicine. He holds adjunct faculty position at Emory University School of Medicine; University of Georgia & Georgia Regents University, and University of Central Florida School of Medicine. He is a fellow of the American Psychiatric Association. He is a freelance writer who lives in Atlanta.

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