Skip to main content

Sitting Too Much May Boost Odds of Dying

March 26, 2012 — Don't take this sitting down, but spending too much time in a chair is bad for your health -- really, really bad.
New research published in the Archives of Internal Medicine shows that people who spend a lot of time sitting may be up to 40% more likely to die from any cause, compared to people who don't sit as long.
The study tracked nearly 222,500 Australian adults for about three years. During that time, people's odds of dying dovetailed with how much time they spent sitting.
Compared to people who spent less than four hours per day sitting, the odds of dying were:
  • 15% higher for people who sat for at least eight hours
  • 40% higher for people who sat for 11 or more hours a day
“Our findings add to the mounting evidence that public health programs should focus not just on increasing population physical activity levels, but also on reducing sitting time,” the researchers write.
Alpa V. Patel, PhD, has published studies on the health risks associated with too much sitting. She is an epidemiologist at the American Cancer Society in Atlanta. “We are continuing to demonstrate time and time again in different populations that there is something real to the association between sitting time and reduced longevity.”
Get Up Out of That Chair
What's so bad about sitting for long periods? That's not totally clear. But exercise and movement do have a positive effect on blood fats called triglycerides and other heart risks, and improves blood pressure, Patel says.
Her advice: Sit for five fewer minutes per hour. “Small changes can have a big impact," she says.
Technology may fight that. It's given us fewer reasons to move, says David A. Friedman, MD. He is the chief of heart failure services at North Shore Plainview Hospital in Plainview, N.Y.
Instead of texting or emailing a colleague, “walk down a few cubicles and say, ‘Hi, how are you?’ This is good face time and it’s also good exercise.”
Olveen Carrasquillo, MD, MPH, is the chief of the division of general internal medicine at the University of Miami’s Miller School of Medicine. “A sedentary lifestyle is not good for your health,” he says. “Today we don’t even have to leave the house to go to the bank or mail a letter.”
The new study doesn't prove that sitting killed people. It's not clear which came first -- poorer health or spending more time in a chair.
Still, there's no doubt that movement is good for many reasons.
“It is hard to say whether someone is fairly sedentary because they are inactive or if they are inactive because of other things, such as an unhealthy lifestyle that includes smoking," says Scott Kahan, MD, MPH. He is the director of the National Center for Weight and Wellness in Washington, D.C.
Still, there is no doubt that being active is healthy. “The key is to do something you like to do, whether it’s sports, going to the gym, walking, or gardening. “If it is terribly unenjoyable, the likelihood of sustaining it is pretty low.”
SOURCES:
Van der Ploeg, H. Archives of Internal Medicine, 2012.
Dunstan, D. Archives of Internal Medicine, 2012.
Scott Kahan, MD, MPH, director, National Center for Weight and Wellness, Washington D.C.
David A. Friedman, MD, chief of heart failure services, North Shore Plainview Hospital, Plainview, N.Y.
Alpa V. Patel, PhD, epidemiologist, American Cancer Society, Atlanta, Ga.
Olveen Carrasquillo, MD, chief, division of general medicine, University of Miami Miller School of Medicine, Miami, Fla.

Authors and Disclosures

Journalist

Denise Mann

Denise Mann is a freelance medical writer.

Comments

Popular posts from this blog

Contact Precautions May Have Unintended Consequences

Contact precautions, including gloves, gowns, and isolated rooms, have helped stem the transmission of hospital pathogens but have also had some negative consequences, according to findings from a new study. Healthcare worker (HCWs) visited patients on contact precautions less frequently than other patients and spent less time with those patients when they did visit, report Daniel J. Morgan, MD, from the University of Maryland School of Medicine and the Veterans Affairs (VA) Maryland Health Care System, Baltimore, and colleagues. Moreover, patients on contact precautions also received fewer outside visitors. "Less contact with HCWs suggests that other unintended consequences of contact precautions still exist," Dr. Morgan and coauthors write. "The resulting decrease in HCW contact may lead to increased adverse events and a lower quality of patient care due to less consistent patient monitoring and poorer adherence to standard adverse event prevention methods (such...

Antidepressants Linked to Higher Diabetes Risk in Kids

Pediatric patients who use antidepressants may have an elevated risk for type 2 diabetes, the authors of a new study report. In a retrospective cohort study of more than 119,000 youths 5 to 20 years of age, the risk for incident type 2 diabetes was nearly twice as high among current users of certain types of antidepressants as among former users, Mehmet Burcu, PhD, and colleagues report in an article  published online October 16 in  JAMA Pediatrics . The risk intensified with increasing duration of use, greater cumulative doses, and higher daily doses of these antidepressants. The findings point to a growing need for closer monitoring of these products, including greater balancing of risks and benefits, in the pediatric population, the authors caution. They undertook the study because, despite growing evidence of an association between antidepressant use and an increased risk for type 2 diabetes in adults, similar research in pediatric patients was scarce. "To our know...

Missing Data Lead FDA Panel to Vote Against Rivaroxaban for ACS May 23, 2012 (Updated May 24, 2012) (Silver Spring, Maryland) — The missing data issues plaguing the ATLAS ACS 2 TIMI 51 trial of the factor Xa inhibitor rivaroxaban (Xarelto, Bayer Healthcare/Janssen Pharmaceuticals) have prevented the drug from earning the endorsement of the FDA Cardiovascular and Renal Drugs Advisory Committee. At its May 23 meeting, the panel voted six to four (with one abstention) against recommending that the FDA approve rivaroxaban for reducing the risk of thrombotic cardiovascular events in patients with acute coronary syndrome or unstable angina in combination with aspirin, aspirin plus clopidogrel, or ticlopidine. Janssen's application is based on the results of the ATLAS ACS 2 phase 3 and the ATLAS ACS TIMI 46 phase 2 trial. The placebo-controlled ATLAS ACS 2 showed rivaroxaban reduced the risk of both all-cause and cardiovascular mortality while increasing the risk of bleeding and intracranial hemorrhage, but the studies were hindered by early patient withdrawals and missing data. We Don't Know What We're Missing Based on the ATLAS ACS 2 results, FDA reviewer Dr Karen Hicks recommended approval of rivaroxaban for the requested indications except all-cause mortality. However, another FDA reviewer, Dr Thomas Marciniak, was adamant that the trial results are not interpretable because about 12% of the patients had incomplete follow-up, far higher than the 1% to 1.5% differences in the end-point rates between rivaroxaban and placebo. A total of 1294 subjects discontinued the trial prematurely, and the company was only able to contact 183, of which 177 were confirmed to be alive. Because of the patient dropouts, the company adopted a "modified intention-to-treat analysis," whereby patients were observed for 30 days after randomization or the global end date for the trial, instead of observing all the patients until the end of the trial as the FDA originally suggested. Marciniak criticized the sponsor's efforts to follow the patients and said that three patient deaths not counted in the modified intention-to-treat analysis may just be the "tip of the iceberg." Because the percentage of patients whose ultimate vital status remains unknown is much greater than the reported differences in mortality rates, the claimed mortality benefits are not reliable. The majority of the panel sided with Marciniak. For example, Dr Sanjay Kaul (University of California, Los Angeles) voted "no" because "there was enough uncertainty in the quality and robustness of the data that dissuaded me from voting yes. . . . The 'missingness' of the data doesn't invalidate it, but it certainly makes it hard to infer [the conclusion]." Dr Steven Nissen (Cleveland Clinic, OH) said that the decision to use the modified intention-to-treat analysis had a "profound impact" on the interpretability of the data. "It's saying we don't care what happens after 30 days, [and] that colored the trial in ways we couldn't recover from." Given the risk of major bleeding, "I want to see better evidence that this strategy of adding an Xa inhibitor or a direct thrombin inhibitor or something else to a good antiplatelet agent is robustly better for the patient," Nissen said. He recommends that the companies run a new trial of the 2.5 twice-daily dose of rivaroxaban using a strict intention-to-treat approach, but, he said, "I don't expect the death benefit to be too robust." Several panelists said they were concerned that the patients who dropped out of the trial were disproportionately likely to have a bleeding event, which led them to quit the trial, or a "protopathic" event, as statistician Dr Scott Emerson (University of Washington, Seattle) put it. "We're worried that an impending event is what is changing their behavior. We see that all the time in clinical trials--that regularly measured end points do not pick up [all of] the events," he said. He said that since the company was only able to contact 183 of the over 1200 patients who dropped out, it is possible that the dropouts skew the outcomes comparison of the trial. "Differential event rates after dropout are the number-one thing we're afraid of, so you have to explore it" in a statistical sensitivity analysis of the potential impact of these unknown outcomes. "It would not surprise me if, at the end of the day, these data did not hold up under a proper sensitivity analysis," he said. "What I want to know is, among the people who had events, how differential was the follow-up, but I can tell you by just looking at it, there was a very slightly different amount of follow-up of the people in the treatment arm. But I don't know whether everyone in the treatment arm was cured and they were trekking in the Himalayas and everyone in the placebo arm went home to die. I don't know that that's not the case." Dr Maury Krantz (University of Colorado, Denver) voted in favor of approval but said he does not know how rivaroxaban would perform in general clinical practice, especially when used with aspirin and clopidogrel. "I felt very much torn by this. This isn't a simple paradigm shift. It means going to triple therapy, which is really a three-headed monster in many ways. I think that what you're going to see in practice, if this is not done carefully with the proper labeling and secondary studies, is really dramatic magnification of bleeding and perhaps minimization of the efficacy benefit."

May 23, 2012   (Updated May 24, 2012)  (Silver Spring, Maryland)  —  The missing data issues plaguing the  ATLAS ACS 2 TIMI 51   trial of the factor Xa inhibitor  rivaroxaban  (Xarelto, Bayer Healthcare/Janssen Pharmaceuticals) have prevented the drug from earning the endorsement of the  FDA  Cardiovascular and Renal Drugs Advisory Committee. At its May 23 meeting , the panel voted six to four (with one abstention) against recommending that the FDA approve rivaroxaban for reducing the risk of thrombotic cardiovascular events in patients with acute coronary syndrome or unstable angina in combination with aspirin, aspirin plus  clopidogrel , or  ticlopidine . Janssen's application is based on the results of the ATLAS ACS 2 phase 3 and the  ATLAS ACS TIMI 46   phase 2 trial. The placebo-controlled ATLAS ACS 2 showed rivaroxaban reduced the risk of both all-cause and cardiovascular mortality while increasing the ri...