Sitting

[[File:The Chair (8026656051).jpg|thumb|right|165px|An uncomfortable chair: it might help]]
'''Sitting''' is the act of resting your posterior, and in modern societies generally means in a chair. It is blamed for many health problems, and the modern "sedentary lifestyle" is considered a factor in rising levels of [[obesity]], diabetes, back problems, etc.

Alternatives to sitting down include standing up and lying down. The health benefits of standing up have been widely promoted, with products such as standing desks considered by some to be great things, even though standing up all day carries its own health risks.

''Time'' magazine claimed "Sitting Is Killing You" in an article where Dr. James Levine, director of the Mayo Clinic-Arizona State University Obesity Solutions Initiative, claimed that sitting should be a rare thing; to this end Levine promotes ideas such as the treadmill desk and standing meetings.<ref name=timesitting>[http://time.com/sitting/ Sitting Is Killing You], Time, 2 Sep 2014</ref> But is there something uniquely bad about sitting, and is it more dangerous than other forms of inactivity? And more importantly, what can I buy to stop me sitting down?

==Sitting problems==
===Sedentary lifestyle===
It is generally believed that people sit down more than they used to, and in particular stand up and walk less.<ref>{{wpa|Sedentary lifestyle}}</ref> In the past, people might have walked long distances to work or to obtain food or [[water]]. Today many people will drive (although some will stand on over-crowded mass transit). Previously many people in the [[West]] worked in jobs that involved arduous physical labour performed standing up, such as agriculture or heavy industry; today many more people have desk jobs or work seated in jobs such as tele-sales, store cashier, professional driver, receptionist, and computer operator. Performing traditional forms of physical labour while standing is not necessarily healthy, particularly in a dangerous environment like a mine, mill, factory, construction site, foundry, farm, forest, ship, breakers yard, or battlefield,<ref>[http://www.ilo.org/safework/areasofwork/hazardous-work/lang--en/index.htm Hazardous Work], ILO</ref><ref>[https://www.usatoday.com/story/money/careers/2018/01/09/workplace-fatalities-25-most-dangerous-jobs-america/1002500001/ Workplace fatalities: 25 most dangerous jobs in America], ''USA Today'', 9 Jan 2018</ref> but remaining seated and motionless all day may have its own risks.

The particular problems with moving less include lack of exercise and lower calorie requirements. Lack of exercise is linked with cardiovascular disease and other conditions.<ref>[https://www.hopkinsmedicine.org/healthlibrary/conditions/cardiovascular_diseases/risks_of_physical_inactivity_85,P00218 What health risks are linked to physical inactivity?], Johns Hopkins Medicine</ref> Working while standing rather than sitting reportedly burns an extra 500-1000 calories per day.<ref name=timesitting/> If you consume fewer calories than you use, you will gain weight, and obesity is also associated with many health problems. However, neither of these are related specifically to sitting: if you lie down or even stand up but do not move, the health outcome will be no different.

Having said that, the jobs with the biggest risk of coronary heart disease and stroke include security and waste management services, wholesaling (including distribution), and hospitality and food service, which don't necessarily require more sitting time than low-risk jobs like finance and insurance.<ref>[https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6330a1.htm Prevalence of Coronary Heart Disease or Stroke Among Workers Aged <55 Years — United States, 2008–2012], Morbidity and Mortality Weekly Report (MMWR), CDC, August 1, 2014 / 63(30);645-649</ref> Other research shows numerous health problems for those standing all day (see below).<ref name=hazards/> Clearly, there are many other risk factors beyond how much you sit down at work.

===Back problems===
Sitting is often associated with back problems and other skeletomuscular conditions. The exact posture is important, with slouching especially bad, but sitting all day especially in an unsuitable chair can cause problems in the back, neck, arms, and legs.<ref name=ucla>[http://spinecenter.ucla.edu/ergonomics-prolonged-sitting Ergonomics for Prolonged Sitting], UCLA Spine Center</ref> Clearly if you are going to sit down, you should ensure that your chair is of good quality and properly adjusted and not remain motionless all day. The UCLA Spine Center recommends standing up and having a stretch or walk for a minute or 2 every 30 minutes.<ref name=ucla/>

Some people who have back problems will find it difficult or impossible to sit for long periods. Obviously, they should avoid sitting if possible. Whether this applies to others is an open question.

===Deep vein thrombosis===
Deep vein thrombosis is a potentially fatal condition where a blood clot forms in a vein, usually in the leg. It can be caused by sitting motionless, but is also caused by lying motionless, and exercise is a good way to avoid it.<ref>[https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/symptoms-causes/syc-20352557 Deep vein thrombosis (DVT)], Mayo Clinic</ref> Few people, except perhaps pole-squatting mystics and teenagers, would suggest that remaining motionless all day is a good idea.

==Sitting on other things==
In the west, people typically sit on chairs which have a raised base and a back. However this is not the only option.

===Sitting on the floor===
Some [[alternative medicine|alternative health]] people recommend sitting on the floor.<ref>[https://www.thealternativedaily.com/5-reasons-sitting-floor-good-health/ 5 Reasons Sitting on the Floor is Good For Your Health], Alternative Daily, 2014</ref> Various health benefits are touted, most of which reduce to the fact that sitting cross-legged is good for the posture (it also allegedly promotes humility and good digestion). Plus, if you can sit on the floor and stand back up again, you're probably reasonably healthy to begin with.

===Sitting on your haunches===
The resting squat, sitting on your haunches, etc, is the position where you stand on the balls of your feet with the heels close together and fully lower the hips until they are supported by the legs and feet. Many people tout a wide variety of benefits. They commonly point out that human beings have sat like this [[Appeal to tradition|from time immemorial]], so squatting puts you in touch with your ancient ancestors, and many people also recommend it for [[poo|pooping]].<ref>[http://theshawnstevensonmodel.com/resting-squat/ The Resting Squat – How Squatting Makes You More Human], The Shawn Stevenson Model</ref><ref>[http://www.healthguidance.org/entry/17360/1/The-Health-Benefits-of-the-Squatting-Position.html The Health Benefits of the Squatting Position], Adam Sinicki, Health Guidance</ref>

Although there is a lot of interest in whether squatting makes it easier to poop,<ref>[https://www.npr.org/sections/health-shots/2012/09/20/161501413/for-best-toilet-health-squat-or-sit For Best Toilet Health: Squat Or Sit?], ''NPR''</ref> there are fewer studies on the benefits of squatting when not pooping. Additionally, many people may have problems getting into a squatting position. And it's unclear if people can squat for as long as they can sit at a desk or in a chair, so it may not be directly comparable.

===Kneeling chairs===
A {{wpl|kneeling chair}} is a type of seat where some of the body's weight is supported by a pad below the knees and shins, with legs at an angle of about 60-70 degrees from vertical, in contrast to the normal seating posture where the upper legs are horizontal. It is claimed that kneeling chairs maintain better posture, preventing slumping and reducing pressure on the spine. They have the negative effect that they can cause knee pain unless they are properly cushioned.<ref>[https://www.menshealth.com/health/kneeling-chair-back-pain-benefits/slide/3 The Best Thing For Your Back Is This Chair], Mens Health, 9 Mar 2017</ref>

Study results are mixed but some show improved posture and increased circulation.<ref>{{wpl|Kneeling chair}}</ref> One small study showed particular benefits in healthy people, moreso than those with lower back pain.<ref>[https://www.sciencedirect.com/science/article/pii/S1877065715000445 Effect of a kneeling chair on lumbar curvature in patients with low back pain and healthy controls: A pilot study], Annals of Physical and Rehabilitation Medicine, Volume 58, Issue 3, June 2015, Pages 151-156</ref> Another found improved posture compared to normal computing chairs.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/18810008 Ergonomically designed kneeling chairs are they worth it? Comparison of sagittal lumbar curvature in two different seating postures], Bettany-Saltikov et al, ''Stud. Health Technol. Inform.'' 2008;140:103-6.</ref> A note of caution is that most studies were very small-scale and only measured posture, not actual health outcomes.

But as long as your knees are adequately protected, there seems little risk, in contrast to some sitting solutions…

===Exercise balls===
Variously known as exercise, gym, or stability balls, big inflatable balls, often used by [[pregnant]] women, are recommended by some people as workplace seats. Various studies have found that while it may exercise more muscles, such balls are "just too damn uncomfortable to get any work done." After a while people sitting on them end up slouching, negating any benefits to posture, and the balls may pose a health and safety hazard in the workplace.<ref>[https://coach.nine.com.au/2017/02/07/08/03/why-swapping-your-chair-for-an-exercise-ball-wont-work Thinking of sitting on an exercise ball at work? Here's why you shouldn't], Stuart Marsh, Nine Australia, 2017</ref>

A 2006 study found the effects of sitting in a chair were "increased muscle activation in thoracic erector spinae (''p''=.0352), decreased pelvic tilt (''p''=.0114), and increased perceived discomfort (''p''<.0001)" — lower ''p'' means more certain. It concluded "The small changes in biological responses when sitting on a stability ball as compared with an office chair, combined with the increased reported discomfort while on the ball, suggests its use for prolonged sitting may not be advantageous."<ref>[https://www.ncbi.nlm.nih.gov/pubmed/16696264 Stability ball versus office chair: comparison of muscle activation and lumbar spine posture during prolonged sitting], Human Factors, 2006 Spring;48(1):142-53.</ref> An article in ''Jezebel'' put it more succinctly: "Sitting on an Exercise Ball at Work Yields No Results Other Than Making You Look Like a Total Asshole".<ref>[https://jezebel.com/sitting-on-an-exercise-ball-at-work-yields-no-results-o-472679928 Sitting on an Exercise Ball at Work Yields No Results Other Than Making You Look Like a Total Asshole], ''Jezebel'', 12 April 2013</ref>

==Avoiding sitting==
There are many things sold or promoted as ways to avoid a sedentary lifestyle and work in a more healthy way. However, many of them have downsides, and there are also health risks associated with being on your feet all day.

===Standing desks===
[[File:Donald H. Rumsfeld works at a stand-up desk.jpg|thumb|right|165px|[[Donald Rumsfeld]] worked at a standing desk: it didn't cure him from being an [[asshole]]]]
These are becoming an increasingly mainstream product, typically allowing the user to adjust the height to produce a comfortable working position while standing. They seem to have some problems, with many prone to wobble, and they tend to be expensive (although you will save money by not buying a chair).<ref>[https://thewirecutter.com/reviews/best-standing-desk/ Best Standing Desks], The Wirecutter</ref>

===Treadmill desk===
The treadmill desk combines a desk and a treadmill - it's like a standing desk except you walk. They typically run at a slow speed, with 1-2 mph (a very slow walking pace) common. They have been promoted as something to do for an hour or two, and using one all day can cause repetitive strain injuries, and may exacerbate existing foot and ankle problems.<ref>[http://www.bbc.co.uk/news/magazine-21076461 Treadmill desks: How practical are they?], ''BBC'', 30 Jan 2013</ref> And while some activities like reading may be easy at a walking desk, the ''BBC'''s reporter found writing to be hard, and precision work would be even more difficult.

===Walking meetings===
Public Health England, a government agency, has promoted the benefits of having meetings while walking round.<ref name=guardianwalkingmeetings>[https://www.theguardian.com/lifeandstyle/shortcuts/2017/sep/12/get-out-of-my-office-how-to-switch-to-walking-meetings Get out of my office: how to switch to ‘walking meetings’], ''The Guardian'', 12 Sep 2017</ref>

Walking at a fast pace is generally considered a good form of exercise, with most sources emphasising the benefits of a brisk walk rather than an amble.<ref>[https://www.nhs.uk/Livewell/getting-started-guides/Pages/getting-started-walking.aspx Walking for health], NHS Choices</ref> Despite the depiction of characters striding along corridors while discussing important matters in Aaron Sorkin's work, a walking meeting may not really allow brisk walking, and may require sensible shoes and appropriate clothing.

Standing meetings are also promoted by some organisations, but more to stop people becoming too comfortable so that they shut up and stop whittering on and go out and do something useful, than for health reasons.<ref>{{wpl|Stand-up meeting}}</ref>

==Dangers of standing==
Standing up in itself can cause health problems. Health and safety publication Hazards magazine reported "individuals spending most of the day on their feet every working day are at greater risk of health problems including varicose veins, poor circulation and swelling in the feet and legs, foot problems, joint damage, heart and circulatory problems and pregnancy difficulties."<ref name=hazards>[http://www.hazards.org/standing/index.htm Standing Problem], Hazards, Hazards 91, August 2005</ref> This contradicts the claim that working standing up will reduce the risk of cardiovascular problems.

Standing is particularly problematic in those with unsuitable footwear. There are many ill effects caused by wearing high heels, not just to the feet.<ref>[https://www.webmd.com/women/features/how-high-heels-affect-your-body#1 Here's What Really Happens When You Wear High Heels], Web MD</ref> Workers are often forced to stand not for any requirement of the job but for image, e.g. to avoid looking lazy.<ref name=hazards/>

Standing desks are often bought with "anti-fatigue mats" to avoid foot pain, and a writer for Quartz Media found they also caused unsightly ankle swelling, known as "cankles".<ref>[https://qz.com/272350/theres-a-huge-hidden-downside-to-standing-desks-that-no-one-told-me-about-2/ There’s a huge hidden downside to standing desks that no one told me about], Quartz Media</ref>

Doubtless, as with most things (except [[smoking]] and [[incest]]), moderation is a good idea. Stand up every now and then if you're sitting, sit down if you're tired, and think before you take gym equipment into the workplace.

==References==
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[[Category:Medicine]]

Categories: Medicine