Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behavior

  • Marc T. Hamilton
  • Genevieve N. Healy
  • David W. Dunstan
  • Theodore W. Zderic
  • Neville Owen
Article

Abstract

Moderate-to vigorous-intensity physical activity has an established preventive role in cardiovascular disease, type 2 diabetes, obesity, and some cancers. However, recent epidemiologic evidence suggests that sitting time has deleterious cardiovascular and metabolic effects that are independent of whether adults meet physical activity guidelines. Evidence from “inactivity physiology” laboratory studies has identified unique mechanisms that are distinct from the biologic bases of exercising. Opportunities for sedentary behaviors are ubiquitous and are likely to increase with further innovations in technologies. We present a compelling selection of emerging evidence on the deleterious effects of sedentary behavior, as it is underpinned by the unique physiology of inactivity. It is time to consider excessive sitting a serious health hazard, with the potential for ultimately giving consideration to the inclusion of too much sitting (or too few breaks from sitting) in physical activity and health guidelines.

References and Recommended Reading

  1. 1.
    Haskell WL, Lee IM, Pate RR, et al.: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 2007, 116:1081–1093.PubMedCrossRefGoogle Scholar
  2. 2.
    Haskell WL, Lee IM, Pate RR, et al.: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007, 39:1423–1434.PubMedCrossRefGoogle Scholar
  3. 3.
    Pate RR, Pratt M, Blair SN, et al.: Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995, 273:402–407.PubMedCrossRefGoogle Scholar
  4. 4.
    Hamilton MT, Hamilton DG, Zderic TW: The role of low energy expenditure and sitting on obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes 2007, 56:2655–2667.PubMedCrossRefGoogle Scholar
  5. 5.
    Tremblay MS, Esliger DW, Tremblay A, et al.: Incidental movement, lifestyle-embedded activity and sleep: new frontiers in physical activity assessment. Can J Public Health 2007, 98(Suppl 2): S208–S217.PubMedGoogle Scholar
  6. 6.
    Hagstromer M, Oja P, Sjostrom M: Physical activity and inactivity in an adult population assessed by accelerometry. Med Sci Sports Exerc 2007, 39:1502–1508.PubMedCrossRefGoogle Scholar
  7. 7.
    Troiano RP, Berrigan D, Dodd KW, et al.: Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 2008, 40:181–188.PubMedGoogle Scholar
  8. 8.
    Owen N, Leslie E, Salmon J, Fotheringham MJ: Environmental determinants of physical activity and sedentary behavior. Exerc Sport Sci Rev 2000, 28:153–158.PubMedGoogle Scholar
  9. 9.
    Morris JN, Heady JA, Raffle PA, et al.: Coronary heartdisease and physical activity of work. Lancet 1953, 265(6795):1053–1057; contd.PubMedCrossRefGoogle Scholar
  10. 10.
    Morris JN, Heady JA, Raffle PA, et al.: Coronary heartdisease and physical activity of work. Lancet 1953, 265(6796):1111–1120; concl.PubMedCrossRefGoogle Scholar
  11. 11.
    Taylor HL, Klepetar E, Keys A, et al.: Death rates among physically active and sedentary employees of the railroad industry. Am J Public Health Nations Health 1962, 52:1697–1707.PubMedGoogle Scholar
  12. 12.
    Matthews CE, Chen KY, Freedson PS, et al.: Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol 2008, 167:875–881.PubMedCrossRefGoogle Scholar
  13. 13.
    Dunstan DW, Salmon J, Owen N, et al.: Physical activity and television viewing in relation to risk of undiagnosed abnormal glucose metabolism in adults. Diabetes Care 2004, 27:2603–2609.PubMedCrossRefGoogle Scholar
  14. 14.
    Dunstan DW, Salmon J, Owen N, et al.: Associations of TV viewing and physical activity with the metabolic syndrome in Australian adults. Diabetologia 2005, 48:2254–2261.PubMedCrossRefGoogle Scholar
  15. 15.
    Dunstan DW, Salmon J, Healy GN, et al.: Association of television viewing with fasting and 2-h postchallenge plasma glucose levels in adults without diagnosed diabetes. Diabetes Care 2007, 30:516–522.PubMedCrossRefGoogle Scholar
  16. 16.
    Healy GN, Dunstan DW, Salmon J, et al.: Television time and continuous metabolic risk in physically active adults. Med Sci Sports Exerc 2008, 40:639–645.PubMedCrossRefGoogle Scholar
  17. 17.
    Healy GN, Dunstan DW, Salmon J, et al.: Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose. Diabetes Care 2007, 30:1384–1389.PubMedCrossRefGoogle Scholar
  18. 18.
    Healy GN, Wijndaele K, Dunstan DW, et al.: Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care 2008, 31:369–371.PubMedCrossRefGoogle Scholar
  19. 19.
    Healy GN, Dunstan DW, Salmon J, et al.: Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care 2008, 31:661–666.PubMedCrossRefGoogle Scholar
  20. 20.
    Hamilton MT, Hamilton DG, Zderic TW: Exercise physiology versus inactivity physiology: an essential concept for understanding lipoprotein lipase regulation. Exerc Sport Sci Rev 2004, 32:161–166.PubMedCrossRefGoogle Scholar
  21. 21.
    Bloom WL, Eidex MF: Inactivity as a major factor in adult obesity. Metabolism 1967, 16:679–684.CrossRefGoogle Scholar
  22. 22.
    Levine JA, Lanningham-Foster LM, McCrady SK, et al.: Interindividual variation in posture allocation: possible role in human obesity. Science 2005, 307:584–586.PubMedCrossRefGoogle Scholar
  23. 23.
    Raynor DA, Phelan S, Hill JO, Wing RR: Television viewing and long-term weight maintenance: results from the National Weight Control Registry. Obesity (Silver Spring) 2006, 14:1816–1824.CrossRefGoogle Scholar
  24. 24.
    Bergouignan A, Blanc S: The energetics of obesity [in French]. J Soc Biol 2006, 200:29–35.PubMedCrossRefGoogle Scholar
  25. 25.
    Cai G, Cole SA, Butte N, et al.: A quantitative trait locus on chromosome 18q for physical activity and dietary intake in Hispanic children. Obesity (Silver Spring) 2006, 14:1596–1604.CrossRefGoogle Scholar
  26. 26.
    Simonen RL, Rankinen T, Perusse L, et al.: Genome-wide linkage scan for physical activity levels in the Quebec Family study. Med Sci Sports Exerc 2003, 35:1355–1359.PubMedCrossRefGoogle Scholar
  27. 27.
    Dietz WH: The role of lifestyle in health: the epidemiology and consequences of inactivity. Proc Nutr Soc 1996, 55:829–840.PubMedCrossRefGoogle Scholar
  28. 28.
    Bey L, Akunuri N, Zhao P, et al.: Patterns of global gene expression in rat skeletal muscle during unloading and low-intensity ambulatory activity. Physiol Genomics 2003, 13:157–167.PubMedGoogle Scholar
  29. 29.
    Bey L, Hamilton MT: Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity. J Physiol 2003, 551(Pt 2):673–682.PubMedCrossRefGoogle Scholar
  30. 30.
    Zderic TW, Hamilton MT: Physical inactivity amplifies the sensitivity of skeletal muscle to the lipid-induced downregulation of lipoprotein lipase activity. J Appl Physiol 2006, 100:249–257.PubMedCrossRefGoogle Scholar
  31. 31.
    Hamilton MT, Areiqat E, Hamilton DG, et al.: Plasma triglyceride metabolism in humans and rats during aging and physical inactivity. Int J Sport Nutr Exerc Metab 2001, 11(Suppl):S97–S104.PubMedGoogle Scholar
  32. 32.
    Hamilton MT, Etienne J, McClure WC, et al.: Role of local contractile activity and muscle fiber type on LPL regulation during exercise. Am J Physiol 1998, 275(6 Pt 1):E1016–E1022.PubMedGoogle Scholar
  33. 33.
    Hennig R, Lomo T: Firing patterns of motor units in normal rats. Nature 1985, 314:164–166.PubMedCrossRefGoogle Scholar
  34. 34.
    Bauman A, Armstrong T, Davies J, et al.: Trends in physical activity participation and the impact of integrated campaigns among Australian adults, 1997–99. Aust N Z J Public Health 2003, 27:76–79.PubMedCrossRefGoogle Scholar
  35. 35.
    Salmon J, Owen N, Crawford D, et al.: Physical activity and sedentary behavior: a population-based study of barriers, enjoyment, and preference. Health Psychol 2003, 22:178–188.PubMedCrossRefGoogle Scholar
  36. 36.
    Sugiyama T, Salmon J, Dunstan DW, et al.: Neighborhood walkability and TV viewing time among Australian adults. Am J Prev Med 2007, 33:444–449.PubMedCrossRefGoogle Scholar
  37. 37.
    Epstein LH, Roemmich JN: Reduced sedentary behavior: role in modifying physical activity. Exerc Sport Sci Rev 2001, 29:102–108.CrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  • Marc T. Hamilton
    • 1
  • Genevieve N. Healy
  • David W. Dunstan
  • Theodore W. Zderic
  • Neville Owen
  1. 1.Department of Biomedical Sciences and Dalton Cardiovascular Research CenterUniversity of MissouriColumbiaUSA

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