Have you ever considered how much time a day you spend sitting down? And what impact this may be having on your health? Well the average person living in the United Kingdom now spends approximately 8 to 9 hours sitting down every single day. This is quite a staggering statistic and a major health concern, one that carries distinctly separate health risks to those associated with a 'lack of exercise'. But what are the negative impacts that a sedentary lifestyle has on our health? And how is it different from simply not exercising enough?

Our blog this week is provided by Jackie Tarling, a Registered Nutritional Therapist, Level 3 Pilates Instructor and Personal Trainer.  She has been working as a private nutritional practitioner since 2008 working with numerous patients specialising in digestive/gut issues.

Jackie looks at the scientific research behind sedentary behaviour and why it is considered to have such a negative impact on your health. She also looks at the positives and the negatives when it comes to exercise, and why placing too much emphasis on exercise can have a detrimental effect on your health.

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Is sitting really the new smoking? From the driver’s seat to the office or school chair to the couch at home, adults and children in the UK and across the world are spending more time seated than ever. It was reported in 2014 that the average Brit now spends a -staggering 8.9 hours every day sitting down. Since 2008 international research on sedentary behaviour has increased dramatically and there is growing evidence that many serious health risks may be connected to excessive sitting. In 2014 Dr James Levine, co-director of the Mayo Clinic and the Arizona State University Obesity Initiative, and author of the book Get Up! Why Your Chair Is Killing You and What You Can Do About It, summed up his findings after many years of studying the adverse effects of our increasingly sedentary lifestyles. His statement was: “Sitting is more dangerous than smoking”. His investigations show that when you have been sitting for a long period of time and then get up, a number of molecular cascades occur. As a consequence of sitting, your blood sugar levels, blood pressure, cholesterol, and toxic build-up all rise. The solution to these adverse events do not involve a prescription. All you need to do is get up, and avoid sitting down as much as possible. Sedentary behaviour science is still emerging, however the evidence to date is compelling. A variety of studies warn that sedentary lifestyles increase the risk of developing several serious illnesses. The prolonged periods of inactivity increase our risk of obesity, but they also cause a staggering list of other conditions. This includes heart disease, diabetes, colon cancer, muscular and back issues, brittle bones, depression and even dementia.1, 2,3 The World Health Organisation has already identified physical inactivity as the fourth biggest killer on the planet, ahead of obesity. It now costs the UK economy more than £1billion every year in sick days due to back, neck and muscle problems and that figure is constantly rising. Dr John Buckley, an expert in exercise science at Chester University, says: “A person may have got more than 30 minutes’ exercise by cycling to work and home again, but if they have been sitting still all day they will lose some of those benefits. It is like exercising but then eating an unhealthy diet or exercising and being a smoker. Physical inactivity is equally as important as those other well-known issues like diet and smoking.” Benefits of exercise/movement For many people exercise is all about losing weight, but it’s about so much more than that! Below are some of the benefits. Improves Insulin Sensitivity Exercise is one of the most effective ways to normalise your insulin level and lower your risk of insulin resistance. Insulin resistance is commonly the underpinning factor of virtually all chronic disease, as it promotes chronic inflammation and speeds up your body's aging processes. During exercise, your body burns glycogen, a form of glucose that is stored in your muscles. After exercise, your muscles replenish their glycogen stores with glucose from the bloodstream. The more glycogen that is burned during a bout of activity, the longer the body's insulin sensitivity is improved.4 Any type of physical activity has the potential to increase your insulin sensitivity, and combining aerobic activities — such as brisk walking, running, swimming, and cycling — with resistance training (weight training) appears to have the greatest effect.5 Essentially, being of a healthy weight and exercising regularly creates a healthy feedback loop that helps maintain healthy glucose and insulin levels through optimisation of insulin receptor sensitivity. It’s Anti-inflammatory Regular exercise induces anti-inflammatory actions and so offers protection against chronic metabolic and cardiorespiratory diseases, such as atherosclerosis and insulin resistance. It effectively stimulates your muscles to release anti-inflammatory myokines, which increase insulin sensitivity and glucose use inside your muscles. In addition, myokines increase liberation of fat from adipose cells, and the burning of the fat within the skeletal muscle. Acting as chemical messengers, myokines also inhibit the release and the effect of inflammatory cytokines produced by body fat. However, it’s important to note that an unhealthy diet can sabotage these beneficial effects. Reduces Cognitive Decline The mechanism for this is less well understood, but exercise reduces neuro-inflammation, increases blood supply to tissue and aids the release of brain-derived neurotrophic factor (BDNF), which promotes growth and regeneration of new nerve cells. According to the Alzheimer’s Research & Prevention Foundation, regular physical exercise can reduce your risk of developing Alzheimer’s disease by up to 50%. What’s more, exercise can also slow further deterioration in those who have already started to develop cognitive problems.6,7 Relieves Stress, Improves Mental Health and Wellbeing Exercise boosts natural "feel good" hormones and neurotransmitters associated with mood control, including endorphins, serotonin, dopamine, glutamate and GABA which create feelings of happiness and euphoria. Exercise also increases concentrations of noradrenaline, a chemical that can moderate the brain’s response to stress, which may help the brain deal with stress more efficiently. Evidence suggests that physically active people have lower rates of anxiety and depression and negative mood than sedentary people. In addition, exercise also improves self-esteem and cognitive functioning.8

Reduces your Risk of Major Illnesses

The NHS report that exercise is the miracle cure we’ve always had, but for too long we’ve neglected to take our recommended dose.9

They state it's medically proven that people who do regular physical activity have:

• up to a 35% lower risk of coronary heart disease and stroke
• up to a 50% lower risk of type 2 diabetes
• up to a 50% lower risk of colon cancer
• up to a 20% lower risk of breast cancer
• a 30% lower risk of early death
• up to an 83% lower risk of osteoarthritis
• up to a 68% lower risk of hip fracture
• a 30% lower risk of falls (among older adults)
• up to a 30% lower risk of depression
• up to a 30% lower risk of dementia

A great quote given in this article from Dr Nick Cavill, a health promotion consultant is:

“If exercise were a pill, it would be one of the most cost-effective drugs ever invented.”

Negative effects of exercise

It’s clear exercise is important, but how much is too much and what are the consequences of the tremendous amount of stress that excessive amounts of exercise may place upon our health and bodies?

Exercise can be inflammatory

Emerging data suggests that chronic training for and competing in long distance endurance events such as marathons, ultramarathons, ironman distance triathlons, and very long distance bicycle can do more harm than good—particularly to your heart.

Recent studies are giving us a much better understanding of exercise physiology, and many of our previous ideas have been quashed. It has been found that long-distance running leads to high levels of oxidative stress, inflammation, and damage to your heart tissues, producing acute physiological responses that can trigger a cardiac event. Research by Dr. Arthur Siegel, director of Internal Medicine at Harvard's McLean Hospital found that long-distance running leads to high levels of inflammation that may trigger cardiac events.10

Exercise can be Addictive

Consistent exercise causes the body to produce endorphins, which are hormones that block pain, decrease anxiety and create feelings of euphoric happiness. But endorphins are chemically similar to the drug morphine, and so for many people, compulsive exercise can be psychologically addictive. For regular exercisers, missing one single workout can result in depression, stress and anxiety. This desire to exercise can result in overtraining because of an intense “need” to exercise, and a worry that fitness will be lost or weight will gain with a day of missed exercise.

Excessive exercise may also result in a body that is prone to injuries leading to strained ligaments and tendons.

Excessive Exercise is stressful

The adrenal glands produce hormones such as adrenaline, cortisol and DHEA, which allow your body to respond and make adjustments to physical or emotional stress. If the intensity and frequency of the stress becomes too great, the adrenal glands can begin to become exhausted, and the hormones that they produce can become depleted, resulting in serious imbalances. The consequences are a fatigued individual with a potentially weakened immune system more prone to colds and viruses. In addition, chronic stress can cause issues such as oestrogen dominance in women or testosterone deficiencies in men as well as thyroid issues.

Excessive Exercise and Body Dysmorphic Disorder

The NHS describe body dysmorphic disorder as an anxiety disorder that causes a person to have a distorted view of how they look and to spend a lot of time worrying about their appearance. They may exercise excessively targeting the area they are concerned about.

Typically, this type of activity can begin in adolescence or early adulthood, when people are generally most sensitive about their appearance.

Body dysmorphic disorder may also cause other problems such as eating disorders.

If the person is unable to exercise and address what they perceive to be a significant body issue, this can result in depression, social anxiety, and even social phobia.

Conclusion

The idea that exercise is good for us is a message that is constantly being engrained by the medical community, health coaches and the mass media. And while certain types of exercise can certainly be beneficial in context, placing too much emphasis on formal exercise may be highlighting the wrong area and contributing to long term health problems. It is movement rather than exercise that has the most dramatic impact on our health. An activity tracker that you wear on your wrist is a really great way to keep track of your movement. I’ve owned one since March this year and have stepped 979 miles in 6 months!

Research shows that our cells age more slowly when we are active and that even those who are very frail can gain strength from moving and our health will definitely thank us for it.

A statement written by Hippocrates 2,500 years ago sums this topic up quite nicely:

"The right amount of nourishment and exercise, not too little, not too much, is the safest way to health."

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Jackie Tarling Jackie Tarling is qualified Registered Nutritional Therapist, Level 3 Pilates Instructor and Personal Trainer.  She has been working as a private nutritional practitioner since 2008 working with numerous patients specialising in digestive/gut issues. During the last few years Jackie has also returned to the fitness arena and now holds weekly small group pilates classes focussing on improving core stability, posture, flexibility and strength.  She has developed a great interest in posture, lifestyle and movement and regularly supplements her knowledge through workshops, podcasts and webinars. She is also a regular contributor to local publications on health, movement and nutrition matters. jackie@nutrihealthpilates.co.uk

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With many thanks to Jackie for this article. If you have any questions regarding the topics that have been raised, or any other health matters please do contact me (Amanda) by phone or email at any time. amanda@cytoplan.co.uk, 01684 310099 Amanda Williams and the Cytoplan Editorial Team: Clare Daley, Helen Drake, Joseph Forsyth and Jo Doverman Related Cytoplan blogs Reversing insulin resistance - The role of physical activity Yoga - a remedy for back pain? Can yoga ease stress? Insulin and insulin resistance

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References

1. Owen N et al., 2010. Sedentary Behavior: Emerging Evidence for a New Health Risk. Mayo Clinic Proc, 85(12) pp.1138–1141

2. Henson J et al., 2013. Associations of objectively measured sedentary behaviour and physical activity with markers of cardiometabolic health. Diabetologia, 56(5) pp.1012-20.

3. Hamer M et al. 2014. Associations between objectively assessed and self-reported sedentary time with mental health in adults: an analysis of data from the Health Survey for England. BMJ open, 4(3) pp.e004580.

4. King DS et al. 1988. Effects of exercise and lack of exercise on insulin sensitivity and responsiveness. Journal of Applied Physiology, 64(5) pp.1942-1946

5. Diabetes Self Management, 2008. Increasing Insulin Sensitivity [Online] Available at: http://www.diabetesselfmanagement.com/managing-diabetes/treatment-approaches/increasing-insulin-sensitivity/[Accessed 14 September 2016]

6. Liu-Ambrose T et al., 2010. Promotion of the mind through exercise (PROMoTE): a proof-of-concept randomized controlled trial of aerobic exercise training in older adults with vascular cognitive impairment. BMC Neurol, 10:14. doi: 10.1186/1471-2377-10-14.

7. Brown BM et al., 2013. Multiple effects of physical activity on molecular and cognitive signs of brain aging: can exercise slow neurodegeneration and delay Alzheimer's disease? Mol Psychiatry,  18(8) pp. 864-74.

8. Callaghan P., 2004. Exercise: A neglected intervention in Mental Health care?. Journal of Psychiatric and Mental Health Nursing, 11(4), pp.476–483.

9. NHS Choices. 2015, Benefits of Exercise [Online] Available at:http://www.nhs.uk/Livewell/fitness/Pages/Whybeactive.aspx [Accessed on 14 September 2016]
10. Siegel AJ et al., 2001. Effect of marathon running on inflammatory and hemostatic markers. Am J Cardiol, 88(8), pp.918-20