Thank you! I agree that treadmill desks are a great idea. I don't own one, but I have seen evidence of cardio/metabolic benefits.
I hope my readers take your main point seriously. If I didn't emphasize the dangers of sedentariness strongly enough, it's because in a lot of the studies I've seen, plausible third variables aren't definitively ruled out. Some highly sedentary people have health problems, or substance misuse issues, or something else that contributes to their sedentariness and may also reduce their longevity. As a result, we might question exactly how much mortality risk can be attributed to sedentariness alone.
I'm not disagreeing with your point though. I just want to emphasize that when I write about health, I try to be cautious, and so I look closely at sampling strategies, adjustment for covariates etc. and sometimes view the data pretty conservatively.
First I have to say I love the opening joke. It’s the perfect medical / Dad joke that I enjoy.
Second thank you for the thorough review which I found as a restack. I appreciate the fact that you point out the paper reporting on statistical and clinical significance and I will be reading this paper myself for my take as a physical therapist who works with people who have sedentary lifestyles either by choice or force from pathology. Over the years my personal recommendation for patients is:
-relatively home bound patient: “Every time you get up to go to the bathroom, before you go back to sit down walk to the other end of your house and back 2-3 times then sit down.”
-limited community ambulatory:” if you go shopping get a shopping cart (usually for support) and take a lap around the store then start shopping. “
My opinion is if you get a person to incorporate some walking in to usual tasks they will be more likely to do it. Won’t say I get 100% compliance but like one of the doctors said a little is better than nothing or something like that.
Just an aside I once got a back pain patient mad at me. When asked about his pain, he said “I can’t stand to sit.” So as a joke I said, “Of course you can’t stand to sit, you stand to stand.”
No more joke with that guy for the course of his PT.
Thank you! I have no expertise in PT, but I think you're very wise to recommend incorporating walking into daily tasks, as opposed to just saying: "Go out for a walk every day." Not everyone lives in a walkable neighborhood or enjoys walking. (Apparently not everyone appreciates your sense of humor either. lol)
Great post, but I honestly think you've undersold the dangers of being sedentary and the benefits of exercise here.
Exercising Westerners vs sedentary westerners have up to 4x all cause mortality benefits, and exercise follows a "dose response" model where the more, the better:
Not just that, but exercisers have decades of lower morbidity (and so, decades of higher quality of life) - look at the shaded portion of the graph here. This is Hadza hunter gatherers at the top, and sedentary vs exercising moderns at the bottom - all that dark gray area is morbidity and lower quality of life if you don't exercise:
Also, if I may insert a bit of advocacy - the biggest and most life-changing thing for myself on this front (and a couple of other people I've convinced) would be a treadmill desk for your daily work / internet browsing, and I would actually recommend that over exercising for most people for adherence reasons. Just thought I'd throw that out there.
Thank you! As you note in your post, change doesn't come easily (I'm speaking from personal experience too), but the kinds of recommendations you provide are worthwhile, because they promote healthier aging and a longer life.
Thank you! I agree that treadmill desks are a great idea. I don't own one, but I have seen evidence of cardio/metabolic benefits.
I hope my readers take your main point seriously. If I didn't emphasize the dangers of sedentariness strongly enough, it's because in a lot of the studies I've seen, plausible third variables aren't definitively ruled out. Some highly sedentary people have health problems, or substance misuse issues, or something else that contributes to their sedentariness and may also reduce their longevity. As a result, we might question exactly how much mortality risk can be attributed to sedentariness alone.
I'm not disagreeing with your point though. I just want to emphasize that when I write about health, I try to be cautious, and so I look closely at sampling strategies, adjustment for covariates etc. and sometimes view the data pretty conservatively.
Feel free to post a link to your review!
First I have to say I love the opening joke. It’s the perfect medical / Dad joke that I enjoy.
Second thank you for the thorough review which I found as a restack. I appreciate the fact that you point out the paper reporting on statistical and clinical significance and I will be reading this paper myself for my take as a physical therapist who works with people who have sedentary lifestyles either by choice or force from pathology. Over the years my personal recommendation for patients is:
-relatively home bound patient: “Every time you get up to go to the bathroom, before you go back to sit down walk to the other end of your house and back 2-3 times then sit down.”
-limited community ambulatory:” if you go shopping get a shopping cart (usually for support) and take a lap around the store then start shopping. “
My opinion is if you get a person to incorporate some walking in to usual tasks they will be more likely to do it. Won’t say I get 100% compliance but like one of the doctors said a little is better than nothing or something like that.
Just an aside I once got a back pain patient mad at me. When asked about his pain, he said “I can’t stand to sit.” So as a joke I said, “Of course you can’t stand to sit, you stand to stand.”
No more joke with that guy for the course of his PT.
Thank you! I have no expertise in PT, but I think you're very wise to recommend incorporating walking into daily tasks, as opposed to just saying: "Go out for a walk every day." Not everyone lives in a walkable neighborhood or enjoys walking. (Apparently not everyone appreciates your sense of humor either. lol)
Great post, but I honestly think you've undersold the dangers of being sedentary and the benefits of exercise here.
Exercising Westerners vs sedentary westerners have up to 4x all cause mortality benefits, and exercise follows a "dose response" model where the more, the better:
https://imgur.com/HLiuVJp
Not just that, but exercisers have decades of lower morbidity (and so, decades of higher quality of life) - look at the shaded portion of the graph here. This is Hadza hunter gatherers at the top, and sedentary vs exercising moderns at the bottom - all that dark gray area is morbidity and lower quality of life if you don't exercise:
https://imgur.com/IWp5OT2
These graphs came from Dan Lieberman's book Exercised. I wrote a review at my Substack, but don't want to spam your comment section with links.
EDIT - adding link at Dr. Springer's suggestion: https://performativebafflement.substack.com/p/dan-liebermans-exercised-review?r=17hw9h
Also, if I may insert a bit of advocacy - the biggest and most life-changing thing for myself on this front (and a couple of other people I've convinced) would be a treadmill desk for your daily work / internet browsing, and I would actually recommend that over exercising for most people for adherence reasons. Just thought I'd throw that out there.
Thank you for this in-depth analysis. I've linked to it in my post:
https://drmick.substack.com/p/healthy-aging-and-longevity-621
Thank you! As you note in your post, change doesn't come easily (I'm speaking from personal experience too), but the kinds of recommendations you provide are worthwhile, because they promote healthier aging and a longer life.