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What turns out to impact everyone’s health, but we all do it? Too much sitting. And just what is too much when it comes to something as basic as sitting? Does exercise make up for too much of it? And what new science now connects it to certain chronic health conditions? Finally, what alternative benefit can be found in, of all things, squatting? So let’s try some wintertime reflections on sitting and squatting.

The September 2018 American Journal of Nursing, reports from the Centers for Disease Control and Prevention and online materials in Google Scholar, MEDLINE and PubMed, all describe new research in the “physiology of inactivity.” We learn that “high volume sitting,” or sitting seven or more hours per day, and “prolonged uninterrupted sitting,” such as sitting for 30 minutes or more, may not only negate the benefits of exercise, but also may have detrimental effects — very serious ones at that.

Since the mid-1900s, sports and exercise scientists have linked our lifestyle of sitting at home or at work, before screens or otherwise, to many chronic diseases and premature death. But until very recently, physical activity — moderate to vigorous — was believed to counteract the harm of such inactivity. Sounds logical, but it’s a debunked theory.

Now the American College of Sports Medicine and others report that too much sitting, with its reduced expenditure of energy and absence of whole body movement, jeopardizes health “even in the presence of regular exercise.”

In fact, the overall amount of time sitting and reclining during our waking hours, regardless of whether a person exercises, and regardless of how much exercise, may be linked to several chronic health conditions, including obesity, cardiovascular disease, certain cancers and diabetes — as well as “all cause mortality” in adults.

This research concludes that overall sedentary time, sitting time, TV or screen time, or leisure time spent sitting was “independently associated” with a greater risk of breast, colon, colorectal, endometrial and ovarian cancers as well as cardiovascular disease and type-2 diabetes. And note: while cancer rates in general are dropping, obesity-related cancers are climbing.

With social, technological and cultural advancements since the mid-1900s, sitting time in all developing countries has increased exponentially. It’s widely accepted that most people in the U.S. sit for more than half their waking hours at home, school, work and community settings, even sitting in cars or on trains, commuting to and from their destinations.

And it is among older adolescents, male adults, all adults over the age of 60, and people who are overweight or obese where daily total sitting and prolonged, uninterrupted sitting times are highest. And we are learning that this sedentary behavior affects the health of people of all races, ethnicities and socioeconomic backgrounds.

So if exercise does not compensate for this, what does? The answer from all this new research is becoming clear: interrupt sedentary behavior every 20 to 30 minutes with some physical activity, even simply walking around or stretching. But while this relatively new field of “inactivity physiology” needs more research, these recent findings point the way to some very specific lifestyle changes.

Start with a standing desk. If not available, take frequent standing or walking breaks — say five minutes for every 30 minutes of sitting. What a lifestyle change that will be! Stand when talking on a cell phone. Reduce total, daily sitting time for viewing TV by standing or walking during commercial breaks. Get into some hobbies that involve some physical activity. Use apps on smartphones or try computer software that offer prompts to take brief, physical activity breaks. Even try social networks for self-reporting and supportive feedback. Physical activity monitors will help. We have to adapt to frequent sitting with standing or walking breaks. Motion is magic.

For many years, just to address the weight-gain epidemic, the emphasis has been on diet with moderate physical activity. Yet in both the U.S. and worldwide, there have been no declines in obesity rates. The vital shift is to reduce sedentary habits. And consider this report from the CDC: one-third of American adults (about 84 million people) are obese. Also, diabetes is cited as the leading cause of kidney failure, lower-limb amputations and new adult blindness. And now we can add the growing body of knowledge that sedentary behavior may be a more important indicator of overall health than physical activity.

And while we overindulge in sitting, we have abandoned, to our detriment, the “archetypical position” of squatting. A New Zealand based osteopath, Dr. Phillip Beach, is widely regarded as a pioneer in the health benefits of archetypical postures, chief of which is the simple, basic squat. He finds from his research that the “whole way your physiology is built is around these postures.” He tells us that squatting is not only good for us, but is “deeply embedded in the way our bodies are built,” and that it improves joint health and flexibility. He adds, “Squatting is where humans came from – we should revisit it as often as we can.”

Yet to squat is uncomfortable for populations of the Western world. Observe how children, learning to walk, will squat and get up from a squat with grace and ease. But as adults, we have a cultural aversion to squatting, unless it is in a crossfit or pilates workout, or the weightlifting squat, all repetitive rather than reclining. The only venue for the normal squat that goes back to our ancient ancestors is yoga.

Resting in the West is synonymous with sitting, which as we have seen, we do all too much. We look upon squatting as a habit of peasants in foreign lands. In these foreign places as well, the rich and middle classes, as in the West, no longer squat. But globally and historically, we are well out of the norm.

The largest part of the rest of the world’s population still squats. Most populations do it daily to rest, pray, cook, share a meal, or use the toilet. Interestingly, squat-style toilets are the norm in Asia, and are just as sanitary as ours. In countries with few hospitals, squatting is the position for childbirth.

Coming full circle, the holistic birthing movements here in the U.S. increasingly advocate squatting as the ideal birthing position. The perception that it was primitive is why women went from these active positions to being in the bed, where they are less “embodied” and have “less agency in the birthing process,” according to Dr. Bahram Jam, founder of the Advanced Physical Therepy Educational Institute of Ontario, Canada.

Dr. Jam also explains that squatting, with its ideal movement and compression, enhances the production of synovial fluid, the oil in our body that nourishes cartilage in our joints, saying further, “If a joint doesn’t go through it’s full range, if hips or knees never go past 90 degrees, the body starts to degenerate as it stops the production of synovial fluid.” Such benefits should open our minds about squatting. And Dr. Jam shares a wise insight about us and the disappearance of squatting: “We think we have evolved past that, but really we have devolved away from it.”

So there you have it – dramatically reduce the sitting habit, in which it is in our very nature to overindulge, and start to cultivate the initially uncomfortable but highly beneficial rest position of a squat – two unexpected but effective ways to good health.

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Greg Blass
Greg has spent his life in public service since he enlisted in the U.S. Navy as a teenager. He is a former Suffolk County Family Court judge, six-term Suffolk County legislator and commissioner of Social Services. Now retired, Greg is active in volunteer work and is a board member of several charities. He lives in Jamesport. Email Greg