It’s time for us to rise up and fight slothfulness

This week the British medical journal The Lancet published a new series of studies on the health consequences of physical inactivity. The figures are staggering. They show physical inactivity is responsible for as much as 10 per cent of the “burden of disease” (years of life lost to mortality or disability) from illnesses as diverse as colon cancer, Type 2 diabetes and coronary heart disease.

All told, physical inactivity is now the fourth-leading cause of death around the world. More than 5.3 million people die of it every year, accounting for nearly one death in 10. That’s more than die from smoking. It’s more than die from all injuries combined (traffic accidents claim a mere 1.2 million lives annually). Yet while these have been the focus of massive campaigns aimed at their eradication, inactivity has been largely ignored. Indeed, it is in some ways encouraged.

We should be clear what we are really talking about here. It isn’t some vague condition called inactivity that is killing people. It is the specific activity of sitting, which is how most of us spend most of our days. The usual prescription for inactivity is more exercise, which certainly can’t hurt. But a 15-30 minute daily walk, as the Lancet advises, is of little benefit if you are sitting for six to eight hours a day at work, plus another three to four hours outside it – with a half-hour commute each way in between.

That’s not just my opinion. A growing body of evidence shows the cumulative effects of all that sitting are not easily remediable by exercise. For example, a 2010 study of more than 100,000 adults in the American Journal of Epidemiology found those who sat for more than six hours a day were more likely to die than those who sat for less than three, even if the former exercised regularly and the latter did no exercise at all. An earlier study of 17,000 Canadians (“Sitting time and mortality from all causes, cardiovascular disease, and cancer”) found much the same.

In short, sitting kills. The chair you’re in is a machine for producing human fat. Sitting slows the

Physical inactivity is now the fourth-leading cause of death around

the world.

metabolism, inhibiting the creation of lipoprotein lipase, an enzyme the body uses to break down fats. In the same way, sugars are less easily processed. more over, slower blood flows increase the risks of clots forming, especially in the legs. Like smoking, sitting demonstrably increases your risks, not only of death, but of serious illness, and like smoking, the risks compound over time.

Yet, notwithstanding the known risks – indeed, the predictable, quantifiable annual death toll – whole industries are organized around cooping people up in the human equivalent of fattening pens. We sit in cubicles, for hours at a time. We sit in meetings. We sit at lunch, and then we go back to our cubicles and sit some more. We have taken cigarettes out of the workplace. We haven’t taken the chairs.

We were not meant to work like this. Primitive man was more or less constantly on the move, hunting and foraging. Even as late as the 20th century, most people worked in jobs that required substantial amounts of physical labour. We are properly appalled at the excesses of the Industrial Revolution, when it was common for factory workers to be exposed to toxic fumes or sucked into the machinery. Yet the modern,

Sitting kills. The chair you’re in is a machine for producing

human fat.

upholstered office is orders of magnitude more lethal.

It isn’t only our employers who are killing us, softly. Whole industries are as well devoted to encouraging us to sit in our leisure time, and to stay seated much longer than is good for us. Flop down on the couch, turn on the television, and what do you see but ads for sofas, ottomans and recliners, luring us to a slow, comfortable death. No need to get up to change the channel: the remote control has seen to that. Even the exercise machines sold on late-night infomercials are as often as not designed to be used sitting down.

I guess the question this raises is: are we serious? We claim to be concerned for public health, and yet we do nothing to prevent this silent, fatty carnage. We congratulate ourselves on banning jumbo soft drinks, when our chairs are the deadlier foe by far. We pass laws requiring seatbelt use, when sloth kills four times as many people as traffic. And why? Simple: money talks. Billions of dollars have been invested in the sedentary economy. They are not easily moved – not even at the cost of millions of lives.

If we were serious about public health, what would we do? Exercise, as I say, is scant remedy, and in any case it has proved difficult to get people to work out more. But it is comparatively easy to get people to sit less. I am not saying we should ban the chair, but we could certainly make them less comfortable. Regulatory cures are typically inefficient, but perhaps a seat tax might be in order, varying with the thickness of the cushion. We might also think of suing the chair manufacturers, to recoup some of the costs to the health care system.

Perhaps you will say that’s going too far. Tell it to the 5.3 million dead. Tell it to those suffering from diabetes, heart disease, and other ailments of inertia. When you count all the costs, it is clear that, as a society, we can no longer stand for sitting.