Cover Story

Sitting too much is associated with a host of ills, including cardiovascular disease, Type 2 diabetes and other serious health problems.

Don't take this news sitting down: Your chair is trying to kill you.

A growing body of evidence suggests that sitting too much is associated with a host of ills, including cardiovascular disease, Type 2 diabetes and other serious health problems. What's worse, that's true even if you're in good shape and get the recommended 150 minutes per week of vigorous aerobic exercise.

That's bad news for many graduate students, says psychologist Alan Hedge, PhD, a professor of ergonomics at Cornell University, who adds that students often log more desk time than full-time office workers. Add slouching over laptops and tablets, texting too much and other ergonomic no-nos to long hours in a chair, and you've also got the potential for musculoskeletal problems.

"Grad school is often the first time that students have had to do really intensive computer work," says Hedge. "When it gets close to thesis time, my grad students suddenly come to me saying, 'Ouch!'"

Fortunately, say Hedge and other experts, you can protect your body from both short- and long-term problems through such simple strategies as putting your monitor at eye level, using an activity tracker and setting a timer to remind yourself to get up, stretch and walk around. What's more, they say, you don't need a treadmill desk, rubber balance ball chair or other special equipment to keep you healthy.

Sitting in peril

Various studies now show that the more you sit, the unhealthier — and shorter — your life may be. In a 2012 paper in Diabetologia, for instance, researchers reviewed data from nearly 800,000 people participating in 18 studies. They found that those who sat the most had a 147 percent increase in relative risk of cardiovascular events, 112 percent increase in relative risk of diabetes and a 49 percent greater risk of dying prematurely compared with those who sat the least.

While that study examined sitting both on and off the job, a 2012 study in the British Journal of Sports Medicine zeroed in on the effects of leisure-time sitting — specifically, television watching. After adjusting for diet, exercise habits and other variables, the researchers found that every hour of TV watched by those age 25 and over reduced their life expectancy by almost 22 minutes — double the reduced life expectancy caused by smoking a cigarette.

And it doesn't matter if you exercise a lot when you're not sitting, according to a 2012 article in the Archives of Internal Medicine. Linking prospective questionnaire data from more than 220,000 people age 45 and older to mortality data, the researchers found prolonged sitting to be associated with a higher mortality risk — independent of both physical activity and body mass index.

Protecting your health

Prompted by his conviction that sitting means trouble, Mayo Clinic researcher James A. Levine, MD, PhD — the grandfather of what's called "inactivity studies" — created a prototype treadmill desk and then collaborated with the furniture manufacturer Steelcase to debut the first commercially available product in 2007.

But you don't have to go to such great lengths to protect your health, even as you face a library's worth of books to get through, data to analyze and a dissertation to write. Alan Hedge and other experts suggest these simple tips for overcoming sedentariness and protecting your health for the long haul:

Save your money

As the literature on sitting's danger grows, so do the number of products designed to alleviate the problem. In a small study in Obesity this year, for example, Levine and other researchers found that treadmill desks significantly decreased sedentary time and led to modest weight loss. But while treadmill desks and similar products may be good for upping your activity level, they're not a good idea ergonomically, warns Hedge.

Take the standing desk, for example. Ask any shop clerk, he says, and he or she will tell you that standing is tiring. Sitting uses 20 percent less energy than standing, so you can work longer, says Hedge. "What you find with a standing desk is that pretty quickly, people start to lean because standing is so tiring," he says, adding that that can lead to backaches or arm problems if you're leaning on your arms. The same is true with treadmill desks, which also bring another problem: reduced productivity. "Research shows that typing speed goes down and error rates go up," says Hedge, citing a 2010 study by Levine and other researchers in Human Factors. "If you really want to walk on a treadmill and do computer work, be prepared for your performance to suffer as a consequence."

Faddish seating options, such as balls or forward-leaning chairs, can also cause problems. Ball chairs, for instance, don't provide any support. Plus, sitting on rubber eight hours a day isn't comfortable. "Simple solutions get overlooked because everyone wants to buy the magic bullet," says Hedge. "You really don't need most of the stuff out there: Pay attention to how you should be working, and you're going to be just fine."

Make your work space fit you

You're going to have to sit down and work at some point, so make sure you do it right, says psychologist Ann Marie Hernandez, PhD, an assistant professor of psychiatry at the University of Texas Health Science Center in San Antonio and co-author of a chapter on work-related musculoskeletal disorders in the "Handbook of Occupational Health and Wellness" (2013). Choose a chair that allows your feet to rest flat on the ground, your hands to lie flat and straight and your knees to bend at a right angle; it should also support your back and have armrests wide enough for your arms. "The type of chair is less of an issue; it's how the chair fits you," says Hernandez. Also make sure you adjust your monitor height so it's at eye level. "That's the problem I see most often," says Hernandez. "People don't adjust the screens they're using and just leave them on the default setting."

And don't use your laptop on your lap, Hernandez emphasizes. While a laptop is convenient, it will also make you slouch if you're using it in bed or anywhere else where the screen ends up below eye level. Instead of adjusting your body to a laptop or tablet, she says, put the device on a raised surface so it's at the right height for your eyes and posture.

Take a break

Grad students have a tendency to leave things to the last minute and then have an "18-hour blitz," says Hedge. "That may seem time efficient, but from the standpoint of your body, it's like going from taking a walk every day to running an ultra-marathon without training," he says. Instead of chaining yourself to your desk, intersperse periods of rest and recovery when you're reading or just thinking about things. Or go out and have fun, says Hedge, explaining that high stress levels change your resting muscle tone and increase the likelihood of injuries.

Technology can help, adds Hernandez. She has a smartphone app that sets off an alarm every 20 minutes to remind her to get up, stretch and look out at her view rather than her computer screen — an important way to avoid eye strain as well as musculoskeletal problems.

But it's not just sitting that's a problem, says Hedge. The more you use your body to perform forceful, repetitive actions, he says, the more likely you are to develop an injury. With the growth of texting, for instance, has come the common problem now known as "texter's thumb." This isn't a new injury, just a new cause. "This injury has been known since the very first book on occupational medicine in 1700, when it was called 'baker's thumb' because bakers kneading bread dough developed inflammation to the outside of their thumbs," says Hedge. The injury became washerwoman's thumb by the end of the 1800s, pipetter's thumb in the biotech era of the 1980s and then Nintendo thumb in the 1990s. Explaining that the thumb is designed for stabilization rather than dexterity, Hedge urges hard-core texters to use an external Bluetooth keyboard, try a voice application that converts their speech to text or simply alternate texting with other activities to give their thumbs a rest.

Use an activity tracker

A pedometer can make you realize how much time you spend sitting and up your activity, says Jeanne Johnston, a clinical associate professor of kinesiology at Indiana University–Bloomington School of Public Health. In a small study presented at the American College of Sports Medicine's annual meeting this year, Johnston had participants wear pedometers and receive exercise and nutrition tips by email. When the study ended 12 weeks later, the subjects had reduced their sitting time from four hours a day to 3.3 hours on average while increasing their physical activity and reducing their body mass index. Use a pedometer with Internet capability, and you can track your progress online or compete with online pals.

Focus on fun

In a 2011 study in the International Journal of Behavioral Nutrition and Physical Activity, psychologist Michelle L. Segar, PhD, of the University of Michigan and colleagues found that middle-aged women who focused on the immediate quality-of-life benefits of exercise stuck with it more than those who exercised to lose weight or ensure healthy aging.

Courtney Stevens, a clinical psychology graduate student at the University of Colorado at Boulder, has taken that finding to heart, in both her academic and personal lives. "The American College of Sports Medicine has a campaign called 'Exercise is Medicine,'" says Stevens. "That message needs to be in conjunction with another message: Exercise helps you feel good immediately." In a 2012 article in the American Journal of Health Promotion, Stevens and her mentor, psychology professor Angela Bryan, PhD, proposed creating a smartphone app or some other way to help people monitor their immediate affective response to exercise and make those benefits more salient. But even before that dissertation project gets underway, Stevens is practicing what she preaches by taking gym classes with her classmates every week, having a standing date with a friend to run several times a week and just getting up from her desk whenever she feels herself lagging.

For more tips on setting up an ergonomically sound work station, visit Hedge's ergonomics website.

Rebecca A. Clay is a writer in Washington, D.C.

Digital Extra

Video: Want to make your workspace ergonomically correct? Visit our digital edition for tips from Alan Hedge, PhD.