Adonis Diaries

Posts Tagged ‘Epidemiology

 

You Might Want to Sit Down for This

Picture1 10It turns out that sitting in a chair, commonly associated with rest, relaxation, recuperation and work, is actually bad for us.

At least, the way we approach sitting is health harmful.

The occasional dalliance with a straight-backed office chair probably isn’t a problem, but when we spend most of our waking life sitting or slumping over in a chair, we invite disaster.

Such sedentarism is a real problem, and a recent one.

Grok certainly wasn’t bound to a desk. He may have had more off time than we do (if modern hunter-gatherers are any indication), but he didn’t spend it subjecting his body to extended bouts of unnatural contortions.

And there’s the other big difference: the way we sit is completely unnatural. Instead of sprawling out, hands behind our heads, legs outstretched, we moderns “relax” in a chair – a piece of furniture with which we have relatively new relations.

From “You Don’t Know Squat” we already know that the modern toilet has only been in widespread use for a couple centuries, and that squatting to eliminate is probably healthier than the sit/strain method, but did you know that chairs with backs enjoy a similar history?

Until the 16th century, chairs were reserved primarily for the gilded classes. Kings, noblemen, and statesmen used them to conduct business and hold court, while your average serf or peon was relegated to sitting on (backless) stools, chests, or even the ground.

Early chairs were ornate, exquisite things made from expensive materials like ivory, ebony, bronze, and acacia wood, and festooned with beautiful carvings and designs; there weren’t any latter-day Ikea-equivalents pumping out mock kings’ thrones made of particle board.

Handcrafted works of art versus utilitarian products mass-produced in China. It almost sounds like chairs are the refined grains of the furniture world.

Or, perhaps more fittingly, chairs are like shoes. They are modern “conveniences” that force our anatomy into unnatural positions while purporting to correct flaws intrinsic to our bodies.

It’s not enough to say that we’re merely imperfect (because we are); we also possess a fatal flaw that only manmade artifice can fix. But what chairs actually do is make sitting in a harmful, slumped-over position for a dangerously long period of time possible.

We bypass our built-in feedback system (you know – pain, fatigue, a sore back) that would usually direct us to correct our posture (or even, maybe, stand up and move around) and we’re able to sit relatively pain-free for hours on end – but the damage is being done.

We’re getting progressively weaker and more reliant on the backing of the chair, and when we’re in a sitting situation without added back support, we can’t handle it.

Instead of sitting erect, shoulders back, back strong and straight, head held high, we just slump over and use the curvature of our spine to support our bodies.

If you don’t believe me, start watching for it. Look around at your colleagues, family, and friends, and see how they sit. Most people slump. Can you imagine the average modern twelve year old, weaned on couches and cheap school seating, slumping over in the saddle as he tries to ride down game on his first hunting trip with the warriors of the tribe? It simply wouldn’t work.

A weak back, one might argue, can be mitigated by proper exercises.

Deadlifts and squats (performed correctly and with great form, of course) will strengthen your “core” and could even make up for all the sitting (personally, I wouldn’t risk it – and it seems kinda counterproductive, like eating a bunch of fish oil just so you can “safely” consume tons of Omega 6s), but are there any other health disadvantages to leading a sedentary, chair-ridden lifestyle? Of course there are.

There’s the obesity that accompanies sloth.

Time spent sitting is invariably time spent not moving. While there is the occasional IT guy who bikes to work, hits the gym on his lunch break, and gets plenty of exercise when he’s not sitting in front of a computer, one Australian study (PDF) concluded that office workers “who spend high amounts of time sitting at work tend to spend high amounts of time sitting on non work days.” 

In other words, it may be that sedentary employees really do take their work home with them. That same study also found that those same workers had a flawed perception of their own activity levels.

The most sedentary ones thought they were getting way more exercise than they actually were. As many of you probably know, a false sense of progress can be highly detrimental to one’s actual progress.

How do you feel about blood clots in your legs?

A New Zealand (they’re really on top of things in that part of the world in matter of ergonomics) study found that workers who spent an inordinate amount of time sitting at their desks were at a higher risk of developing deep vein thombrosis (DVT). Workers who used computers while sitting were at an even high risk.

Metabolic syndrome, our favorite catchall for most of what ails the average insulin-resistant, obese, and near-diabetic, may also be exacerbated by “too little exercise and too much sitting.”

Epidemiological data suggesting that “excessive sitting” is a health hazard prompted researchers to suggest amending current health guidelines, while one scientist even compared the deleterious impact of sitting to smoking regularly.

When doctors compare anything to smoking, you know they mean business (of course, that same doctor’d probably include saturated fat among the condemned, but no one’s perfect).

If all that isn’t enough to convince you, perhaps a healthy dose of all cause mortality will.

The study, conducted by the American College of Sports Medicine, examined whether time spent sitting was an independent indicator of all cause mortality.

The study factored in leisure time, alcohol and tobacco consumption, and even physical activity (the lack thereof which is a common explanation of the poor health ramifications of too much sitting), but sitting time emerged as a factor – “independent of leisure time physical activity.”

Physical activity certainly helps reduce mortality rates, but it might not be enough, and the downsides of sitting can’t completely be explained away by a reduction in exercise.

So, what can we do about it?

In a world of cheap and plentiful chairs, where social protocol and workplace decorum usually demand we plop down for hours at a time, how can the dedicated Primal Blueprinter maintain postural health and strength and avoid the pitfalls of too much sitting?

Ideally, we would avoid sitting for prolonged periods of time – or at all. That’s not very realistic, of course, for obvious reasons. We aren’t all Ernest Hemingway, who famously said, “writing and travel broaden your ass if not your mind and I like to write standing up.

(Hemingway’s method of standing to type is actually really nice if you can manage it; my editor, Aaron, has been doing so the past few weeks after injuring his back, and he may never go back to chairs if he can help it.)

If your boss is the type to let you nap and wear Vibrams to work, you might be able to work the “no-chair” angle, but I wouldn’t count on it.

If standing isn’t an option, trying using a stool to sit.

Humans used stools (also chests, or anything backless) for centuries before chairs became common, so we can definitely manage without the support.

The advantage of the stool is that you aren’t tempted to use the backing; in fact, you’re almost forced to maintain a straight, strong back by virtue of the backing’s absence. Sit up straight and tall.

You’ll probably have to consciously maintain the arch in your back (like you’re deadlifting) at first, but in time your muscles will strengthen and you’ll grow accustomed to the position. Oh, if you don’t mind looking ridiculous, I suppose you could use a big yoga/balance ball as a seat.

Constantly punctuating your day with bouts of activity is a decent way to reduce the damage.

Eight hours of sitting broken up into digestible chunks and interspersed with random walks and stretches every fifteen minutes is always going to be better than eight hours of uninterrupted sitting.

You could take a walk for your lunch break, or even find time to hit the gym. Just get up, get moving, and get your blood flowing, and do it as often as you can (while still getting your work done, of course).

This may belong strictly in the “flights of fancy” category, but treadmill desk would certainly help you avoid sitting. Plus, you could switch it off and simply stand and work if you ever got tired of walking.

If you absolutely can’t leave your chair for the entire day, you’ll need to put more emphasis on getting regular exercise outside of work. Eating Primally should be helping you avoid sugar crashes and carb comas, so mustering enough energy for a session shouldn’t be a problem.

The reason we formally “workout” is because our lives are so structured; Grok didn’t decide to exercise. His life just naturally required it. In a way, both you and Grok need to exercise to survive – only for slightly different reasons.

To sum things up, staying on your feet or lounging instead of sitting in a chair are the most desirable ways to deal with the chair problem. Modern conveniences, though, have basically become modern requirements, and we’re going to have to deal with sitting in chairs from time to time.

When you are forced into sitting, maintain a strong torso. Keep your shoulders back, your chest up, and your lower back tight and slightly arched.

Get up every 15 minutes or so for a brisk walk. Explore alternative seating arrangements, like yoga balls or backless stools that force you to exercise proper postural positioning. Think of the chair as a crutch – use when needed, but don’t rely on it too much or you’ll never be able to graduate.

Above all, don’t get hung up on the fact that you sit in a chair everyday. Don’t let the perfect be the enemy of the good. It’s not going to kill you as long as you take the necessary steps to minimize the negative impact of sitting.

And now for some questions:

How many hours a day do you spend sitting in a chair?

What type of chair do you use?

How would you rate your posture?

Has anyone successfully negotiated a standing working environment at their office job? If so, share your experience.

Let me know your thoughts in the comment board. Thanks, everyone!

Read more: http://www.marksdailyapple.com/sitting-unhealthy/#ixzz36VlklbEp

Chicago: Short history of public health

Part of Commencement Address given by Dr. Bechara Choucair to Feinberg PPH, May 4, 2011

“Today is about you. You decided to invest in your education. You decided to focus on public health. You worked hard. You read many articles.

I am sure you wrote many papers. You participated in many work-groups. You sat for many exams. You gave many presentations. It is all paying off today.

Brief description of the history of public health in Chicago.

The population-based approach of public health has had a tremendous impact on the health of our communities for almost two hundred years.  In Chicago, the formal establishment of public health took place in 1834, when the Board of Health was established to fight the threat of cholera.

During this Early Sanitation era, sanitation and quarantine were our best tools for fighting disease. The first sanitation regulations were passed and required all men over 21 years old to help clean the city’s streets and alleys.

We conducted home visits to persons with infectious diseases and boarded ships in Chicago’s harbor to check on the health of crewmen.   Our deepest public health roots can be traced to disease control.

The earliest public information efforts starting in the 1850’s. 

The efforts in the era of sanitary reform, focused heavily on sewers, water and food and dairy. During this period, the Health Department issued regulations governing the drainage and plumbing of new buildings (1889); we initiated meat inspections at Chicago’s Union Stock Yards (1869), and full milk inspection activities began (1892).

We saw some of our highest death rates during this era due to diphtheria, typhoid and scarlet fevers, measles and whooping cough. Using his regulatory authority, the health commissioner at the time, Dr Oscar Coleman De Wolf, required the reporting of contagious diseases by physicians in 1877.

By 1887, our advancements in medical understanding helped us see that typhoid would continue to kill, unless we stopped the flow of contaminated water into Lake Michigan–the source of the water we drank, the water we cooked with, and the water in which we bathed.  Building the 28-mile Sanitary and Ship Canal, which reversed the flow of the Chicago River by 1900, was a major medical/public health intervention.

With the advent of the Hygiene Movement (1880’s-1950’s), and the continued advances in understanding disease and medical practice, the focus of public health shifted to individual hygiene and medical care, particularly children’s health.

In 1890, a Chicago child had only a 50% chance of reaching 5 years of age. By 1900, the odds of surviving to age 5 had increased to 75%.

In 1899, with the support of 73 physician volunteers, the City initiated its first campaign against infant mortality.

Service delivery focused on the provision of dental services in schools in 1915, public health nurse home visits to infants in 1925 and educational campaigns against venereal disease in 1922.   These remain among our priorities today.

The early public health nurses at work.

The nurses “finders of sick infants” would seek out sick babies and refer them and their mothers to Tent Camps, where they would receive medical treatment and hygiene education.

In 1956,  516 persons were stricken with polio. Public health authorities assigned 90% of the city’s health workers to reach a goal of one million inoculations in 2 weeks. One year later, Chicago had only 28 cases, and in 1959 when the U.S. went through a record- breaking year for polio, Chicago had only one case.

The 1950’s saw the beginning of dramatic growth in medical interventions which prompted the era of health care services. During this time, the delivery of personal health care services, primarily to low-income populations, was becoming the primary public identity of public health in Chicago.

In 1959, the Health Department opened the Mid-South Mental Health Center, the first of what would become a network of community mental health centers by the early 1970’s.

The first half of the 1970’s  saw the development of several Department neighborhood health centers, under the federal Model Cities Program.

The first of our centers, in the Uptown community, was established in 1970. On this slide, you can see our clinics in Lakeview, and the 1987 groundbreaking for the expansion of our West Town clinic.

The 1960’s and 1970’s brought significant changes at the federal level as well. The passage of Medicare and Medicaid in 1965 greatly expanded access to care for some of our most vulnerable populations.

Since that time, CDPH has greatly expanded its capacity in Epidemiology, Policy, Planning, Resource Development, and more recently, Information Technology, while maintaining its efforts in critical public health functions such as disease prevention and control, and in the last decade, emergency preparedness.

Note:  This article is part of the Commencement Address at Feinberg School of Medicine at Northwestern University, delivered by Dr. Bechara Choucair, Commissioner of public health of the city of Chicago.  This speech covered all the grounds and it is impressive.


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