Sitting is the new smoking…

Maybe you’ve heard this phrase before but it really highlights the need for all of us to optimize our behaviours to become less sedentary. I thought I’d blog about this issue as it relates to diabetes but the issue of physical activity transcends diabetes and is something we all should prioritize.

According to Statistics Canada, less than 15% of Canadian adults meet the physical activity requirements outlined in Canadian guidelines updated in 2011 (

Over the years health professionals have stressed again and again, the need to be physically active. The evidence supporting the benefits for physical activity is abundant. Studies show the health benefits of exercise can include:

  • Improved blood sugar control in patients with diabetes
  • Lower rates of obesity
  • Lower risk of heart disease, stroke and hypertension
  • Lower risk if developing type 2 diabetes
  • Lower risk of osteoporosis
  • Lower risk of premature death
  • Improved mental health
  • As we age – improved independence and mobility

It’s not news to anyone that exercise improves health outcomes but how do we get motivated to be more active? How do we change our behaviours to encourage physical activity? There are numerous barriers to being more active in our society. Cities are often designed with the automobile in mind so something simple like walking to pick up our groceries is often not an option. So many of our jobs, including mine, are spent sitting at a desk. Canadians spend a great deal of time watching TV or working at a screen of some sort. We need to do better as a society. As we often say to patients in the office, it’s not the gap between what we know and what we don’t know, it’s the gap between what we know and what we do that’s the problem. How do we start to change our behaviour?

There is a growing body of literature that is looking at the effects of being sedentary, and in particular sitting, on health outcomes. We’ve been stressing exercise for years to our patients but in addition to that we really have to combat our sedentary behaviour that is so ingrained in our modern culture. So how do we get moving? Here are just a few suggestions:

  • Walk/cycle to the store or the coffee shop instead of jumping in the car.
  • When you move, think about whether your new home location will encourage you to walk vs drive.
  • At work – think about walking meetings. Stand up to take a phone call instead of sitting. Walk at lunch. Start a walking club.
  • Park the car a good distance from your destination and walk the rest of the way.
  • Get off the subway or bus a stop ahead and walk that extra block.

There are a multitude of little things we can do in our everyday lives to be even a little more active. These are just a few suggestions.

Coming back to the idea of motivation – how do we motivate ourselves to get moving, to get off our behinds and do what we already know what’s good for us? There is a lot written recently about “nudge theory”. This theory talks about tiny little things we can do that “nudge” us to make even a small change in our behaviour to achieve a more active life. We know that behaviour change is always challenging especially if it is a big change. The idea with nudge theory is that it if we can make a really small change in our behaviour then we can start to make more small changes and eventually manifest enough change to result in a better health outcome. One of the things that have nudged me to be more active this year is getting a pedometer.

Pedometers have been around for a long time but the newer high tech fitness trackers that are now available bring the concept of tracking activity to a whole new level. If you’re a bit of a gadget lover this may be for you. I actually got this idea from a patient of mine who was trying to keep herself and her diabetic husband more active. It was really working for them and I was inspired. There are a number of activity trackers on the market at the moment. Some of the brands are Fitbit, Nike Fuelband, Jawbone and Garmin Vivofit just to name a few. The new, soon to be available, Apple watch will have a tracking function as well. Most of them clip to your belt/pocket/clothing or you can wear it as a wristband. If cost is an issue you can stick with an inexpensive low-tech pedometer which will track your steps accurately.

Personally I love my device. It tells me how many steps I’ve done each day. I set a personal goal as to how many steps I want to get. It links to my phone and nudges me along to keep active throughout the day. It’s a constant reminder all day that I need to be vigilant against inactivity. It doesn’t let me forget that I need to stay active and keep my health at the forefront of my priorities. These trackers often have a cool feature where you can compare (in real time) your activity with friends and family who also have a similar device. This allows you to tap in to your natural competitiveness and allows your friends to nudge you (or taunt you!) to keep moving. It’s a fascinating phenomenon that starts to happen when you wear these trackers and stay connected with friends and family who are also trying to stay active. It becomes a bit of a high tech support group over time.

I hope this post reminds you to not just stay active (ie exercise) but to combat our sedentary lifestyles every day.

So how do you stay motivated to keep active? What’s your secret? Please share in our comments section so we can learn from one another. We need all the tips and tricks that we can get to stay healthy.

Dr. Bill

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