Conversations about sitting: are we and should we be telling patients to sit less?

Eat well. Eat moderately. Exercise regularly. These are messages we hear and repeat as doctors. But how often do we advocate sitting less in our health promotion information and lifestyle advice? Sedentary behaviour is defined as any waking behaviour with low energy expenditure equivalent to ≤1.5 metabolic equivalents (METs).1 Less than 1.5 MET is thought to be the amount of energy we use when resting. Not surprisingly, sitting is the commonest sedentary behaviour. The UK 2011 Start Active, Stay Active document2 advises avoiding lengthy periods of sitting. It should, therefore, perhaps be entering conversations in the consultation room. Yet are we facilitating this and are we equipped to? Do we know the detrimental effects of the inconspicuous pastime of sitting? Even if being sedentary is detrimental, will advice from the primary care team change this behaviour?There has been a dramatic societal change increasing our likelihood of spending time being sedentary. Older adults are thought to be particularly vulnerable to spending prolonged time being sedentary. A meta-analysis of 22 studies utilising objective measures by Harvey et al reported that older adults (aged ≥60 years) spend an average of 9.4 hours daily being sedentary, equating to 65–80% of their waking day.3There is emerging evidence of worse metabolic health outcomes associated with spending prolonged periods being sedentary.4 It has also been suggested that …