A couple of weeks ago on a Friday morning, while scrolling through Facebook, a colorful image of empty chairs popped up in my feed along with the headline, “The Futility of the Workout-Sit Cycle.” I hesitated, then fell victim to the click bait and opened the link. Here’s a brief excerpt from the conversation in my head:
Why are you reading this? It’s just going to make you angry. I bet you the author concludes sitting will kill you. What are those of us who can’t help but sit supposed to do? Am I the only one who reads this and thinks ‘I’m screwed?!’
It’s the same conversation I have with myself whenever I read an article about some new study related to physical activity and health. Some group, in this case it’s the American Heart Association, issues a report such as this one with the catchy title of “Sedentary Behavior and Cardiovascular Morbidity and Mortality.” Then someone writes a summary, which appears in a magazine like the article I saw in The Atlantic. I read the article to see if there is any mention, just one tiny mention, of disability. Usually, there is not.
After reading the article in The Atlantic, I shared it on the Disability Visibility Project (DVP) Facebook page (full disclosure – I am a co-moderator of the page). Founded by the amazing Alice Wong, the DVP is an online community dedicated to recording, amplifying and sharing disability stories and culture. The DVP Facebook page is public, and the articles often lead to some interesting discussions about disability culture and identity, ableism, and media representation of disability. When I shared the article, I wrote:
Once again, a major medical organization tells us that sitting can kill you. As someone who has no option to stand, I always wonder if activity and exercise performed while sitting is even considered by these researchers. What are those of us who aren’t able to stand supposed to think when we see these articles? Yes, I know a sedentary life is not healthy. If that is the message, why not just say that and be inclusive of those of us unable to stand?
As the day progressed, and the comments continued, I realized I was not the only one to have these questions. Knowing I might write about this article, I asked if I could share comments. Some of the thoughts and comments are included here. While I have edited them down for brevity, I have kept the original language each person used.
Sparrow: “That’s an excellent point and one I confess I hadn’t considered. No one is researching active sitters and that’s a huge omission….Thank you for helping me re-think the whole “sitting is bad for you” assumption. I’m going to be more careful with my language around that now. I write ad copy part-time and had to write about a standing desk last week and would have written differently if I’d read your comments first.”
Luticha: “I have spoken to researchers about this. and basically it boils down to disabled bodies behaving differently than nondisabled bodies. So while they know that disabled folks have higher rates of obesity and heart issues the issues don’t stem from disability per se but lack of access to recreational sports or accessible gyms. And for those completely immobilized there isn’t much outside of controlling diet.”
Linda: “I dislocate things when I exercise (or even move sometimes), any part of my body… Even walking more than a few feet makes me dizzy and fall. The only way I can lose weight is to starve myself – even back when I could and did exercise for hours each week, it was like this. I ended up with anorexia, twice. Not planning on risking that again. Anything other than life saving surgery is way too risky, so lapband surgery etc is also out. I move my muscles when I can to keep the blood flowing and the nerves fresh, but other than that, what’s a girl with rotten metabolism in the best of circumstances to do? I like that this research is done, but I hate reading it…”
Shayna: “It’s not written well to consider people who use wheelchairs or have disabilities/illnesses/injuries that mean being upright for long, or at all, is not an option. But this part of the article talks about raising your metabolism to 1.5 times being completely still (which they describe as sitting or reclining). And that would mean that seated activity would count. So that’s good, would be nice if they had considered this and stated it explicitly though.”
Heather: “Good points shared and yeah, I usually read this kind of stuff with a grain of salt and long stop taking blanket advice like drinking 8, 8 oz glasses of water a day..way too much for this body, bladder response is like hell naw.”
I decided to search the original report from the American Heart Association and read it instead of just reading the summary article. Sure enough, on the second page there it was:
Therefore, we restrict this advisory to adults without ambulatory limitations.
Again the voice inside my head speaks up: Right – because who cares about the health of adults with ambulatory limitations? ‘They’re disabled and their health must be poor anyway, so why should we focus precious research dollars on them? It’s not like they worry about their health anyway, because they have such poor quality of life.’ That’s what you’re really thinking, right?
The report defines sedentary and gives examples of sedentary behaviors. Basically, anyone who does not get moderate-to-vigorous physical activity (MVPA) is sedentary. What is MVPA? According to the article (and the Sedentary Behavior Research Network), “MVPA is defined as activities that expend at least 3.0 metabolic equivalents.” In case you didn’t know (because I had to look it up too), one metabolic equivalent is the energy expended while a body is sitting at rest.
I may be sitting all day, but I am NOT sedentary! I can get an increase in heart rate simply by trying to reach for my phone when my Personal Assistant (PA) has moved it without thinking. I can break a sweat trying to transfer in and out of the driver’s seat in my van. When I go for walks around the neighborhood, my muscles are actively engaged trying to maintain an upright posture in my wheelchair as it rolls over uneven surfaces. Even sitting and reading can get my blood pumping – especially when I read articles which equate sitting with sedentary! But I was talking about the article…
The focus of the article was to explore the research to identify potential public health messages or guidelines to reduce sedentary behaviors. After describing the clear need for more research (do articles ever NOT say there is a need for more research?!), the authors conclude with this simple advisory, “Sit less, move more.”
Sure. I’ll get right on that. As soon as I figure out how to move more once I’m no longer sitting – given that sitting is my only means of mobility and I cannot independently move if I am not in a seated position.
Yes, I understand that what they really mean is “move more,” be more active, don’t sit and stare at the computer screen for hours on end without moving. Well, if that is what they really meant – why couldn’t they just say that? Why do the recommendations always involve an activity I (and millions like me) cannot do?
In 2015, the United States Surgeon General issued Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities. The report aims to, “get Americans walking and wheelchair rolling for the physical activity needed to help prevent and reduce their risk of chronic diseases and premature death.” To help involve people of all abilities, the National Center on Health, Physical Activity and Disability (NCHPAD) launched the “How I Walk” campaign. The campaign is described on the NCHPAD website as a “movement to rebrand the word walking by challenging individual and societal perspectives.” In doing so, the campaign aims to focus on inclusive physical activity for everyone, recognizing that each individual has their own means of “walking” or moving.
As someone who “walks” differently from most people, I appreciate this effort. Of course I realize the majority of people “walk” on two feet. I even use the term “taking a walk” to describe what I do when I head out to explore the trails and paths around my town. That doesn’t mean I don’t want people to consider how I “walk” when they are planning their public health interventions. When public health professionals consider all adults, and design systems and interventions which meet the needs of people with disabilities, they will meet the needs of EVERYONE. An inclusive public health infrastructure will benefit everyone, including disabled adults who are three times more likely to develop a chronic disease than nondisabled adults.
Now, if you’ll excuse me, I think I’ll go for a walk. I am now living near the Champlain Canal Trail and I feel like exploring before I die from sitting too long.