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  • Dr. Allison Andre, DPT

Stop Sitting, Start Moving. Your Health Matters.

In the rapidly evolving world of health and wellness, new insights often dismantle old beliefs and demand our attention. Phrases that seem exaggerated or even shocking can serve as crucial wake-up calls. One such phrase making rounds in the health community and beyond is:

"Sitting is the New Smoking."

This intriguing analogy has sparked curiosity and controversy, but most importantly an evaluation of our sedentary lifestyles.

With our jobs, transportation, and entertainment increasingly centered around sitting, we have become a society at rest. Unfortunately, this rest is far from restful and the harm inflicted by our chairs might be more insidious than we've ever imagined.

But can the harm really equate to that of smoking, a well-known and heavily researched public health hazard?

"Sitting is the most underrated health threat of modern times." - Nilofer Merchant

a brown chair

Table of Contents:


What Does "Sitting is the New Smoking" Mean?

This modern phrase is meant to highlight the serious health risks associated with a sedentary lifestyle. Just as smoking was once considered a harmless, even a fashionable activity, only for us to discover its lethal health impacts. It seeks to shine a light on the severe health consequences from sitting for extended periods of time, a behavior that has become normative in our increasingly sedentary society.

This catchphrase originated from Dr. James Levine, a endocrinologist and researcher at the Mayo Clinic, who's work focuses on modern occupational structures pushing us into an era of sitting. He coined the term in 2014 to shed light on his research into the detrimental health effects of a sedentary lifestyle, putting us at risk of various health issues - akin to the dangers presented by smoking.

Health Risks of Prolonged Sitting

While it's important to clarify that sitting isn't exactly equivalent to lighting up a cigarette, there are parallels to be drawn in terms of potential health risks. As we know, smoking, over time contributes to severe health issues such as lung cancer, heart disease, stroke, and more. Prolonged sitting has also been linked to a range of health concerns like obesity, metabolic syndrome, cardiovascular disease, hypertension, diabetes, increased visceral fat, elevated cholesterol levels, postural impairments, chronic pain, anxiety and depression. Here are a few sobering statistics:

  • The findings of studies indicate that for each two-hour increment in sitting time, the risk of obesity and diabetes increases by 5% and 7%, respectively [1].

  • Prolonged sitting behavior raises the risk of musculoskeletal disorders, especially low back pain [2].

  • Greater overall sitting time is associated with an increased risk of sarcopenia, which climbs by 33% for each one-hour increment of sitting [3] (Sarcopenia = age related loss of muscle mass and strength. This is a normal age related change and sitting will accelerate this process as we age).

  • Sedentary occupations are associated with a higher risk of developing some types of cancers, such as colorectal, ovarian, prostate, and endometrial cancer [4].

  • The World Health Organization (WHO, 2013) estimates that 3.2 million people worldwide die prematurely each year due to a sedentary lifestyle. Studies have shown that people who spend almost all of their working time in a sitting position have a 1.4-times greater chance of premature death after 12 years than their counterparts who sit for less time at work [5].

The dangers of prolonged sitting span across multiple domains of health - physical as well as mental. It's essential to recognize these risks and adjust our lifestyles accordingly, emphasizing more active periods and fewer sedentary ones. The phrase "Sitting is the new smoking" might seem dramatic, but when we consider these health risks, the comparison becomes less hyperbolic and more a call to action.

"Sitting for long periods is not part of our nature. We are designed to move." - Katy Bowman

a woman sitting looking at a computer screen

Understanding NEAT

With the majority of our day often consumed by sitting, it's vital that we understand the significant role that Non-Exercise Activity Thermogenesis, or NEAT, can play in counteracting these negative effects.

You see, even if you are physically active, the ramifications of prolonged sitting are significant. Research has shown that just two hours of sitting can eliminate nearly 8% of the health benefits gained from the equivalent amount of running. This means that if you run for an hour in the morning but sit for 10 hours during the day, you lose roughly 80% of the health benefit from that morning’s run.

This is where it is important to understand NEAT - Non-exercise activity thermogenesis is the energy expenditure of all physical activities other than volitional sporting-like exercise. This could include activities as commonplace as going to work, strumming a guitar, tapping your foot, or even dancing. Unlike planned exercise, NEAT activities contribute to our energy expenditure every day, throughout our work and leisure hours.

The correlation between NEAT and obesity has become a crucial area of study in recent years. Dr. James Levine's research highlighted that lean, sedentary individuals are standing and mobile for approximately 152 minutes longer each day compared to their obese counterparts. This suggests that by adopting a similar posture allocation as lean individuals, obese participants could potentially expend an additional 350 calories per day. This equates to the energy cost of standing or walking, which matches previous findings on the level of exercise needed for obese individuals to attain negative energy balance and lose weight.

The study also observed that NEAT varies by as much as 2000 calories per day between different people.

The modulation of NEAT appears to be essential in weight gain, and interestingly, individuals with obesity tend to show low NEAT. They seem to have an inherent predisposition to be seated for 2.5 hours per day more than their lean counterparts. This suggests that obesity could, in part, represent an enhanced response to environmental cues to remain seated.

Our urbanized and mechanized environments provide overwhelming cues to remain sedentary. The decline in physical activity as societies move from agricultural to urban settings, coupled with the rise in services designed for convenience at the cost of physical movement, like drive-through facilities and automated machinery, have had a dramatic impact on NEAT.

Walking, even at a slow pace of 1 mph, can double an individual's energy expenditure, leading to an additional 100 calories burnt per hour for a 70-kg individual. If someone were to "walk and work" for half of each workday, they could expend an additional 400 calories per day, potentially surpassing the NEAT deficit in obesity and leading to significant weight loss over a year.

The concept of NEAT illustrates how our bodies expend calories through daily activities and emphasizes the differences between individuals, particularly highlighting those who lead predominantly sedentary lifestyles.

a woman working at a standing desk

How Can We Move More During the Day?

While leading an active lifestyle may sound challenging, especially if you have a desk job or a generally sedentary routine, there are many strategies to incorporate more movement into your day:

  1. Use a Standing Desk: Switching to a standing desk can reduce the time you spend sitting. Remember to alternate between sitting and standing to avoid fatigue and maintain comfort.

  2. Take Walking Meetings: Instead of sitting in a conference room, suggest a walking meeting. It's a great way to get your body moving and can even boost creativity. Alternatively, a treadmill desk (or walking pad) is an amazing way to get some extra movement into your day if this option is available to you.

  3. Take Regular Breaks from Sitting: Set a reminder to stand up and move around every 30 minutes to an hour. Even a short stretch or a quick walk around the office can help.

  4. Active Commuting: If possible, walk or cycle to work. If you have to drive or take public transport, park a little further away or get off a stop early to include some walking.

  5. Make the Most of Your Leisure Time: Instead of watching TV or playing video games, engage in more active pastimes. This could include gardening, walking the dog, or playing a sport to increase your NEAT levels.

Embracing an active lifestyle doesn't require drastic changes. Simple, consistent modifications to your daily routine can significantly reduce the health risks associated with prolonged sitting.

Changing our Habits

As human beings, we tend to be creatures of habit, and our behaviors often fall into patterns. This is not necessarily a bad thing, as our brain's tendency to fall into patterns allows us to automate many of our daily activities, freeing up cognitive resources for other tasks. This, however, also means that if we fall into patterns of sedentary behavior, they can be challenging to break.

Our habits are made up of three parts: the cue, the routine, and the reward. The cue is the trigger that initiates the behavior, the routine is the behavior itself, and the reward is the benefit gained from the behavior. By understanding and manipulating these three components, we can create new, healthier habits.

For example, the cue could be the end of a TV episode, the routine could be doing a quick five-minute workout or stretch, and the reward could be a healthier snack or a few minutes of mindfulness.

As with any lifestyle change, it's important to start small and gradually build up. Trying to drastically overhaul your lifestyle in a short period of time is usually unsustainable and often leads to burnout. Instead, focus on making small changes that you can consistently maintain.


While the phrase "Sitting is the New Smoking" may seem extreme, it serves as a valuable reminder of the significant health risks associated with prolonged sedentary behavior. By raising awareness about this often overlooked public health issue, it encourages us to take control of our health and make positive lifestyle changes.

As we move forward, it is important for us to rethink our societal structures and routines that perpetuate sedentary behavior. From our workplace policies to our transportation systems, we need to integrate opportunities for movement and physical activity throughout our day.

Remember, every little bit of movement counts. So get up, get moving, and take steps towards a healthier, more active lifestyle. After all, health is our greatest wealth.

If you enjoyed this post, spread the love and click the share buttons below! Don't forget to subscribe here at Lifelong Adventure to never miss a post! Cheers! Allison



  1. Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA. 2003;289:1785–91. doi: 10.1001/jama.289.14.1785.

  2. Nourbakhsh MR, Moussavi SJ, Salavati M. Effects of lifestyle and work-related physical activity on the degree of lumbar lordosis and chronic low back pain in a Middle East population. J Spinal Disord Tech. 2001;14:283–92. doi: 10.1097/00002517-200108000-00002.

  3. Gianoudis J, Bailey C, Daly R. Associations between sedentary behaviour and body composition, muscle function and sarcopenia in community-dwelling older adults. Osteoporos Int. 2015;26:571–9. doi: 10.1007/s00198-014-2895-y.

  4. Parent MÉ, Rousseau MC, El-Zein M, Latreille B, Désy M, Siemiatycki J. Occupational and recreational physical activity during adult life and the risk of cancer among men. Cancer epidemiology. 2011;35:151–9. doi: 10.1016/j.canep.2010.09.004.

  5. Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc. 2009;41:998–1005. doi: 10.1249/MSS.0b013e3181930355.

  6. Levine, James. "Non-exercise activity thermogenesis (NEAT)." Best Practice & Research Clinical Endocrinology & Metabolism, vol. 16, no. 4, 2002, pp. 679-702.


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