GET UP!

WHY YOUR CHAIR IS KILLING YOU AND WHAT

YOU CAN DO ABOUT IT
JAMES A LEVINE
MAYO CLINIC + ARIZONA STATE UNIVERSITY
HOW CAN SOMETHING
THAT WE DO SO MANY
TIMES EACH DAY HURT
US?
HOW CAN SOMETHING
THAT WE DO SO MANY
TIMES EACH DAY HURT
US?
QUIZ:
1 POINT FOR EACH YES
Do you work seated on a chair?
Have you ever shopped on the Internet?
Do you watch TV sitting for one hour a day or more?
Do you ever eat while watching TV or in the car?
Have you ever Internet dated?
Do you own a recliner?
If you go to a party, do you seek out a chair?
Look at your sofa. Does it have an imprint of your buttocks?
Do you spend more time with friends electronically than in real life?
Have you ever fantasized about or engaged in sexual intercourse
while in a chair?


QUIZ:
1 POINT FOR EACH YES
Do you work seated on a chair?
Have you ever shopped on the Internet?
Do you watch TV sitting for one hour a day or more?
Do you ever eat while watching TV or in the car?
Have you ever Internet dated?
Do you own a recliner?
If you go to a party, do you seek out a chair?
Look at your sofa. Does it have an imprint of your buttocks?
Do you spend more time with friends electronically than in real life?
Have you ever fantasized about or engaged in sexual intercourse
while in a chair?

HOW DID YOU DO?
12: Chair pre-addict
35: Chair addict
68: Chair imprisoned
910: Chairaholic

THE CHAIRMANS RISE TO POWER
200 years
FEED ME: MOVE ME
Lavoisier, Antoine (1743-1794)
NEAT: NON-EXERCISE ACTIVITY
THERMOGENESIS
NEAT: NON-EXERCISE ACTIVITY
THERMOGENESIS
Science 283;212
NEAT: NON-EXERCISE ACTIVITY
THERMOGENESIS
Sit
More:
More
fat
Body
postures
Movements
e.g. walking
300
400
500
600
Lie Sit Stand &
ambulate
T
i
m
e

(
m
i
n
/
d
a
y
)
Lean Obese
**
*
Science 307;584
Sit
More:
More
fat
THE BRAIN
STRAIN
THE BRAIN
STRAIN
Orexin increases
NEAT more in:
lean rats
than obese
Obese
Lean
Orexin A (nmol)
Kiwaki AJ P 2004, Novak AJ P 2006
NEAT
THE BRAIN
STRAIN
AM I AN
INDIVIDUAL?
Transportation
Ecology
Schooling
Economy
Urban environment
W
e
s
t

F
o
r
e
s
t
E
a
s
t

F
o
r
e
s
t
Savana
Gulf of Guinea
150 km
Study regions in Ivory Coast (Cote dIvoire)
3352
women & men
0
100
200
300
400
500
15-19 20-24 25-29 30-39 40-49 50-59 60-69 >70
Age (years)
M
i
n
u
t
e
s

w
o
r
k
/
d
a
y

(
m
i
n
)
Women Men
Forrester et al 2010 Urban Stud
Rural
Urban
Urban
AM I AN
INDIVIDUAL?
United States 3,319 counties
Diabetes
AM I AN INDIVIDUAL?
Frances Mabel Staples
OCTOBER 2013 | VOLUME 15 | NUMBER 10
When were you born?
I was born on June 30, 1928 at a
summer campsite in the woods. I
had two sisters, Elsie and barb

My family did logging there and
picked rutabagas when it was
rutabaga season. They picked those
by the bushel.
What was life like when you were
little?
It was beautiful. We had to work all the
time, help our parents outside in the
heat and sun.

We used to wash socks on one of those
washboards. That was tough duty,
those socks. They sure get dirty.
What foods do you remember?
Same as what we eat now. Oatmeal.
Bacon. Fry bread. Pancakes.

We had a big garden. We used to go
up and take radishes. And wed go out
in the woods. We had deer meat, our
dads hunted and fished. We picked
berries.
TRADITIONAL -400 KCAL/DAY
MODERN
TRADITIONAL -600 KCAL/DAY
MODERN
FEED ME: MOVE ME
Occupation-type NEAT
(kcal/day)
Chair-bound 300
Seated work: no option of moving 700
Seated work: discretion & requirement to move 1000
Standing work; e.g. homemaker, shop assistant 1400
Strenuous work; e.g. agriculture 2300
Black, Eur J Clin Nutr 50:72
Data assuming BMR = 1600 kcal/day
S
i
t
t
i
n
g

S
t
a
n
d
i
n
g

G
u
m

C
h
e
w
i
n
g

S
t
a
i
r

C
l
i
m
b
i
n
g

1 mph 2 mph 3 mph
Walking
200
70
220
150
15
5
20
Kcal/hour
Call me Auntie.
AM I AN
INDIVIDUAL?
Call me Auntie.
AM I AN
INDIVIDUAL?
WHEN I CAN BE
THE CHAIRMANS
CURSE
THE CHAIRMANS
CURSE
Manohar Dia Care 2012;35:2493
THE CHAIRMANS
CURSE
TRADITIONAL
MODERN
? KCAL/DAY
THE
CHAIRMANS
CURSE
CHAIR
CURSED
CAR
CHAIR
CURSED
CAR

San Francisco in 2013, the average persons travel time
by foot was 4 minutes/day.
In a leg-based travel active scenario, average commutes
would increase by 18 minutes.
2,404 avoided premature deaths per year.
healthcare cost savings in San Francisco would
approximate $34 billion/year.
OUST THE
CHAIRMAN
J Phys Act Health. 2009;6:781
N=7,433
Walk n play:
4 months 7,543 users
6 months 28,000 users
The app:



Non-Exercise Activity Thermogenesis
NASA Design of the future 2005
Dress NEAT:



Depression
Stress
management
Mens health
Womens health
Ob, menopause
Diabetes
Cardiovascular
CHF, HTN
Cognitive
decline
Diabetes
Clinical Space
Homeless
children
Poverty clusters
Homeless
children
Traditional Modern
Responsible
2006
ACTIVE CLASSROOM
ACTIVE CLASSROOM
2012
Copeland
Science proceeds from the assumption that misery is
not fated..
Copeland

..that because all events are caused, all
problems can eventually be solved.
Science proceeds from the assumption that misery is
not fated..