How To Control Sleep Interruptions at Any Age

By Dr. Joan Vernikos

March 2014

It is taken for granted that as we get older we will need to get up several times during the night to pee. Yet I do not believe this has anything to do with aging. Rather, it is something we can almost wholly control through a shift in one key lifestyle habit. My own experiences really turned me on to this reality as I myself passed the age 65 mark.

I was approaching retirement from NASA and was looking forward to getting a proper night’s sleep. During the years leading up to retirement I had been waking up at 5am. My routine was to get off to work early to beat the traffic, then exercise and call colleagues in other time zones before launching deeper into my new day. Yet I was anxious about my sleep. Was it a given that as I aged I would  experience nocturnal diuresis – the technical name for having to get up to pee in the night? I hadn’t yet experienced it but decided to take a proactive approach to preventing this reportedly age-related consequence. If you and your sleep are bothered by these frequent episodes, and even if you are currnently not, you may wish to try it out. Imagine how much better you will feel during the day after a night of uninterrupted sleep.

The Causes

There can be many reasons for nocturnal diuresis:

• Various kidney, bladder and cardiovascular disorders, prostate issues, diabetes and medications commonly prescribed for them.
• Diuretics prescribed for high blood pressure and heart conditions, also called ‘water pills’ like Lasix, Bumex, Esidrix or Zaroxolyn.
• Common non-medicinal diuretics like alcohol, coffee, milk, juice, watermelon or too much water
• Jet lag, shift-work or other day/night shift habits when the body’s day and night are confused.
• A sedentary lifestyle.
• When astronaut and cardiologist Drew Gaffney returned from his 9-day Shuttle mission(STS-40) eager for a good night’s sleep in his own bed, he was frustrated by having to get up multiple times. In space the day-night, light dark cycle is every 90 minutes leaving the body clock very confused.

Sedentary Lifestyle or Aging?

When a baby is born, its diaper is wet around the clock. When it stands up and learns to live in gravity, mechanisms develop involving Antidiuretic Hormone (ADH) that regulates the water in its body. For example drinking lots of water at one time inhibits your ADH making you need to empty your bladder.

During the day, when you are meant to move, ADH starts off low but increases as you stand up, move and are active. This is to help you preserve normal blood volume. But if you spend time lying down during the day or sitting for many hours at the office or at home in front of the TV, or go into a swimming pool, all conditions where gravity’s effect is reduced, your ADH is reduced as it is at night; you urinate more and can become dehydrated.

During the night, ADH is higher overall, reducing the urge to urinate and allowing you to sleep.  Yet research has shown that unlike during the day, if you get into a pool at night the kidneys do not respond to the ADH in the same way as during the day, and you do not need to urinate.  This is because a protective mechanism in your kidneys prevents them from responding to ADH at night in the same way as during the day. However, in the microgravity of space, in volunteers lying in bed continuously and in  those who sit much of the day and therefore use gravity less, this kidney shut-off mechanism eventually  becomes less effective. The result is the need to pee whenever you lie down whether it is day or night.

If you are like so many today and spend most of the day sitting, and especially if you sit uninterrupted for long periods, your body cannot tell the difference between day and night. So it responds to lying down at night with the same urge to pee as it does during the day when the body is expecting more frequent posture changes and movement. This has nothing to do directly with old age except that perhaps one may move less with age.  Much of this is up to us.

My Solution for Nocturnal Diuresis – Move!

I adopted the following habits that have served me well for the 15 years since I retired. Some are based on reducing the challenge you provide your system overnight, and the others on tuning your system so that it functions more optimally:

• I eat my last light meal and avoid drinking anything the 3-4 hours before I go to bed.
• I empty my bladder just before I go to bed.
• My meals are low in fluids; I rarely eat soup or juicy fruit especially later in the day.
• I avoid naps, rarely read and never watch TV in the bedroom.
• Most of all I make a point of moving all day, frequently changing posture and never sitting for more than 30 minutes at a time even if I only break it up with 1 minute of standing and easy stretching.
• Find your preferred activities: For more vigorous activity I personally play tennis doubles once or twice a week and practice yoga twice a week. In the summer months I swim regularly.

Simply, to minimize the need to awaken in the night to pee we can re-tune our systems and the regulatory mechanism of ADH with frequent, all-day movement. Participate in some more vigorous exercise activity from time to time as is possible, and you most suredly will see fewer sleep interruptions and more satisfying sleep. 

For more information on healthy aging habits, visit ThirdAge Health

Developing Relaxation Habits

by Dr Joan Vernikos

In recent weeks I have shared information on the importance of quality sleep and its impact on personal well-being. We all know that a good night’s sleep leaves us refreshed and full of energy to tackle the day. What a wonderful feeling that is!

So what about during our waking hours? During these times the analog to getting quality sleep is our ability to relax.

Let’s talk about relaxation

Relaxation is to release tensions – the tension that comes from feeling that things are not quite right (or really not right!). This tension manifests as different emotions but is characterized by a lack of ease. To relax is to let go and settle into what is, to stop being carried away by the things we see, hear, taste and touch (including ourselves), and instead remain open and curious to what is happening. In essence it is a change in how we relate to the vast amounts of information we manage each day.

Relaxing is a way to lessen the negative effects of stress on your mind and body. Practicing relaxation techniques is basically free and will help you cope with daily stress as well as stress related to particularly difficult situations, from illness to job loss to the death of a loved one. When we are more relaxed, it improves how we feel and how we relate to those around us. Like improving your sleep habits developing ways to relax will help you de-stress your life and improve your health (and surprise! experience more restful sleep.)

The first step begins with developing greater awareness of what is happening around you and especially of what you are feeling. It’s important that we learn to notice when we are getting stressed out in a way that is not helpful or necessary. When we can recognize getting uptight we can then apply instant relaxation techniques. Similarly, we can practice techniques that help us be more relaxed on an ongoing basis. 

Remember that relaxation techniques are skills. As with any skill your ability to relax improves with practice. Be patient with yourself — don't let your effort to practice relaxation techniques become yet another stressor. If one relaxation technique doesn't work for you, try another.

But it does take practice.

Relaxation Tips for Today

• Breathe. Take a deep breath into your abdomen, hold it and exhale in a big sigh. Do this 3 or 4 times. Breathing is the easiest way to experience immediate relaxation, and your breath is always available to you.
• Relax your face, jaw and scalp. Allow it to droop - you'll feel better in only a few seconds.
• Pull your shoulders down. Drop your ear to your shoulder and hold for a couple of breaths. Repeat on the other side.
• Practice gratitude. In mornings it is easy to feel a bit anxious. Instead, as you wake up consider the gift of another day and what you want to do with it. During the day take a break to recognize a few good things about your life. The more you look, the more you'll find.
• Participate in your own creative hobbies. Shoot photographs or paint, write or scrapbook, whatever yours may be.
• Spend time with your pet, showing it love and affection.
• Exercise. People who are more active experience a greater level of positivity.
• Unplug. Need any more be said on this?
• Laugh! Watch or listen to funny shows or spend time with people who make you laugh.
• Shift it from You to Them. When around stressed out or unhappy people practice developing compassion for the person, thinking how terrible it is for them to be feeling so poorly. Even if they are being unkind, consider that they are only that way because they are unhappy.
• Go easy on the caffeine.
• Soak. How stressed can you be in a warm bathtub or jacuzzi?
• Get a Massage. But don't marry a massage therapist - you'll never get one!
• Keep a journal. Journaling may be the best way to develop a more accurate view of what is going on in your life, and what you might do differently.

Ongoing Methods for Relaxation 

Practice Meditation, Tai Chi, Yoga or a myriad of other traditionally calming activities. Many have now been scientifically proven to relax you both while you are doing it and well afterwards. Personally, I practice yoga in a class setting once or twice per week and have found it greatly beneficial since I took it up in recent years.

For tips on getting started with a mindfulness meditation practice click here .

A Gravity-based Technique for Deep Relaxation

Here is what I use that might help you too achieve whole body relaxation. 

   

Lie on your back on the floor with eyes shut, palms up. Try and clear your mind of thoughts. Focus on your breath, gently in and out. Think about gravity pulling you down through the floor. Feel the weight of your heels sinking. Holding onto that feeling, slowly move up to your calves, hips, lower back, abdomen, shoulders, arms; let go giving in to gravity pulling you downward. Feel the knots in your shoulders and neck let go and dissolve.  Mentally move up to your head. Let go of all 15 pounds of it sink through the floor. Feel your scalp and your hair slide down away from your face. Let all thoughts on an imaginary screen be erased by gravity. Nothing is more important than this moment. Now you are in total relaxation. Stay there as long as you like. Relish the moment. Nothing else matters. When you open your eyes you shall feel calm and energized.

We live in a world today that sometimes seems to value busyness over calm – a go-go-go lifestyle that often leaves us feeling stressed out. But the good news is that our natural state is relaxed and open – this is why it is possible to become relaxed at any moment, just like that. If we practice habits of relaxation, over time it becomes easier and easier to let go, even when things are quite challenging. Commit to practicing some or all of these relaxation techniques for two months, and I guarantee the changes you experience in your life will not disappoint you. Good Luck!

Sleep Better, Now!

...And Improve Your Health

by Dr. Joan Vernikos

Here are 10 things you can do starting today to improve the quality of your sleep, and your overall health.

I recommend you print these reminders and put them somewhere you can easily refer to them.

Start with perhaps 2 or 3 and commit to doing them for at least 6 weeks – this is how long it takes to engrain a habit for long-term benefit. Great sleep and the benefits it brings are worth it!

1.    Get up and go to bed at set times. 

2.    When tired, don’t sleep in but rather go to bed earlier.

3.    Be active during the day but avoid exercise or excessive activity for two hours before bedtime.

4.    Reduce your exposure to lights 90 minutes before bed. Avoid laptop, tablet, and smart-phone screens and turn off the TV!

5.    Eat sparingly within 3 hours of bedtime.

6.    Stop drinking fluids within two hours of bedtime.

7.    Well before getting in bed, review the day gone by and then calmly mentally prepare for the next day’s commitments.

8.    Sleep in a dark cool room.

9.    Make the bedroom for sleep and amore. Do not have a TV in the bedroom. And do your reading whenever possible sitting upright in a chair, and not in bed.

10. Spend two or three minutes before getting in bed doing calming breathing  exercises or more formal sitting meditation. For tips on meditation for the average person, click here.

Remember, small investments in your sleep will pay back in a myriad of ways.

Yoga Therapy – Fitness in a Healing Context

The Proof of Yoga's Benefits
by Dr. Joan Vernikos

In 2012 most all of us have heard of yoga and some of us know, or are ourselves, regular practitioners and familiar with the well-being it seems to encourage.

In the West, people practice yoga for a myriad of reasons. Personally, I began a relationship with yoga almost 10 years ago, and though I greatly enjoy my twice weekly yoga class and love the way I feel afterwards, my understanding of how it works has been minimal. I felt like most in the medical community, that the claims of yoga’s health benefits were overrated, and lacking the scientific research to provide the evidence and credibility.

So I organized a workshop in  Palo Alto, California on “Space Health, Aging and Yoga Therapy” in order to hear what the experts had to say and become better educated. This workshop was scheduled to precede a large international gathering of Yoga Bharati followers, some 400 yoga practitioners, teachers and members of the local community.  Tracks included Philosophy, Health, and Research, where perhaps predictably I spent most of my time. It did not take long until my skepticism was addressed.

Research evidence of Yoga Therapy
All medical research begins with observation and case studies, before progressing to controlled evidence-based research. Today, such research from top US and global research institutions is providing much needed evidence about the significant benefits of yoga practice that is understandable to mainstream medicine. For example:
•    Dr. Sat Bir Singh Khalsa , Assistant Professor of Medicine at Harvard Medical School focused on the growing body of clinical research showing its efficacy in a wide variety of mental health conditions, particularly in chronic stress, anxiety, insomnia and depression.
•    Dr. Shirley Telles reported on a study in Bangalore, India that after two weeks of daily yoga children were calmer, improved cognitive skills, better focused and memorized verbal and spatial information.
•    Dr. Helen Lavretsky, Professor of Psychiatry at UCLA used PET imaging and changes in cell gene expression to compare listening to music for relaxation to the daily practice of yogic Kirtan Kriya meditation  in stressed family dementia patient caregivers. The daily yogic practice led to reduced stress, better coping and cognitive function as well as a 43% increased telomerase actvivity indicating improvement in the stress-induced biological changes of aging.
•    Several studies reported reduced blood sugar levels in diabetics and improvement in irritable bowel syndrome and multiple sclerosis in other examples of the healing benefits of yoga interventions.

In the West we have come to rely on the wonders of modern medicine to replace our broken parts, taking a pill to cure a discomfort or an illness, relying on expert advice of medical doctors to guide us. Alternately, we sometimes adapt a technique that is popular in the East to a western method intended for a similar purpose. Power Yoga is one such example. We “modify” yoga believing that making a movement faster, stronger, more contorted than the person next to us, will make it more effective on that muscle, bone, balance, circulation or controlling function. Essentially we bolster the egoic when the benefits of a physical yogic activity are rooted in our doing the opposite. The results, in hindsight, are perhaps to be expected.

In essence we have effectively segregated mind and body in the west. We do not fully appreciate it although intellectually we might recognize that separating mind and body will not lead to total healing. I hear stories repeatedly of healing, of the importance of mind, attitude, and faith to healing even in a physically weak body. How else can we explain countless examples of miraculous recoveries in cancer patients, stroke victims and others with incapacitating conditions?

While we are now beginning to successfully demonstrate through evidence-based research how each yogic practice works physically and physiologically, we frequently ignore the context in which it was practiced in the East, the spiritual component of healing and wellness, thus undermining its full benefits.

In the quest for fitness I have learned that Yoga is much more than exercise. This ancient behavioral practice allows for the development of skills of self-regulation of internal physiological states. For this reason its use and promotion for treatment of a range of conditions has increased, including as an adjunct therapy for psychological wellness and psychiatry.

The Search for Healing
A question we must ask ourselves is “What is the healing we are searching for?” And then, “How can we best find it?” In order to answer these two questions we can begin by observing the practices of other cultures, look back into our own, and learn from centuries of observation and successes. Evidence-based research is now clearly showing that greater health and vitality does not come when we separate the body’s needs from those of the mind.

What is highly attractive about yoga is that it works best when it is practiced in this way –  meditative concentration and self-awareness is blended within a comprehensive physical approach. Research is now supporting these long-held beliefs. Yoga stands to be of great benefit to improve health in the west.

Caregiving is Growing - How You Can Be of Greatest Benefit

by Dr. Joan Vernikos
 
Giving care is the most noble form of human compassion. Yet it is necessary for the survival of a society, a  need that makes a society work. It fulfills the emotional requirement of giving and receiving, interdependence, generating or strengthening personal bonds. It taps into the instincts of love and nurturing; brings out the best in being human.

However, maintaining the balance between caring for others and sacrifice is a delicate one. It can quickly turn negative; it may take its toll physically and emotionally on the giver as well as those that surround them.  Excessive, unmanaged stress tips the balance. The key word here is balance. In trying to put together a set of guiding principles for effective and satisfying care-giving what struck me was the enormity of the task because every situation is different. Achieving balance begins with learning, understanding, assessing and being prepared.

As the number of those requiring care increases the social, personal and financial impacts of care giving will need to be better addressed, just as the need for child care became accepted and recognized as a social responsibility when working practices changed as women entered the workplace.

Who is a Caregiver?
Anyone who is concerned or cares for another individual or living thing. It begins with children, brothers, sisters or even pets. It includes parents, a husband, partner or wife, friends and neighbors. Professionals like nurses and doctors may be paid for care-giving. Becoming a doctor has been considered a vocation for centuries whether one is paid or not. Florence Nightingale drew attention to this fact when nursing was recognized as a profession.

Stress and Burnout?
Caring for others involves expending tremendous amounts of time and energy. That energy can be physical, emotional, mental, and spiritual. Usually all of those modalities are involved when you care for others. If you expend more time and energy caring for others, eventually you will find yourself feeling completely overwhelmed. Burnout, the next step, can occur when you give more of yourself than you are taking in, It is more likely to happen when you are pulled in different directions outside your care-giving, criticized or not supported by family and friends.

Guilt: Feeling Selfish
It is common to neglect yourself when caring for others. I like the example of flying on a plane that experiences sudden oxygen loss. The instructions to adults are to place the oxygen mask on your-self FIRST, and then place the mask on the child next to you. The idea is, if you give oxygen to the child first, you will lose consciousness and be of no help to the child. The idea is the same. When you are caring for an individual but neglect yourself, you may reach a point where you are really not able to care effectively for the other person. Though we think of care-giving mostly in the sense of caring for a parent, caring for a disabled child can also be all-consuming. Though professional caregivers, you would think, do not have the added emotional load that caring for a family member does, they frequently have a difficult time dissociating their emotions from their care giving job.

Self-care: Manage your time, Take Time Outs
Taking time for yourself will have great energy rewards. You will feel better. You will be able to give better care to those you are caring for. Regular time-outs can take two forms. The same paid help at regular intervals, as for example every Tuesday and Thursday afternoons, allows you to plan your errands, appointments or some social activity. Agreeing with the care-receiver to go to a facility for two to six weeks to allow you to take a holiday. At other times, take a walk or a bike ride. Get a massage, meditate, learn to breathe to relax. What do you do for yourself? Taking a Health Assessment inventory will allow you to monitor where the energy leaks are. Do not sacrifice your sleep habits, nutrition and movement.

It’s a Team Effort
•    The Care-receiver
Care-giving is limited at best without the cooperation and motivation of the care receiver. Before starting make sure you sit down and have a heart to heart talk alone with your care-receiver. Honestly define your and their expectations. Many seniors used to being in charge and independent feel a loss of dignity when they find themselves on the receiving side.  For others, decisions made for them allows them to complain. Explain the options available to each of you, your and their expectations, and how working together and communicating openly can bring about the best results.
•    Family or Others Responsible for the Care
Whether you are a professional caregiver in an Assisted Living Facility, part of a growing At Home Care team or an ICU nurse, you will experience a similar pattern of physical and emotional responses as the amateur family-member.
•    Public Resources
Know your resources – whether they are free or not, identify what helps others most and when you can get help when you need it. Most work environments have employee assistance programs. Use them. Do your market research, ask others. Almost every family has some case of care-giving and most have had to find out the hard way.

Today people are living longer but are not necessarily healthier. The need for giving care to these older persons will continue to grow. More and more of us will be significantly involved in the giving of care in some manner. When greater attention is paid to the well being of everyone involved, and beneficial resources are more wisely used, the caregiving itself can be a more rewarding experience for all.
   

Your Take-Away Benefits from "Sitting Kills, Moving Heals"

by Joan Vernikos

Since the publication of Sitting Kills, Moving Heals in December 2012, people who have read the book or heard me speak, have been sharing their stories on how they have benefitted. This has been informative and very rewarding, as the reason I wrote Sitting Kills was to offer a different way to approach our lives and our health – one based far more on what is possible without relying so much on things outside ourselves.
Today I’ll share what you have said matters.

1. It raises awareness of how one’s lifestyle directly affects one’s health. And that this is up to each one of us.

“I had not realized that what I do and don’t do all day makes a difference to how I feel.”

When one becomes aware of how profoundly lifestyle habits have become more sedentary in the modern era, then people seem inspired to do something about it.  Today we are sitting uninterrupted at rates never before seen, so often slouched in a comfortable chair or looking at a computer or smartphone screen. Our reliance on pills to solve more minor complaints can be reversed. Even youngsters can benefit from greater awareness about what impacts their health.

No one else can move for you. You are the only one who can become aware of how you feel in order to better manage the conditions in your life and your response to them.

Some things you have said:
“I pay more attention to my eating and sleeping habits now.”
“I think of stretching instead of taking a pill.”
“The Health Assets Questionnaire was a useful start and guide to where I was health-wise.”

2. Increasing movement in small ways yields big results.

“I feel 20 years younger. I have walked every morning but was not aware how much I sat the rest of the day. Now I am doing something all day long and still enjoy my TV.”

The key here is that sitting (and indeed relaxing) is ok as long as it is interrupted often and with gravity-challenging activities, and that exercise alone likely will not do it. It seems that almost weekly there is more research showing how uninterrupted hours of sitting increases the risk of cancer and cardiovascular disease even if you exercise regularly. Between TV and other media we are encouraged to sit many hours but we can reverse the impacts simply by getting moving.

If your mobility is constrained you can experience significant improvements just by briefly standing up every 20 minutes. Even if at first you cannot stand up at first you can regain your mobility in a few months. If you cannot get up at all there are many stretching and strengthening activities you can do. “I find that sitting on a straight-backed chair instead of a comfy chair has improved my posture and strengthens my core muscles.”

Some things you have said:
“Chuck sits in front of a computer screen all day long. He does not care to exercise because he has back pain but once he understood how this works, he can go along with the idea of standing up every so often and stretching.”

3.  Weight Loss

“I lost weight without dieting.”

No, really, and it isn’t complicated. Have you noticed that when you are generally more active that your weight stabilizes or goes down? The non-exercise activities I promote specifically target fat metabolism. Therefore the more one moves all day the more one will use fat stores for the energy needed to function. Couple this with good food choices and adequate sleep and you have a perfect storm for weight management.

4. Feeling More Energetic

 “Moving about with housework, gardening, cooking, all day makes me feel energized throughout the day in a way that exercising once a day did not!”

Maybe there isn’t a more important benefit than this one.

When you exercise once a day, you generate one large spurt of energy. You then cool down because you have over-stimulated your body and then often rest from the fatigue often brought on by this type of activity.  Your hunger may also increase, leading to your eating more. However if you can change your daily habits to include more non-exercise movements you will feel a kind of sustained energy, without some of the highs and lows associated with traditional exercise. By all means exercise, but do so in ways that allow you to  keep moving the rest of the day too.

“I get up at TV commercials and do something around the house.”
“I told my work-mates that I am ignoring internal e-mails. They can come and talk to me instead.”

 A very handy side-benefit here is More Free Time
“It doesn’t take more time or effort to remain active and healthy.”

We may not realize how much time exercising takes up – driving to the gym, prepping and showering after a run, and so on. As one reader has shared, “I realized that I can get the same or better benefit to my health and mobility in less time.”

5. Reduced Health Care Expenses

“I have extra money in my pocket because I feel better, sleep better and don’t think of the doctor first.”

It is likely that if you follow many of the suggestions in Sitting Kills you will experience a greater sense of health overall - benefiting from an improved immune system. As people being to feel better more of the time based on changes to their habits, the old reflex to pop a pill or call the doctor at the first twinge subsides. Who doesn’t want to save money today on health care? But it’s probably up to you as I don’t think we can expect insurers to give us a deal.

As one reader directly shared:
“I spend less money now on my health and drug costs.”

We hear often today that we are living longer than ever, which is true. But the big question is: are we living better? Trending data may paint a bleak picture on this front, but I am not deterred. In fact I am more confident now than ever that we each have a great deal of influence over the quality of our lives, both in the present and for future times. If we choose, each of us can take action to improve our health and overall quality of life. Starting right now.

An Interview on Commuting, Sitting, and Managing the Effects

I was recently interviewed by Meg Boberg of Los Angeles-based Traffic Byte about the challenges of commuter life- the average commute in the US today is now over 46 minutes. The one defining feature of commuting in a car is the inability to stand up, and the increasing amount of time spent sitting is a problem for most of us in this modern age.

So I thought I'd share some of our conversation about how the body deals with this kind of sitting, and what we can do to reverse the effects of too much sitting. 

Meg: How does the body respond when we stand versus when we sit for extended periods of time?
Dr Joan: Think of the body as toys that you need to shake to keep them working. The body needs to move up and down in relation to gravity to keep the blood circulating and tune the machine that pumps the blood around – not unlike a car. Gravity then pulls the blood down to the feet while the heart and arteries pump the blood against gravity up to the head to fuel the brain. Unlike the rest of the body that converts what we eat to glucose, the brain needs the blood to transport the oxygen and nutrients, mainly glucose, to supply it with fuel to function. No fuel, or running on low, compromises how the brain works.
Standing up and sitting down or lying down and standing up again is how we do it. Doing so once a day and expecting it to work all day doesn’t do it.

Every time you stand up the blood is drawn to the feet by gravity – plain hydraulics. The sensors in the neck register reduced volume topside triggering the heart to begin to pump harder.  This increases heart rate and raises blood pressure thereby increasing blood flow to the brain. If you stand up often you will hardly notice anything was happening. If you have not stood up for a while, as with a couple of days in bed with the flu, you may pass out because your pumping system is out of shape. You faint because your brain is not getting the blood supply to carry the oxygen and nutrients it needs to function. Start moving again and you quickly recover.

If you stand up or sit down for too long the blood stagnates in the feet and legs (encouraging swollen feet, blood clots and varicose veins) and even though the heart and pumping system may work well for a while eventually it slows down or quits. So, neither uninterrupted extended sitting nor uninterrupted standing are good for you. Guards at Buckingham Palace learn to squeeze their muscles periodically to pump the blood up. 

Meg:  What are some of your suggestions for office workers, who can’t control the fact that they must commute to work, sit during office hours and may sit even more when they go home?
Dr Joan: Office workers who commute by train or who sit at work or when they get home need to structure their lives to introduce frequent opportunities to stand up often throughout the day until they become habits. They can do this with electronic or web-based reminders, by getting out of their chair to communicate with others – more sociably rewarding – or drink water, or use the restroom, but not all at once, as well as using the stairs instead of lift or escalator. In other words, consciously take every opportunity to incorporate movement of all kinds into the day. They also need to sit up in as upright a chair as possible. Slouching or tucking legs under the chair cuts off the circulation to and from the legs even further. Upright posture with feet flat on the floor encourages unobstructed circulation even when sitting. Working at upright desks and upright desk treadmills are fads that are hard to sustain. A new sliding adjustable desk - the XTensionDesk - looks more promising and can be adjusted to your height and your best work level from sitting to standing – better for your back as well.

Commuter driving is bad for your health not merely because you are sitting. But if you have to, choose your work hours carefully to avoid stress and minimize the drive. Do not have a full breakfast before you start. The combination of stress, sitting and a full stomach that draws blood to your stomach and away from your brain is lethal. Use the slow traffic and traffic lights as an opportunity to practice deep breathing and some isometric leg contractions. Make sure the seat is at optimum level and back position for upright active posture. Introduce using the stairs, taking a walk, using the gym for short periods; shower immediately on arrival at work to provide a time-out between your commute and beginning of the work day.

Meg:What are some of the detrimental effects of prolonged periods of sitting?Dr. Joan: Recent studies have linked increased mortality of hours of uninterrupted sitting per day to breast and colon cancer. Deaths from cardiovascular disease have also been linked to too much sitting even in people who exercised.

Sitting is a leading cause of obesity, Type II diabetes, bone and muscle loss, joint problems, back pain, depression and reduced immune function.