Showing posts with label perils. Show all posts
Showing posts with label perils. Show all posts
Get Up and Move The Perils of Sitting
Tuesday, April 29, 2014
When I first heard that sitting too much was associated with chronic disease, I was extremely skeptical. Of course it is, I thought... people who sit more exercise less, they lose cardiovascular fitness, and they burn fewer calories throughout the day, setting themselves up to gain weight. Its not that sitting too much directly promotes disease, I thought; it must be all that goes along with it. Its the lack of exercise and the weight gain thats the real problem.
Welp, I was wrong (1). Turns out, we now know of specific molecular processes that take place when we sit, and theyre distinct from intentional exercise. In fact, even if you get the "recommended" amount exercise, 30 minutes a day, you can completely undo those metabolic benefits by spending the rest of your day sedentary in a chair. Sitting continuously sets off a series of unwanted cellular mechanisms that immediately reduce your HDL and increase your triglycerides, two common risk factors for cardiovascular disease. Over the long term, we put ourselves at high risk for chronic disease, and that includes heart disease, high blood pressure, diabetes, and obesity.
The experimental studies have all been done on rats at this point, but the results are pretty startling. In one study in which rats were restricted access to running wheels or treadmills, physical inactivity rapidly produced a 22% reduction in HDL (thats a bad thing). This was seen on the very first day of inactivity and persisted as long as the inactivity continued.
In another experiment, radioactive triglyceride (fat) tracers were used to track their movement about the rats body. When seated, important postural muscles cease to take up triglycerides from the bloodstream by 75%, increasing our blood level (again... bad). There was a silver lining though: when the rats were periodically allowed to walk on a treadmill, this unwanted process was mitigated. It was the long-term, persistent sitting that caused the problem.
The solution is simple on paper but not so simple in practice: move more. Most of us probably don’t realize how much we sit… every time we’re at the computer, when we’re in the car, when we’re on the subway, when we’re at the movies, when we’re watching TV, when we’re reading a book, when we’re eating… it’s a part of everyone’s life. There’s nothing wrong with relaxing and spending time in a seated position; just don’t overdo it. Of course there will be situations when we’ll be forced to sit all day. Luckily for us, simply getting up periodically to stretch and walk around can mitigate the nasty side effects we get from staying seated.
What’s the take home message in all of this? Just because you’re going to the gym a few times a week doesnt necessarily mean you’re doing your body good. Youve still got 15 or so other waking hours left in your day that can’t be ignored. Be conscious of how much you sit, and do what you can to stay on your feet. Staying active throughout the day is just as important for your long-term health as intentional exercise at the gym!
The Perils of Government Involvement in Health Care
Sunday, February 23, 2014
Which the DMCB appreciates. That doesnt mean there isnt a downside to the meddling of Republicans as well as Democrats. Take health care for example.
Turbocharged by decades of direct government funding and favorable tax policies, insatiable healthcare consumer demand has created a medical-industrial bubble that is eating close to 20% of the U.S. economy. Since Washington DCs direct costs are outstripping tax receipts, the same political process that got us into trouble is now supposed to get us out. While the Presidents proposed 2013 budget has some painful cuts, thats nothing compared to the looming havoc being threatened by the coming fiscal cliff. This is government accountability?
For a smaller example of the dysfunction created by government meddling, consider the electronic health record (EHR) mess. Despite warnings from the DMCB that EHRs documentation capabilities enable increased billings for the same care, both Presidents Bush and Obama promoted the EHR as an informatics cost-reducing panacea.
It turns out the DMCB was right. This OIG report raised the possibility that EHRs are behind a recent coding uptick, which was further examined in this telling New York Times article by Reed Abelson et al.
Government response? This threatening warning to stop using a product as designed that our political class had promoted all along.
(Latest update: Reversing course on years of being conspicuously silent in the face of the Adminstrations health orm bullying, the hospitals are pushing back. Nothing like the threat of budget cuts to clarify just who your allies are - and arent. The cliff promises to be an interesting ride.)
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