Reducing risks in small steps

Taking the stairs rather than the lift is a simple strategy for increasing health and fitness, but it’s easy to undo the good work once you get there.

If you spend the next few hours sitting in front of a computer or the TV, you could increase your risk of anything from cardiovascular problems to type 2 diabetes, obesity or cancer.

Current research suggests that long periods of sedentary behaviour is a risk factor for a number of diseases, even if you are getting your recommended 60 minutes of moderate to vigorous exercise a day.

Sedentary activities are those that elicit low rates of energy expenditure and are characterised by posture (primarily sitting). Both the total sedentary time and the pattern in which it is accumulated are important.

“Historically sedentary behaviour was seen as merely the obverse of moderate to vigorous physical activity, but we now know that its impact is quite independent,” said physiotherapist and Postdoctoral Research Fellow Dr Lucy Lewis.

With colleagues from the Sansom Institute, the University of Queensland and the University of Bath, Dr Lewis is running a pilot study for an intervention designed to encourage and assist older adults to monitor and reduce their sitting time.

The Small Steps program is innovative in two regards. It is one of the first to focus on non-working adults in the home rather than people at work, and the participants (30 of them in this pilot project, all aged 60 or over) are encouraged to set their own goals.

They select six goals to decrease their sitting time from a list combining pre-specified behavioural items with suggestions of their own arising from an interview.

One new goal is integrated each week for six weeks. Each is designed to be easily achievable and to reduce sitting time by approximately 15 minutes a day, leading to a cumulative reduction of 90 minutes over the intervention.

Goals can be as simple as deciding to stand and walk on the spot during each ad break on the TV.

“We’ve had some interesting options,” Dr Lewis said. “One lady decided to get up after finishing the across clues in her crosswords, while a keen reader put a sticky-note reminder to stand up after each chapter in her book.”

Weekly phone calls are used to provide support and remind participants to build on their previous week’s goals.

“The outcomes of interest are adherence to the intervention and feasibility measures such as recruitment, retention, satisfaction, participant burden and the logistics of measurement,” Dr Lewis said.

The project should be completed by the end of the year. It complements work Dr Lewis is leading at the Royal Adelaide Hospital, which is looking specifically at the value of such interventions in people undergoing cardiac rehabilitation.

Areas of study and research

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