Engineering Physical Activity Into Your Day

Additional Info

• Segment Number: 3
• Audio File: train_your_body/1510tb2c.mp3
• Featured Speaker: Edward M. Phillips, MD
• Organization: ACSM
• Guest Bio: Edward M. Phillips, MD, is Assistant Professor of Physical Medicine and Rehabilitation at Harvard Medical School and is Founder and Director of The Institute of Lifestyle Medicine (ILM) at the Joslin Diabetes Center. In his work at the ILM, he has directed 12 live CME programs starting in India in 2006 and continuing with twice yearly courses sponsored by the Harvard Medical School Department of Continuing Education. He is course director of a suite of seven online CME modules in Lifestyle Medicine completed by over 8,500 clinicians from 115 countries.
  
  Additionally, Phillips is a Fellow of American College of Sports Medicine (FACSM) and serves on the executive council that developed and leads the Exercise is Medicine™ global initiative. He is co-author of ACSM’s Exercise is Medicine™, The Clinician's Guide to the Exercise Prescription (Lippincott, 2009) and is chair of the Exercise is Medicine Education Committee. He serves on the Advisory Board of the American College of Lifestyle Medicine and on the Health Sector of the United States National Physical Activity Plan.
  
  He is Adjunct Scientist at the Jean Mayer United States Department of Agriculture, Human Nutrition Research Center on Aging at Tufts University in the Nutrition, Exercise Physiology and Sarcopenia Laboratory where he works as study physician and investigator on several studies that address the areas of exercise physiology, resistance training in the elderly, body composition, and nutrition. He is site PI for the Health Resource Service Administration Preventive Medicine Training Grant (2010-2013) (2014-2018) educating Yale Preventive Medicine residents in Lifestyle Medicine. Phillips has published over 60 scientific publications.
  
  Phillips is an active clinician and researcher who speaks and consults nationally guiding a broad based effort to reduce lifestyle-related death, disease, and costs through clinician directed interventions with patients. His medical school, SUNY Buffalo School of Medicine and Biomedical Sciences, honored him with its Distinguished Alumni Award for his accomplishments in Lifestyle Medicine. The President’s Council on Fitness, Sports and Nutrition has recognized both Dr. Phillips and the ILM with its Community Leadership Award. He appears on national media including Good Morning America, ESPN radio, Huffington Post, Slate, and in Time Magazine.
  
  
  
• Transcription: RadioMD Presents: Train Your Body | Original Air Date: March 3, 2015
  Host: Melanie Cole, MS
  
  RadioMD. RadioMD.com. Train Your Body. Here's exercise physiologist, Melanie Cole, MS.
  
  MELANIE: Just how much physical activity do you have to incorporate into your day to actually get the benefits that you hear about on this show and so many other media outlets about getting your 150 minutes and walking in between working; getting up from your seat. How much do you really need?
  
  My guest today is Dr. Edward Phillips. He's the Assistant Professor of Physical Medicine and Rehab at Harvard Medical School.
  
  Welcome to the show, Dr. Phillips.
  
  DR. PHILLIPS: Thank you, Melanie.
  
  MELANIE: So, physical activity. What is considered truly a sedentary lifestyle? I think of myself as active and yet I'm stuck in front of the microphone—well, not stuck—but, I'm in front of the microphone for many hours a day and at my desk, but I'm on my treadmill and I'm running around with the kids. What is considered sedentary?
  
  DR. PHILLIPS: So, one great example, which a lot of my patients have is, they say, "I get up in the morning. I brush my teeth. I get into the car. I drive to work. I park as close as I can. I wait for the elevator, go up to my office. I sit and I do—and it doesn't really matter whether they're an accountant; they're running a bank; whatever it is, they sit. They do. They sit. They might have a sitting lunch and they drive home and then they tell me, "I'm a little tired so I turn on the television to check the news and brush my teeth," and we've got a day here with not a lot of activity. That's a sedentary lifestyle and it fits the description of just too many Americans. Actually, too many people world-wide at this point.
  
  MELANIE: Okay. So, the sitting and, you know, I've even heard Dr. Jordon Metzl say, "Sitting is the new smoking," so it's really bad for us. We get that, but how much, then, do you need to change? I mean, obviously, you're going to watch TV or you sit down with your family or, you know, you're sitting at work. So, what do you do to change that? Especially if it's part of your daily routine and you're not just sitting around on the couch watching daily reality TV or something.
  
  DR. PHILLIPS: Sure. So, as you mentioned in the intro, the physical activity guidelines for Americans calls for 150 minutes of moderate intensity activity. That's jargon for "take a brisk walk" where you get to the point where, you know, you can talk but you would have trouble singing. You don't have to be in a sweat. You don't have to change. You've just got to be out there. That's over the course of a week. Just two and a half hours.
  
  That's where the science was in 2008 when the activity guidelines were written. They were revised a couple of years ago and what's coming out in the last year or two is that, in addition to that, we have to break up those long periods of sitting. Some of the studies, like the big one in the American Journal of Epidemiology looked at over 120,000 middle-aged folks and they determined that the ones that sat, which is a risk of dying, was appreciably higher for the ones that sat the most as opposed to the ones that sat the least. It was worse in women and the effect of people that were not getting the 150 minutes per week was even more astounding. So, the women were dying at rates twice as high as those that were getting their 150 minutes even if they had sedentary job. So, there are two parts to this. You want to get your 150 minutes and you want to break up the long periods of sitting.
  
  That seems to be the magic. There's no clear length of time. I tell my patients, every couple of hours, maybe every hour and a half, you should be up on your feet and maybe look at this more, flip it around. As I talk to you on the phone, I'm standing. Why not? My voice probably carries a little better. It's obviously healthier for me. I'm not moving a lot. You can hear me. I'm not panting, but I am standing. So, it's breaking up those long periods for all sorts of health benefits.
  
  MELANIE: Okay, Dr. Phillips, you just got me to do it, too. So, I just stood up.
  
  DR. PHILLIPS: Stand up! Everybody that's listening, stand up!
  
  MELANIE: So, instead of sitting my fat tush down in front of this microphone, I just stood up and now that I'm standing up, my producer's probably going to yell at me afterwards.
  
  DR. PHILLIPS: Okay.
  
  MELANIE: But, you're right. So, I see all of these things. You know, there are all these neat kind of desks that some corporations are taking hold of now that are on angles so you can lean against a wall.
  
  DR. PHILLIPS: Yes.
  
  MELANIE: Or, you know, standing treadmill desks. I'm sorry, I couldn't do what I do in front of a treadmill, but sitting on a ball so that you're moving constantly and you're a little unstable.
  
  DR. PHILLIPS: Sure.
  
  MELANIE: So, what do you think about all these kinds of things that corporations are really looking at to get you to not just sit like that.
  
  DR. PHILLIPS: So, what's interesting when you described the desk, you called it a "neat desk" and I don't think you may have been using kind of neat in the way that kids would say, "Oh, that's really neat." I guess I used to say that when I was a kid, but it was actually a phrase coined by Dr. Jim Levine from Mayo, N-E-A-T, and it describes what we're talking about and it's "Non-Exercise Activity Thermogenesis".
  
  The thermogenesis means that you're creating some sort of heat. It means that you're twitching around a little bit; that you're choosing to stand. You're sitting on a ball, which requires you to keep your balance. It may only account for a few calories an hour, but it adds up and studies that they've done comparing people that were—a non-exercise study. So, they didn't let anyone exercise. Same jobs. They looked at the people to see just how much they kind of twitched or moved around in the course of their day. You know you could describe your friends and family and I can't see you, Melanie, over the phone, but maybe you're one of these people that just keeps on moving like I am. Those people tend to be slimmer, okay? So, that's the neat part of the story here--what works for you.
  
  I've got lots of colleagues, these are physicians, who choose to use a treadmill desk. Not to see a patient, but to do their dictation. To do their typing. You're not sprinting. You're not even walking at a pedestrian pace.
  
  MELANIE: I know. It's like 1 mile an hour. Our Michael Roizen is...
  
  DR. PHILLIPS: You know what? At one mile an hour, in about an hour, you're going to do about 100 calories. Not bad. If you do it for an hour a day, it's 100 calories you hadn't burned up and you're not sitting.
  
  MELANIE: I mean, I guess so and I look at the pictures we've got of our Dr. Roizen and he's got all his papers around him.
  
  DR. PHILLIPS: Yes.
  
  MELANIE: And his computer up there and he's walking on the treadmill, but it just seems to me like I would sound like I'm bouncing or I couldn't type in my computer. You know? Efficiency.
  
  DR. PHILLIPS: But, Melanie, at least we got you standing.
  
  MELANIE: At least you did get me standing, Dr. Phillips. I'm definitely standing now and that's great. So now, give us your best advice for the people listening that do have to sit at the desk, standing up or that their boss is going to give them the hairy eyeball if they get up a lot, how they can get that extra physical activity into their day.
  
  DR. PHILLIPS: So one thing is, we've got the "got to get up out of your chair". If you're on a conference call and you put on a headset and you're standing there, even in a cubicle, the evidence is coming along that he might be giving you the hairy eyeball, he should be doing that to the people that are just sitting there because what was that evidence?
  
  MELANIE: Absolutely.
  
  DR. PHILLIPS: And, given the chance, I would love to go in to talk to the boss, go in to talk to their Human Resources to say, "Your employees that are sitting are not giving you their all because the other folks are perfusing their brains better. They're thinking more clearly. They're moods are better. They're more productive and just encourage them to get out of the chair.
  
  I'll just tell you one brief sidelight. I went to give a talk at a conference center. People heard me speaking one year. By the next year, they had standing desks and I took pictures of them. Then, their employees at another facility, they wanted standing desks and the employer said, "You need a doctors' note." I said, "I'll tell you what. You need a doctor's note if you want to stand?"
  
  MELANIE: That's got to...
  
  DR. PHILLIPS: We need to flip this around. We need to change the culture. The other things that people can do is, if you just say "exercise" and you think about going to the gym, lovely. If you can do it, you want to do it. I do it. Many of my patients do it. But, we just need to engineer some more activity into the day and be really creative.
  
  I'll give you a quick example.
  
  MELANIE: We only have about 30 seconds.
  
  DR. PHILLIPS: Okay. If you come to see me in Boston, do you not park at the local garage for $30 bucks. Park a half a mile away and walk for 10 minutes. Walk back to get back into your car. I challenge anyone who will not take $30 to walk that mile back and forth rather than paying the garage attendant. That's a creative way of just getting a little exercise in. It may be a couple of extra minutes. You've saved some money. You're healthier. You're happier and we can look for examples like that.
  
  MELANIE: And that is great, great advice and in my family, we've got music playing all the time, so my daughter and I, we dance around. We dance around the kitchen--any extra movement that you can get. It may look silly. It may feel a little bit weird, but boy, it sure does work to give you that little extra boost in physical activity.
  
  This is Melanie Cole. You're listening to Train Your Body right here on RadioMD.
  
  Thanks for listening and stay well. I'm standing.
• Length (mins): 10
• Waiver Received: No
• Host: Melanie Cole, MS