And so could I, but the title isn’t meant to be a reflection on my current state of obesity or yours.
An interesting article appeared in the New York Times online that caught my eye centered on the idea that we gain weight because we sit too much and that we can reverse that to some degree at least if we stand more.
Reading the article brought to mind another piece I had read recently, about how former Defense Secretary Donald Rumsfeld had gotten excoriated in the press for a note he jotted on a GITMO report about the detainees there being asked to stand for up to four hours a day. His hand-written comment in the margin of the report was “Only 4 hours?”
The note was seen by many in the press and elsewhere as proof of his approval of the use of cruel and unusual punishments for GITMO detainees. Whatever Mr. Rumsfeld’s feelings might have been on the subject of treatment of detainees (about which I am making absolutely no value judgement here pro or con) the ‘standing’ comment probably wasn’t proof of callousness or cruelty, because apparently it is Mr. Rumsfeld’s habit to stand all day long as he works. According to the article I read, he long ago had a special standing-height desk fashioned for himself and he works, standing at it, all day long. Thus, for a man who chooses to stand for 8 hours a day, the seemingly heartless ‘Only 4 hours?’ comment maybe wasn’t intended to be. Whatever else one may say about Rummy, for a man who will turn 78 this year, he’s in pretty darned good shape. He stands ramrod straight and is reasonably trim of frame and flat of ab, so maybe there’s something to this standing business.
For quite some time now, this very idea–standing more–has been something that Mike and I have discussed at length in our ongoing search for what changed in our lives (and the lives of our peers) during the quiet slide from 40 to 60. What happened that could account for the difficulty so many of us clearly experience in holding the line against weight gain (let alone losing weight) as we age, even in the face of a eating about the same amount of food and doing about the same amount of exercise as we did in our younger years.
One of the things that has changed, for us at least, is what we do for a living and the lifestyle differences that shift engendered.
Thirty years ago we first went into clinical practice and for the next nearly twenty years after that, our days were spent working 10 to 12 hours a day, 5 to 7 days a week, seeing patients in the clinic. A day in our lives as clinic doctors looked something like this: walk to exam room door, pick up chart, go into exam room, sit on a backless stool for about 5 or 10 minutes coning down on the patient’s chief reason for being there, stand to wash hands and examine the patient, sit again (or often continue to stand) beside the patient to discuss findings and recommend testing to be done, walk out of room, track down nurse to carry out the orders, walk to the x-ray suite to check developed films or to the lab to check results, all done standing, walk to the next exam room, repeat the process 50 or more times a day. We were in and out of rooms, up and down and up and down all day long, with a whole lot of it spent ‘up’ and not much spent sitting. Most of those years, we spent almost zero time ‘working out’ or doing any formal kind of ‘exercise’.
Contrast that with our lives of the last ten or so years, spent mainly as writers and researchers of the medical literature.
When we’re home, in our normal routine, our lives as full-time writers and researchers look something like this: sit down at the computer and work for three or four hours in the morning. Take a break every hour or so to walk to the kitchen to make a cup of coffee, then right back to the computer.
I go to the kitchen about 1 o’clock or so to fix lunch or we might hop in the car to go grab a burger someplace, where we sit to eat it. Mike usually works at the computer until time to eat.
Then it’s back to the computer to sit for two or three more hours, with maybe a break to get another cup of coffee, and right back at it, sitting.
Our level of formal ‘working out’ on average hasn’t really changed much over the years. If anything it’s increased. Some days we’ll do a Slow Burn weight work out, which takes just a few minutes. In summer or when we are in SB, Mike will take a break in the late afternoon to go walk a few holes on the golf course and he plays 18 a couple of times a week. I occasionally will take a walk on the beach or on trails, but not regularly. Sometimes I will do pilates. Or maybe I will just go to the kitchen to fix dinner, which is at least standing.
Most days, we’ll both go back to the computer after dinner to sit, working, for another hour or two. Sometimes we’ll work late into the night, depending on whether there’s a big writing project going or not.
Then we get up the next day and do that again.
While we haven’t really changed the amount of time we spend doing ‘actual exercise’ what’s really changed when you compare the last ten years to the twenty before them is the standing. As a clinical doctor, you do a lot of standing. Or at least we did. And it takes a lot more muscle work to stand than to sit.
If you’ve followed our writing in books and blogs, you’re probably saying, Hey wait a minute! You’ve said many times before that exercise is not a good way to lose weight. And that is absolutely true.
In our most recent book, The 6-Week Cure for the Middle Aged Middle, we wrote an entire chapter debunking the whole idea of ‘eat less and exercise more’ as an effective strategy for weight loss. And we stand behind that chapter.
What we also discuss in The Cure is the difference in EAT (exercise activity thermogenesis) and NEAT (non-exercise activity thermogenesis.) EAT is the energy cost in calories of exercise taken for exercise’s sake–i.e., running, rowing, the hour spent doing aerobics or pilates or yoga. NEAT is the energy spent doing every other sort of activity in the remainder of the 24 hour day–i.e., the fidgeting, wiggling, walking, standing, stooping, and squatting we do in the activities of daily living and the moving we do in our sleep. It’s easy to see that 30 minutes or an hour spent ‘doing exercise’ even if it’s pretty rigorous, is far outweighed by the amount of time in a day we don’t spend doing it. So as far as energy expenditure in the course of a day or a month or a lifetime, NEAT is the main source of guzzling calories, not EAT.
Let me illustrate. The average 150 pound person expends 720 calories in an eight hour day just lying quietly in bed. If sitting at a desk to work, he or she expends 912 or an additional 192 calories during that same 8 hour period. Standing to work, the caloric expenditure rises to 1176 or an additional 264 calories. So all other things being equal (and I realize that’s a pretty big assumption) just spending most of one’s work day standing instead of sitting costs the body an additional 1874 calories per week or the rough equivalent of a one-half pound of potential weight gain a week.
But the body isn’t merely a ‘black box’ into which calories go and out of which calories flow. A change in one area (expenditure) causes changes in other areas (intake) that can easily correct course and keep the body in balance. It’s not just eat more exercise less. Clearly it isn’t that simple, because if it were, taking a brisk 3 mph walk every day (which would burn 300 calories) would offset the difference occasioned by sitting all day to work. But it doesn’t, at least not completely.
As I wrote about in The Cure, when my weight began an inexorable creep upward as I passed 50, in spite of my knowing what to do and for the most part doing it, I undertook a program of daily walking of about 3.5 miles per day, six days a week for a solid 10 months, and didn’t lose a pound or an inch. There’s more than simply calories in and calories out as we normally think of those things in what drives us to store fat. If it were that elementary, we’d all be thin!
The kind of calories coming in matter. Hormonal balance matters. Stress matters. And maybe, just maybe, standing more matters.
At any rate, I intend to do the Rummy and give it a try. I’ll let you know how it works out.
*Rumsfeld photo – Wikipedia