|Ask the Expert |
Brian Harrison, MD
Affinity Occupational Health
"The Sitting Disease"
Q: My job requires me to sit a lot. How is this affecting the health of my heart, and what can I do about it?A: London, England 1953
- Dr. Jeremy Morris reported that London's double-decker bus conductors, who regularly climbed 500-750 steps daily to collect fares, developed heart disease less often than did the drivers of those buses, who sat all day. In the same report, Morris also proved that letter carriers who walked or cycled their routes acquired heart disease infrequently compared to sedentary post office workers. With this single paper, Occupational Cardiac Epidemiology was born!London, England 1956
- Morris studied work uniform sizes ordered by city bus garages, to compare the body measurements of conductors to drivers. He showed that drivers "measure more round the chest and waist" than conductors. And, he found that the comparatively lean conductors had rates of sudden cardiac death half that of the relatively portly drivers. With this paper, metabolic syndrome became a recognized workplace issue, though it was not so named for another 30 years!
Today it seems like doctors have always promoted regular exercise as an essential strategy for staying well. But in fact, pioneers like Morris faced an uphill climb. It took decades before research like theirs won Medicine over to the simple idea that "some exercise is better than none, while more is better than some" (Paffenbarger, 1996).
Now in our "enlightened age" of nuclear and echo cardiology, intracoronary stenting, and cardiac transplantation, Morris's studies with their "obvious" conclusions and quaint methodology may seem like amusing relics from the dust bins of history. Even the idea of "epidemiology," as in the "study of epidemics," seems like the work of a bygone era.
Think again. I plopped at my
desk like a portly bus driver to write this. Most likely, you sat like a British postal clerk while reading it. In fact, we probably have "sat the day away." Next, consider the modern "epidemics" that beset us--obesity, metabolic syndrome, diabetes, and heart disease. Have nearly six decades of Occupational Cardiac Epidemiology taught us anything? Not enough, apparently, to make us live what we've learned.
Now I present another British physician, Dr. James Levine, who conducts research at the Mayo Clinic in Rochester, Minnesota. In 1999, he tackled the question of why some people gain weight and others don't, even when they consume equal calories. In controlled research settings, he pinpointed the difference. Subjects who gained significant weight simply sat more than those who gained little weight, two hours daily on average. He had found The Sitting Disease in Rochester, Minnesota, the same phenomenon that had caused premature heart disease among the London bus drivers studied forty years earlier by Dr. Morris. While we would now call his countryman's research simple and quaint, Dr. Levine's seems best described as NEAT--that is, Non-Exercise Activity Thermogenesis, his term for the burning of calories by simply increasing ordinary daily motion and limiting inactivity.
He and other researchers have since linked prolonged sitting to heart disease, diabetes, and lipid abnormalities. Conclusions include:
--Sitting more than four hours a day watching TV has an 80 percent increased risk of death from heart disease compared to two hours or less.
--The increased risk remains independent of other factors such as smoking or diet.
--The increased risk comes with any type of daily extended sitting (in front of the TV, behind the wheel, at a work desk).
--Periodic vigorous exercise, such as a gym workout, does NOT offset the risk imparted by a day of prolonged sitting.
--One must sit less and move more. Even just standing burns triple the calories as sitting. Leg muscle contractions that happen automatically while standing trigger important processes related to the breakdown of fats and sugars.
--Sitting ends these muscle contractions and slows caloric burning.
Dr. Levine advocates a new technology to counteract The Sitting Disease. He has demonstrated the effectiveness and acceptability of a work desk mounted on a 2 mph-maximum treadmill. Called the "walkstation," it does what it says, providing walking at a work station.
Having tested a walkstation, I can advocate that it effectively treats The Sitting Disease. And, it allows full work productivity. Sadly, I don't own one (yet). I do use an ordinary treadmill and recumbent station bike at home while doing the extensive reading my job requires. At the office, I do all my telephone-line dictation while using an exercise stepper. Still, I sit more hours than I'd like. That's why, I believe, the uniform of a London double-decker bus driver would fit me better than that of a conductor, unfortunately.
I have The Sitting Disease. So do you. I know what I must do; so do you. Let's do it. Or else, as yet another Brit told us in 1873,"Those who think they have not time for bodily exercise will sooner or later have to find time for illness."
- Dr. Edward Stanley, Liverpool, England 1873. Click for a list of references
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Workplace Wellness Tip
Safe Snow Habits
We've had a mild winter so far, but chances are a snowstorm or two is still on the way. Remember to keep home and workplace entrances clear of snow and ice, and always stretch before and after shoveling. Many winter urgent care visits are due to slippery falls and muscle injuries.
|February is American Heart Month. Do you know how healthy your heart is? This edition of Health e-News serves up some important tools and know-how for keeping tabs on your heart health. From knowing your numbers, to discovering what heals heartache, the team at Affinity Occupational Health is here to help you keep your ticker in tip-top shape.
Please pass it on! Employees and their families can benefit from the information shared in Health e-News. Their version of this newsletter is available at: http://conta.cc/AdvCg1
Happy Heart Month!
Director, Employer Solutions and Urgent Care
Know Your Numbers
Good cholesterol (HDL), bad cholesterol (LDL), triglycerides, blood pressure, body mass index... these terms are household words with a direct impact on your health. Trouble with these factors can lead to heart disease, heart attack or stroke, so it's important to know where your numbers fall on the spectrum. Here's what the average person should aim for:
Total cholesterol = Less than 200 mg/dL (150 mg/dL is optimal)
LDL (bad) cholesterol = Less than 160 mg/dL (less than 100 mg/dL for people with heart disease)
HDL (good) cholesterol = Women, 50 mg/dL or higher; Men, 40 mg/dL or higher
Triglycerides = Less than 150 mg/dL
Fasting glucose (blood sugar) = Less than 100 mg/dL
Blood pressure = Less than 120/80 mmHg
Did you know?
Compared to a total cholesterol level (TCL) of 200 mg/dL...
- TCL of 250 mg/dL doubles your risk of having a heart attack in middle life.
- TCL of 300 mg/dL quadruples the risk.
See your primary care doctor to keep track of your numbers annually.
Introducing Healthy Travels FitPak for Drivers
By Brian Harrison, MD
Close your eyes for the count of five. Notice that you haven't moved.
Now do it a second time, imagining yourself driving a truck.
Five seconds easily took you 150 yards down the highway.
Or off the highway.
Our clinic provides thousands of Commercial Driver Medical Exams yearly. This privilege allows us to serve public safety and health promotion among this essential workforce. With a maximum two-year interval, drivers receive the benefit of these medical interviews and exams to ensure they remain fit for duty.
We also know the hardship that comes both to employer and employee whenever we identify a driver who has unacceptable health risks, whom we cannot certify. That has always motivated us to also use these exams to help all drivers stay well and comply with needed medical management, despite the challenges of life on the road.
With the Healthy Travels FitPak, in partnership with our own Wellness and Prevention staff, this effort leaps forward. This kit exactly fills the void in commercial driver health education with trucker-specific tools, tips, tricks and teaching. Drivers using it will improve their health, well-being, and ability to remain on the job. Employers who promote it will benefit from a more health-literate, educated and empowered workforce that can more easily receive maximum-length medical certification. And, each of us who share public roads and highways with commercial drivers will travel in better safety.
At Affinity Occupational Health, we feel REALLY good about that!
The Healthy Travels FitPak Includes:
- Helpful guides on stress and fatigue management, nutrition, health and fitness
- "Stop and Go Fast Food Guide" to assist drivers in making healthier dining out options with an easy-to-follow stoplight format
- A 10-Minute Stretch & Flex Program along with a resistance band
- Water bottle and hydration tips to encourage drinking water rather than sugary beverages
- Access to a telephonic health coach to help develop a personalized action plan
- And much more...
For more information or to get started, contact Affinity Occupational Health today at (920) 628-1532.
|Heartache on the Job
How to keep heartache from affecting job performance
Valentine's Day is right around the corner--love is in the air! Or is it? Relationships can be a wonderful thing. You meet Mr. or Mrs. Right, and life comes alive! But what happens if, for whatever reason, the relationship comes to an end?
"As an employee assistance counselor, I often find myself face to face with a client's heartache," says Donna Schmitz, Affinity EAP counselor. "I understand that the pain experienced from this type of loss is real and that the symptoms can be debilitating and all-consuming."
Donna helps clients understand that their feelings of sadness, anger, anxiety, exhaustion and even a sense of not being able to move on, are all very normal. "I don't rush them, and I don't want them to feel they need to be 'over it,' either," she says.
Affinity EAP can help people cope with heartache in healthy ways that won't affect them negatively on the job. "Workplaces typically understand that if a good employee is going through a difficult time, they may not be as productive," Donna says. "However, employees often make the mistake of thinking that a concerned boss or co-worker means they are excused from frequent absenteeism or low work performance. I gently help them realize this is not the case."
Here are a few of Donna's tips for handling heartache at work.
Keep your personal life separate from work. "Employees often 'use' co-workers and bosses for support during these times. I strongly discourage this," Donna says. Instead, she helps clients build support systems outside of work. This gives them the support they need, while work can be a place to get away from the problems.
Find ways to fill the hole. Many times people suffering from heartache find themselves feeling lost and alone. Left unchecked, this can lead to isolation and depression, resulting in absenteeism or low work performance. "This is a time for extra self-care--doing some special things for yourself," Donna says. "There is much wisdom to be gained from a failed relationship." She suggests planning a vacation with friends, reading, journaling, joining a book club or Bible study, and re-evaluating personal values.
Develop realistic short-term goals. Setting and reaching goals can boost self-esteem. For example, you might aim to lose five pounds or start a new hobby. "These are all healthy ways of coping that will foster personal growth through a difficult time," Donna says.
If you are suffering from relationship heartache, Affinity EAP counselors are here to help. Call us at 1-800-894-9327.
|Are You Aware?
Ten minutes can save your life! That's all the time it takes to complete each of Affinity's free online health assessments, HeartAware and VascularAware.
Heart disease kills nearly one million Americans each year, making it the leading cause of death in the United States. Are you at risk? Discover what changes you can make to your lifestyle to ward off heart disease.
Vascular diseases are conditions of the blood vessels. They can affect a variety of organs, including the heart, brain, kidneys, arms and legs. Vascular conditions are common with age, but many people may not recognize the symptoms. What are the signs of vascular disease, and what can you do to prevent it? Take our online assessment to find out.
Learn your risk factors today at:
For those who need follow-up care, Affinity's cardiology and vascular medicine experts offer skilled diagnostics and treatment.
Breakfast With the Experts
BIG "R" on little "i"
Presented by Brian Harrison, MD, medical director of health and productivity management for Affinity Health System
Wednesday, March 14, 2012
7:30 - 9:30 a.m.
Bridgewood Resort and Conference Center
1000 Cameron Way, Neenah
Looking for big returns on small wellness investments? Dr. Harrison will present his top five tips for improving the health of your workforce using low cost interventions to bring favorable ROI. Not only will he show how to carry out these programs, but also how to measure their effectiveness. He will focus on interventions that organizations can easily accomplish, whether large or small, blue or white collar, centralized or dispersed.
To register for this free seminar, contact Tammy Davis at (920) 628-1532 or firstname.lastname@example.org.
Up-to-Date Heart Care
On February 28, Affinity Health System will host its annual Heart, Lung and Vascular Symposium for physicians. This event is an opportunity for specialists and primary care providers to gather and learn about the latest developments in heart and vascular health care. Connecting these two physician groups facilitates better communication and ensures our care providers are up to speed, so that you and your family are given optimal personalized care.
For more information about Cardiology and Vascular Medicine at Affinity Health System, visit our web site