Extended sitting or lying down in daytime increases risk of heart disease, type 2 diabetes and cancer – and costs NHS £700m – says study

Sitting or lying down for long periods during the day is not only bad for your health it could be the cause of almost 70,000 deaths and cost the NHS at least £700m a year, new research has revealed.

Scientists have previously flagged that sedentary behaviour increases the risk of a number of diseases as well as a premature death.

Now experts have looked into the financial burden of sedentary behaviour in the UK, revealing that sitting or lying down for at least six hours a day is behind £424m of spending on cardiovascular disease, £281m on type 2 diabetes and £30m on colon cancer alone.

“We don’t have clear guidelines [on sedentary behaviour] yet but any increase in activity is beneficial to your health,” said Leonie Heron, first author of the research from Queen’s University Belfast.

The team add that it isn’t only the public purse that could benefit from more movement: they predict more than 69,000 deaths in the UK in 2016 – 11.6% of all deaths – could have been prevented if people did not sit down for prolonged periods.

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Writing in the Journal of Epidemiology and Community Health, Heron and colleagues from Queen’s University Belfast and Ulster University describe how they made their calculations by estimating the amount of money spent by the NHS on type 2 diabetes, cardiovascular disease, and endometrial, colon and lung cancers over the financial year 2016-2017 across the UK.

They then combined this with estimates, based on previous studies, of the degree to which at least six hours of sedentary behaviour a day increases risk of such diseases, as well as estimates of the proportion of people who went on to develop the different diseases that reported prolonged periods of sedentary behaviour.

The team also drew on data from a large survey in England, conducted in 2012, which revealed 30% of adults spent at least six hours of every weekday sedentary, rising to 37% of adults on the weekends.

After crunching the figures together, and taking into account factors including people’s smoking status, BMI and how much exercise they did, the team found that if sedentary behaviour was eliminated in the UK, 9% of cases of colon cancer, 8% of endometrial cancer and 7.5% of lung cancer could be prevented, as well as 17% of cases of type 2 diabetes and about 5% of cardiovascular disease cases.

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Overall, more than £760m a year was calculated to be spent by the NHS across the UK on the five diseases as a result of sedentary behaviour – about 1.2% of its total expenditure on those diseases. This fell to about £700m after the team took into account that some people have more than one of the diseases considered.

But the team say this is probably an underestimate. The estimated spending for 2016-17 – which was in part based on projections from older data – is believed to be below the actual spending for that year, while it is likely sedentary behaviour plays a role in further diseases.

“I would say it is a conservative estimate because we don’t know the full impact of sedentary behaviour yet,” said Heron. She added that even if people are not able to undertake moderate or vigorous physical activity, increasing light activity – such as just pottering about – could bring benefits.

The study does not prove cause and effect – and sicker people might be more sedentary. What’s more, not all of the data used in the lung cancer calculations was from European populations, and estimates of the risks from sedentary behaviour were gleaned from different studies with different methods.

Nonetheless, the team say the new research provides reasonable estimates of the cost of not moving, and call for public health interventions to reduce sedentary behaviour and provide clear guidelines to the public.

Dr Keith Diaz, an expert in behavioural medicine at Columbia University who was not involved in the study, said the lack of effort by policy-makers to tackle sedentary behaviour might be rooted in concerns that it could decrease work productivity.

“Thus, the findings from this study are immensely important as they provide a strong economic case that public health policy changes to reduce workplace sedentary behaviours could be a worthwhile investment,” he said.

But, he added, getting on your feet is not enough: “Until we learn more about the benefits or risks of standing, the best advice that I can give for some concerned about their sitting habits is to sit less, move more, and move often.”

Others noted it is likely to be more effective to focus on encouraging people to be more physically active in general and that it is not yet clear how much longer individuals would have lived if they had spent less time sitting.

“The ‘bang for your buck’ of reducing sitting time is pretty small in terms of health benefits – you actually have to reduce sitting time by several hours each day to see noticeable improvements in health,” said Dr Gavin Sandercock from the University of Essex. “In contrast, getting people to be more physically active has much bigger effects.”

• This article was amended on 26 March 2019. An earlier version referred to the amount spent by the NHS on the five diseases as a result of sedentary behaviour, £760m, as being about 1.2% of its total budget; it is about 1.2% of its total budget for those diseases.