miércoles, 10 de junio de 2015

"Levántate y anda..." va a ser verdad que funciona

Llevo años recomendando a mis pacientes que se levanten de la silla y caminen. Al principio apoyado en el sentido común, posteriormente en mi experiencia personal. Hoy es el British Medical Journal el que lo recomienda a tenor de una guía publicada en el British Journal of Sports Medicine en la que se aconseja a todo aquel que realice trabajo sedentario que se levante de la silla un mínimo de dos horas cada jornada laboral y camine lo que pueda. El gasto energético es mayor de pié que sentado y mejor dando algún paso por la oficina que inmóvil. Si se multiplica por los días laborales de un año implica mucho para la salud.

Desarrollar estilos de vida y de trabajo que contemplen  cambios posturales y movimiento es determinante para mantenernos en buena forma física y evitar enfermedades. Son intervenciones poco costosas que tienen muchos beneficios a medio y largo plazo. Tan solo hay que tomar conciencia de que acabaremos mejor la jornada si esta no ha sido totalmente sedentaria.

The sedentary office: a growing case for change towards better health and productivity. Expert statement commissioned by Public Health England and the Active Working Community Interest Company


An international group of experts was invited by Public Health England and a UK community interest company (Active Working CIC) to provide guidelines for employers to promote the avoidance of prolonged periods of sedentary work. The set of recommendations was developed from the totality of the current evidence, including long-term epidemiological studies and interventional studies of getting workers to stand and/or move more frequently. The evidence was ranked in quality using the four levels of the American College of Sports Medicine. The derived guidance is as follows: for those occupations which are predominantly desk based, workers should aim to initially progress towards accumulating 2 h/day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 h/day (prorated to part-time hours). To achieve this, seated-based work should be regularly broken up with standing-based work, the use of sit–stand desks, or the taking of short active standing breaks. Along with other health promotion goals (improved nutrition, reducing alcohol, smoking and stress), companies should also promote among their staff that prolonged sitting, aggregated from work and in leisure time, may significantly and independently increase the risk of cardiometabolic diseases and premature mortality. It is appreciated that these recommendations should be interpreted in relation to the evidence from which they were derived, largely observational and retrospective studies, or short-term interventional studies showing acute cardiometabolic changes. While longer term intervention studies are required, the level of consistent evidence accumulated to date, and the public health context of rising chronic diseases, suggest initial guidelines are justified. We hope these guidelines stimulate future research, and that greater precision will be possible within future iterations.