Proper ergonomics and positioning are important aspects of using an active workstation to avoid discomfort or injury from incorrect use. We recommend that individuals follow manufacturers’ instructions for proper use, or seek the guidance of a qualified professional (occupational or physical therapist, exercise physiologist, biomechanist, or certified personal trainer knowledgeable in the area of ergonomics) to make sure that proper setup and form is used.
Working-age adults — defined as ~25 to 60 years of age for the purposes of this article — can certainly face many barriers to being physically active and exercising regularly: being tired after a long day of work; caregiving for children or aging parents; or rushing off to second jobs or other obligations, with little downtime in between. Unfortunately, exercise can become just one more thing on the never-ending to-do list. Combine this reality with sedentary work environments, high amounts of sedentary screen time at home, and lack of knowledge on how to get started being more active, it is easy to see why only one in five adult women, and one in four adult men, in the United States meet the weekly physical activity (PA) guidelines for health (1), which are at least 150 to 300 minutes per week of moderate intensity, 75 to 150 minutes per week of vigorous intensity, or an equivalent combination of moderate and vigorous aerobic activity (2). Performing muscle-strengthening activities that involve all major muscle groups on two or more days per week also is recommended (2).
Clearly, one of the major barriers to PA participation is the daunting task of finding the time and energy to complete PA in bouts of 30 to 60 minutes on most days of the week. Fortunately, evidence shows that PA occurring in short bouts (even as little as a few minutes per bout), multiple times each day, can still result in marked health benefits (3) — a much less intimidating goal for busy working adults. In fact, a recent study reported that compared with inactive individuals, those who exercised for an average of 15 minutes per day reduced their risk of all-cause mortality by 14% and had a 3-year longer life expectancy (4). This knowledge can be motivating and exciting for busy individuals, but most people need some guidance on how to create a realistic and effective plan that works for them. This is where the health and fitness professional can have a significant impact.
This article aims to help exercise and health professionals provide feasible, creative, and effective recommendations to patients and clients who struggle to find opportunities to be more physically active and exercise. Specifically, we will discuss:
- changes that can be made at the workplace to increase PA,
- ways to increase PA at home, and
- both traditional and nontraditional forms of PA and exercise for working adults to engage.
INCREASING PA IN THE WORKPLACE
A recent report from the U.S. Bureau of Labor Statistics stated that 13.3% of all civilian jobs were classified as sedentary, and only ~25% required some light work (5). Adults spend a large percentage of their waking hours at work, so — depending on how you look at it — this can lead to either high levels of sedentary behavior or hidden opportunities to accumulate short bouts of PA. Our task is to help them find and implement those opportunities.
One solution that is gaining in popularity is the integration of active workstations (e.g., under-the-desk ellipticals, standing desks, treadmill desks, and even bicycle desks), which promote very light PA throughout the workday (see Figure 1). Although some people may fear that active workstations might become distracting to their work, some research has shown just the opposite (6). Although more evidence-based research is needed, it is possible that long-term use of active workstations may increase productivity, decrease stress, improve cognitive performance, and even increase mood while at work (6). Fortunately, many active workstations are becoming more commonplace and affordable, making them a more accessible option to decrease sedentary time at work.
Active workstations are just one way to break up sedentary time, however. There are many other effective options to be even more active in short bursts throughout the day, and which do not require modifying the workspace or buying any equipment. Activities such as taking the stairs instead of an elevator or escalator or walking during breaks are common recommendations; however, with some creativity and guidance from exercise and health professionals, the opportunities are virtually endless. Figure 2 lists several ways that individuals can increase PA while at work. These small additions and changes may feel strange at first, but with continued practice, they can quickly become second nature.
It is important to acknowledge that simply increasing PA is not a cure-all for all health conditions. The components of health are multifactorial, and PA is one key aspect of that. However, we know that adults who work at very active jobs in which they easily attain the recommended PA levels for health each week may still be a heightened risk for cardiovascular disease and early mortality if the working conditions are poor and highly stressful and adequate recovery time is lacking (7). Addressing all of these factors with your client or patient is essential for designing a plan to optimize health benefits.
MAKING TIME AT HOME MORE ACTIVE
For many adults, home is not just a place to relax and unwind but also a place to take care of that endless to-do list. Unfortunately, an additional major challenge that adults face at home is minimizing screen time. Between personal computers, traditional and streaming TV, gaming, Internet browsing, and the like, there are more and more opportunities to be sedentary. After a long, stressful day of work, chores, and other duties, the desire to kick back and relax is understandable. However, we know that long periods of sitting can have highly detrimental effects on health, and although this certainly can happen in the workplace as discussed above, it very often happens at home. Alarmingly, recent evidence showed that high levels of moderate-intensity PA (about 60 to 75 minutes per day) seemed to attenuate, but not completely eliminate, the increased mortality risk associated with high sedentary TV-viewing time (8). Therefore, making it a habit to incorporate breaks into sitting time at home should be an essential component for every individual’s overall health and wellness plan. Fortunately, there are many ways to incorporate PA into downtime at home, as well as into many day-to-day household chores. See Figure 3 for some creative suggestions that you can provide directly to individuals who want to increase their PA at home.
ENGAGING IN TRADITIONAL EXERCISE MODALITIES
Although incorporating short bursts of activity into each day is an important strategy for increasing overall PA and health benefits, traditional, longer-duration exercise modalities such as walking, running, swimming, cycling, resistance training, and others still have a key role in greatly improving health and fitness. A significant barrier to performing traditional exercise (endurance, resistance, or a combination of the two) is the perceived amount of time involved. Although a 60-minute workout at the end of a work day sounds like a great plan, the reality is that this time often gets used for other important obligations, or simply different, preferred activities. Especially for individuals with time constraints, high-intensity interval training (HIIT) may be the ideal workout type, provided that they are cleared by a physician to exercise very intensely.
High-intensity interval training (HIIT) is a highly effective, safe, and time-efficient way to improve cardiorespiratory fitness in working-age adults.
As its name suggests, HIIT involves intense yet submaximal efforts that elicit ≥80% of maximal HR during each interval (9,10). HIIT has gained notoriety for its effectiveness in increasing cardiorespiratory fitness, yet requiring shorter duration sessions (often ~15–20 minutes, including warm-up and cool-down), than traditional aerobic exercise (typically 30- to 60-minute sessions). When it comes to significantly improving cardiorespiratory fitness, and its gold standard measure of maximal oxygen consumption (V̇O2max), interval training may actually be superior to traditional continuous exercise, although the time commitment is significantly less (9,10). Interestingly, this holds true even in individuals with chronic cardiovascular and metabolic diseases (11,12) and in the overweight and obese (13). Although it has been shown to be safe in those populations (12,13), it is important to note that appropriate supervision or physician’s approval is necessary before recommending or starting HIIT training in these populations.
Of course, although many individuals find interval exercise more enjoyable and preferable compared with continuous, non-interval-based exercise (14), HIIT might not be well-received by, nor feasible for, every individual because of the vigorous (albeit brief) efforts required during a HIIT session. In such cases, a less demanding and perhaps more easily accessible form of intermittent aerobic exercise could be considered, such as interval walking (i.e., alternating periods of fast- and slower-paced walking) (10).
In addition to cardiovascular exercises, strength or resistance training also should be incorporated into the weekly PA and exercise plan for working-age adults to maintain or improve bone density, reduce the risk of osteoporosis, and build or maintain muscle mass and strength. This can be done at a gym or at home, and it can include body weight exercises as well as traditional weightlifting.
EMBRACING NONTRADITIONAL FORMS OF PA
There are many nontraditional yet beneficial ways to increase PA and exercise that are sometimes overlooked when we think of exercise as only the traditional modalities mentioned above. Alternatives such as yoga, active commuting, and active recreation, including age-group sports and partner/social dancing, can be beneficial for increasing fitness levels, improving overall health, and reducing stress — important goals of any exercise program.
Although stress occurs in every phase of life, the working years can often be highly stressful times because of the demands of one’s job or career (increasing responsibility, potential job loss, or career changes), family responsibilities, and other obligations. Although any form of PA or exercise can certainly help to alleviate stress, mind-body interventions such as yoga have gained popularity as a way to reduce stress as well as to increase PA. Although more research that compares yoga to other forms of PA is needed, meta-analyses and reviews suggest that yoga can help to reduce stress (15,16), can improve health-related outcomes such as hypertension (15,17), and also may improve balance, flexibility, and strength (16).
Practicing yoga has many potential health benefits, such as reducing stress, lowering blood pressure, and improving balance, flexibility, and strength.
The intensity level and associated energy cost of practicing yoga varies greatly based on the intensity and type of yoga and the specific poses (called asanas) that one practices, and there are certainly forms that are meant to be more relaxing than others (e.g., Yin versus Vinyasa). A recent systematic review of the metabolic demands of yoga reported that although the intensity of most asanas and full yoga sessions overall was considered to be light intensity, some asana sequences were classified as moderate to vigorous intensity (e.g., sun salutations; see Figure 4) and, therefore, should count toward the daily recommendations for accumulated moderate- or vigorous-intensity PA (18).
We typically think of yoga as being performed in a studio or other group setting, but it can be practiced individually and almost anywhere, provided that the individual has learned the correct form (just as with many modes of exercise). Classes are commonly found at local fitness centers and yoga studios but also are available through community centers or even through public parks and recreation programs, often at reduced or no cost. For home practice, there are many online “studios” that individuals can join, as well as free online videos available for use.
When possible, making exercise a part of one’s daily commute is an excellent way to replace sedentary time with active time and reap substantial health benefits. A recent longitudinal cohort study in the United Kingdom followed 263,450 working adults for 5 years and categorized them based on their mode of transportation to and from work each day; the categories were nonactive (auto, public transportation, or both), walking, primarily cycling, mixed-mode walking (combination of walking with car or public transportation), or mixed-mode cycling (cycling plus some walking, car travel, or public transportation) (19). Only bicycle commuting and mixed-mode commuting that included bicycling were associated with lower risk of all-cause mortality. It should be noted that although walk commuting was not associated with all-cause mortality, it was associated with lower CVD risk (19). Although bicycle or mixed-mode commuting is not feasible for all working adults, this study does show that replacing sedentary commuting time with a highly active commuting alternative can be a creative way to fit exercise into the daily routine and realize important health benefits along the way.
For individuals who do not own a bicycle, many cities now have bicycle-sharing systems that operate on a per-ride or subscription fee basis, with discounted rates for those who qualify. If public transportation is the most logical mode of travel, individuals could consider getting off a few stops early and walking the rest of the way. If commuting by car is the most logical option, parking further away so that the walk into and from work is longer will help to accumulate some helpful PA. Thus, no matter what the commute type, there are ways to make some of that time more active and beneficial.
Many adults find that age-group team sports such as tennis, pickleball, basketball, and soccer are a fun and social way to be active and exercise. This may be especially appealing to individuals who played a sport in their high school or college days and enjoy the camaraderie of a team environment. Often there are such opportunities through community-based groups, or even through one’s workplace. Although this type of exercise is less well studied compared with more individualized and structured endurance or resistance training programs, a study of recreational soccer in adults demonstrated that it improves V̇O2max, regardless of the age, sex, and health status of the participants (20). This yields credibility to such sports as viable PA options for working-age adults. It is important to remember, however, that sports activities like the ones mentioned above should only be recommended for individuals who are already physically active and exercise regularly, have a foundation of fitness, and who have the appropriate level of coordination and motor skills required for the sport(s) in which they choose to participate to enjoy these activities safely.
Another option for those who enjoy being active in a social setting is partner dancing. There are many forms of dance, from swing to ballroom to salsa and more, and local dance organizations often host weekly dances in many cities throughout the country. For more on the many benefits of dance as a form of PA, see the article in this issue by Dondzila and Glass.
For those who love the great outdoors, there are so many options for being physically active and exercising outside. Activities like canoeing or kayaking, hiking, and, for those who live in snowy climates, snowshoeing or cross-country skiing are great ways to increase active time while enjoying being outside and in nature.
IT’S WORTH REMEMBERING: MORE IS INDEED BETTER
Helping patients and clients achieve at least the minimum of 150 minutes per week of moderate-intensity PA is a very worthy goal and can certainly lead to improved health and fitness outcomes. However, it is important to remember that this is the minimum threshold, and that more than the minimum is indeed better. For more substantial health benefits, such as lower risk of heart disease and type 2 diabetes, adults need at least 150 to 300 minutes of moderate-intensity aerobic activity each week, plus muscle-strengthening activities on two days per week; when adults achieve >300 minutes per week of moderate-intensity PA, however, the risk of several cancers as well as unhealthy weight gain is reduced even further than at the 150- to 300-minute level (2). If individuals are motivated, well supported by family and peers, willing, and able to commit more time to exercise, then adding on more structured PA such as group fitness classes, brisk walking or running, cycling, functional fitness classes, and the like can help to add more prolonged bouts to the weekly program and meet their health and fitness goals.
More is indeed better. Risks of heart disease and type 2 diabetes are further reduced, and overall health benefits are increased to a greater extent, with at least 150 to 300 minutes of moderate-intensity aerobic activity each week, plus muscle-strengthening activities on two days each week.
WHAT’S THE GOAL? IT DEPENDS
As exercise and health professionals, we must remember that the duration and intensity of an individual’s exercise sessions for each day and each week depends on the individual’s health and fitness goals. The goals of running a marathon, running a 5k, participating in a 3-day cycling tour while on vacation, losing weight while maintaining muscle mass, lowering blood pressure, improving blood glucose control, reducing the harmful effects of stress, or simply improving overall health and reducing chronic disease risk factors all are different, with different needs and strategies. It is important to consider the individual’s goals when designing a plan or making recommendations.
Although working-age adults are busy and often have many time commitments, it is possible to devise effective and time-efficient strategies to increase PA and achieve important health benefits. Interrupting sedentary time at work and at home with short bursts of activity and finding ways to reduce sedentary time overall are important steps to take every day. Encouraging other forms of PA and exercise, such as HIIT, yoga, active commuting, and age-group sports, also can be highly beneficial to your client’s or patient’s overall health and fitness goals during their working years.
BRIDGING THE GAP
Finding ways to build PA and exercise into the daily lives of busy working-age adults can be challenging, especially with ever-increasing opportunities to be sedentary. Helping your clients and patients find creative, feasible, time-efficient, and effective ways to increase their PA and exercise levels is of great importance. Incorporating shorter bouts into the work day and into downtime at home and finding enjoyable exercise options that include both traditional and nontraditional modes are all ways to help them enjoy better health and fitness during — and hopefully beyond — the working years.
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