insights

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Approximately 60-85% of people in the world lead sedentary lifestyles without sufficient physical activity incorporated into their day.¹ In fact, sedentary behaviors are on the rise with the popularization of internet-based services and working hours mostly spent in the seated position.^1,2 Data suggests that the average individual engages in sedentary behaviors for eight to nine hours per day.^2,3 The number of hours spent sitting has been positively correlated with risk for diabetes, cardiovascular disease, poor mental health, and even premature mortality.^2,4

Recent research suggests that active microbreaks, defined as two to three minutes of light-intensity activity for every 30 minutes of sedentary work may not only improve cardiovascular health ^5-7 but also improve mental well-being,^2-3,8 alleviate fatigue, and enhance vigor.^2,8-9 Ultimately, this break should be more stimulating and dynamic than simply standing up and stretching.^2-3,10

Patients might consider incorporating mindful movement into everyday routines, such as wall squats, seated leg extensions, static lunges, and standing bicep curls, just to name a few. Small physical activity sessions of about 5-20 reps, or holds and stretches for one to two minutes, can be integrated into the workday in hourly increments. Strengthening programs using dumbbells, elastic bands, kettlebells, and anti-gravity exercises can be broken into microbreak activities lasting about two minutes.¹⁰ Many smartphone and desktop applications available on the market allow patients to set reminders to move during the day; some of these include StretchClock, DeskActive, Break Pal, and OfficeFit.

Delving into the medical research, a 2022 systematic review suggests that active microbreaks may lead to improvement in the physical, mental, and metabolic functions of the human body without posing detrimental effects to employee productivity.² Active microbreaks may have the potential to decrease musculoskeletal discomfort, improve cardiometabolic markers, and help provide relief from fatigue and stress experienced throughout the workday.² Specifically:

• One study in the systematic review, which focused on walking as the intervention of choice for the active microbreak, used parameters in which the walk was of light intensity (with a grade of nine on the Borg RPE scale) and for a period of three minutes. There was a significant decrease in reported mental fatigue levels compared to the control group in which the participants remained seated unless using the bathroom.⁸
• Mainsbridge et al, in a randomized controlled trial, also found that incorporating movement alongside sedentary behaviors can be beneficial to the mental health of office workers, as there was a reduction in stress levels subsequent to frequent active microbreaks throughout the workday compared to those who worked as normal and did not engage in active microbreaks. These movements consisted of 65 different choices such as chair squats, stair climbs, and walking, to name a few.³
• An interesting study by Bailey & Locke, included in the review, reported that while blood pressure, total cholesterol, HDL, and triglyceride levels did not significantly change with an active microbreak intervention (defined as light activity), blood glucose A1C levels did show a significant improvement. Interestingly, breaking up sitting with standing alone did not show an improvement in post-prandial glycemia.⁵

Another 2022 systematic review and meta-analysis by Albulescu et al, published in the journal PLoS ONE, examined 22 studies from the past 30 years and determined short breaks improved worker well-being.⁹ Active microbreaks, characterized here as 10 minutes or less, included walking, which the researchers found to be associated with decreased fatigue and an increase in positive emotions.⁹

Research into the health effects of microbreaks continues to expand. From a patient perspective, altering one’s sedentary lifestyle with physical activity comes at a very low risk. Many of these methods are showing promising results in maintaining a healthy heart and a healthy mind.

Functional Medicine Considerations

How can clinicians help their patients establish a cadence for active microbreaks within their workday? Microbreaks can look different for everyone, but in general, the best breaks are those that the patient enjoys. The functional medicine model emphasizes the importance of helping patients identify what types of physical activity they enjoy the most to create sustainability. To be truly effective, a functional medicine exercise prescription must not only help the patient develop an exercise routine but also help them replace a certain amount of sedentary time each day.

Functional medicine teaches clinicians how to effectively motivate patients to view exercise as a comprehensive physiological benefit, not just a means for weight loss. The patient’s path to wellness may include structured exercise programs, unstructured interruptions of sedentary behavior, or both. IFM’s Exercise Goals and Tracking Journal is a handout within the IFM Toolkit that includes a written schedule for patients for use at home. Learn more about tools and strategies to help patients achieve sustainable lifestyle change and improve their well-being through IFM’s Applying Functional Medicine in Clinical Practice (AFMCP).

Related Insights

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LEARN PROVEN TECHNIQUES TO HELP PATIENTS MAKE LIFESTYLE CHANGES

OVERCOMING BARRIERS TO PHYSICAL FITNESS

References

1. Zhang T, Ham J, Ren X. Why exercise at work: development of the Office Exercise Behavior Determinants scale. Int J Environ Res Public Health. 2021;18(5):2736. doi:3390/ijerph18052736
2. Radwan A, Barnes L, DeResh R, Englund C, Gribanoff S. Effects of active microbreaks on the physical and mental well-being of office workers: a systematic review. Cogent Eng. 2022;9(1). doi:1080/23311916.2022.2026206
3. Mainsbridge CP, Cooley D, Dawkins S, et al. Taking a stand for office-based workers’ mental health: the return of the microbreak. Front Public Health. 2020;8:215. doi:3389/fpubh.2020.00215
4. Solomon TPJ, Eves FF, Laye MJ. Targeting postprandial hyperglycemia with physical activity may reduce cardiovascular disease risk. But what should we do, and when is the right time to move? Front Cardiovasc Med. 2018;5:99. doi:3389/fcvm.2018.00099
5. Bailey DP, Locke CD. Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not. J Sci Med Sport. 2015;18(3):294-298. doi:1016/j.jsams.2014.03.008
6. Dempsey PC, Larsen RN, Sethi P, et al. Benefits for type 2 diabetes of interrupting prolonged sitting with brief bouts of light walking or simple resistance activities. Diabetes Care. 2016;39(6):964-972. doi:2337/dc15-2336
7. Zeigler ZS, Mullane SL, Crespo NC, Buman MP, Gaesser GA. Effects of standing and light-intensity activity on ambulatory blood pressure. Med Sci Sports Exerc. 2016;48(2):175-181. doi:1249/mss.0000000000000754
8. Wennberg P, Boraxbekk C, Wheeler M, et al. Acute effects of breaking up prolonged sitting on fatigue and cognition: a pilot study. BMJ Open. 2016;6(2):e009630. doi:1136/bmjopen-2015-009630
9. Albulescu P, Macsinga I, Rusu A, Sulea C, Bodnaru A, Tulbure BT. “Give me a break!” A systematic review and meta-analysis on the efficacy of micro-breaks for increasing well-being and performance. PLoS One. 2022;17(8):e0272460. doi:1371/journal.pone.0272460
10.  Vitoulas S, Konstantis V, Drizi I, Vrouva S, Koumantakis GA, Sakellari V. The effect of physiotherapy interventions in the workplace through active micro-break activities for employees with standing and sedentary work. Healthcare. 2022;10(10):2073. doi:3390/healthcare10102073