The sitting epidemic
29 Jan 2026
By Ronald Allan M. Ponteres, MD, MBAH
In today’s increasingly digital and industrial environment, much of the workforce spends long hours seated while working at computers, commuting, or attending meetings. This shift has made prolonged sitting a growing public health concern, with strong evidence linking sedentary behavior to cardiometabolic disease, musculoskeletal disorders, and premature death. In the Philippines, where more than 60 percent of urban employees hold office-based jobs, these risks are reflected in rising rates of chronic illness and work-related musculoskeletal complaints.
Cardiovascular risks
Prolonged sitting, commonly defined as spending 8 or more hours per day in seated or reclined positions with minimal energy expenditure, has been shown to adversely affect cardiovascular health (Mayo Clinic Press, 2025; U.S. Department of Health and Human Services, 2018; Ajufo et al., 2025). Extended periods of sitting slow blood circulation and reduce skeletal muscle activity, contributing to impaired lipid metabolism and endothelial dysfunction. Evidence from a large prospective cohort study demonstrated that higher sedentary time was associated with an increased risk of cardiovascular events and mortality, even among individuals who met recommended physical activity guidelines (Diaz et al., 2017). Physiologically, prolonged sitting reduces fatty acid oxidation and promotes sluggish blood flow, mechanisms that may accelerate atherosclerotic plaque formation. With cardiovascular disease remaining the leading cause of death in the country, addressing prolonged sedentary behavior has become an important public health priority (Department of Health, 2023).
Metabolic syndrome
Deskbound work is also linked to metabolic syndrome, a group of interrelated conditions that include elevated blood pressure, impaired glucose regulation, excess abdominal adiposity, and abnormal lipid profiles. A systematic review found that people who sit for extended periods, typically more than eight hours per day, have a significantly higher risk of type 2 diabetes and metabolic syndrome (Wilmot et al., 2012). These risks persist even if individuals meet the recommended levels of physical activity. In Metro Manila, where sedentary office work is prevalent, the prevalence of obesity and overweight has increased, contributing to the growing burden of non-communicable diseases (National Nutrition Council, 2022).
Musculoskeletal problems
Poor posture and insufficient movement during prolonged desk work contribute significantly to the development of musculoskeletal disorders, particularly affecting the neck, shoulders, and lower back. Sustained sitting increases mechanical strain on the spine and surrounding musculature, leading to discomfort and functional impairment over time. A study reported that office workers who sit for more than 6 hours per day are more likely to experience neck and back pain compared with those who sit for shorter durations (Shariat et al., 2020). Occupational health clinics frequently report repetitive strain injuries and chronic back pain among employees in the business process outsourcing sector, where prolonged sitting is common.
Mental health consequences
Prolonged sitting affects not only physical health but also mental well-being. Evidence indicates that sedentary behavior is associated with higher levels of anxiety and depressive symptoms (Teychenne et al., 2015). Reduced movement may limit the release of neurochemicals such as endorphins and serotonin, which play a key role in mood regulation and stress reduction. Mental health concerns are increasingly reported among urban Filipino workers, particularly those engaged in long hours of desk-based employment with limited opportunities for physical activity.
Desk dilemma
The phrase 'sitting is the new smoking' was coined to highlight the severity of health risks linked to prolonged sitting. Like smoking, excessive sitting is now recognized as an independent risk factor for chronic diseases and premature death. Studies show that sitting for more than eight hours a day without physical activity has a mortality risk like that of smoking and obesity (Ekelund et al., 2019; Katzmarzyk & Lee, 2012). This comparison has prompted public health advocates to call for systemic changes in workplace design, programs, and culture.
Motion Is medicine
Physical therapist and family medicine specialist Dr Mariel Anne Coronel‑David emphasized that prolonged sitting places the body in what she describes as a “stagnant mode.” Unlike dynamic activities that demand continuous energy expenditure, extended sitting requires very little effort from the body, causing multiple physiological systems to slow down.
According to Coronel‑David, the absence of regular weight‑bearing movement is a major concern. This leads to progressive weakness of the gluteal and lower extremity muscle groups, alongside joint stiffness that, over time, can result in pain and significant mobility limitations. As these musculoskeletal changes accumulate, individuals may experience functional decline that affects both work performance and daily activities.
Beyond musculoskeletal effects, prolonged sitting also causes metabolic disorders. Coronel‑David noted that extended sedentary behavior can cause insulin insensitivity, thereby increasing the risk of developing Type 2 diabetes mellitus. Cardiovascular consequences are likewise prominent; reduced movement promotes fat accumulation, contributing to elevated blood pressure and worsening the risk for stroke, heart attack, and deep vein thrombosis (DVT). She further warned long periods of sitting may contribute to cognitive decline through reduced cerebral blood flow and associated vascular mechanisms.
To counter these risks, Coronel‑David highlighted the importance of occupational health interventions that reduce prolonged sitting in the workplace. She recommended adjusting workstations to encourage standing and walking, such as providing standing desks or creating dedicated workspaces where chairs are minimized or removed altogether.
Equally important is promoting movement in all forms throughout the workday. This includes integrating desk‑based exercises, promoting walking meetings, and conducting conferences while participants remain standing. For those seeking more active alternatives, she suggested sitting on an exercise ball to engage core muscles or using a treadmill workstation while performing desk tasks.
Ultimately, Coronel‑David stressed that breaking up prolonged sitting with regular movement is not merely a comfort measure but a critical strategy to protect long‑term musculoskeletal, metabolic, cardiovascular, and cognitive health.
Locally, some BPO companies have begun implementing wellness programs that include standing desks, yoga sessions, and ergonomic training to support employee health (Department of Labor and Employment, 2021).
Take a stand
Prolonged sitting at work is more than just uncomfortable; it represents a significant health risk. Its effects extend beyond physical discomfort to include cardiovascular disease, metabolic disorders, and mental health challenges. However, with appropriate workplace strategies such as ergonomic interventions, regular movement breaks, and health focused programs, employees can reduce these risks while maintaining productivity and overall wellness. It’s time to stand up for your health—literally.
References
Ajufo, E., Kany, S., Rämö, J. T., Churchill, T. W., Guseh, J. S., Aragam, K. G., Ellinor, P. T., & Khurshid, S. (2025). Accelerometer‑measured sedentary behavior and risk of future cardiovascular disease. Journal of the American College of Cardiology, 85(5), 473–486.
Department of Health (Philippines). (2023). Philippine Health Statistics 2022. Manila: Department of Health.
Department of Labor and Employment (DOLE). (2021). Occupational Safety and Health Standards (OSH) Updates. Manila: DOLE.
Diaz, K. M., Howard, V. J., Hutto, B., Colabianchi, N., Vena, J. E., Safford, M. M., ... & Healy, G. N. (2017). Patterns of sedentary behavior and mortality in U.S. middle-aged and older adults: A national cohort study. Journal of the American Heart Association, 6(9), e005757.
Ekelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B. H., Jefferis, B., Fagerland, M. W., & Lee, I. M. (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis. BMJ, 366, l4570.
Katzmarzyk, P. T., & Lee, I. M. (2012). Sedentary behaviour and life expectancy in the USA: A cause-deleted life table analysis. BMJ Open, 2(4), e000828.
Mayo Clinic Press. (2025). What happens when you sit too much and what to do about it. https://mcpress.mayoclinic.org/living-well/what-happens-when-you-sit-too-much-and-what-to-do-about-it/
National Nutrition Council (Philippines). (2022). Overweight and obesity prevalence in Metro Manila: Nutrition Surveillance Report. Manila: NNC.
Shariat, A., Cleland, J. A., Danaee, M., Kargarfard, M., Sangelaji, B., & Tamrin, S. B. M. (2020). Effects of stretching exercise training and ergonomic modifications on musculoskeletal discomforts of office workers: a randomized controlled trial. BMC Musculoskeletal Disorders, 21(1), 1-9.
Teychenne, M., Costigan, S. A., & Parker, K. (2015). The association between sedentary behaviour and risk of anxiety: a systematic review. Mental Health and Physical Activity, 13, 1-8.
U.S. Department of Health and Human Services. (2018). Physical activity guidelines for Americans (2nd ed.). https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
In today’s increasingly digital and industrial environment, much of the workforce spends long hours seated while working at computers, commuting, or attending meetings. This shift has made prolonged sitting a growing public health concern, with strong evidence linking sedentary behavior to cardiometabolic disease, musculoskeletal disorders, and premature death. In the Philippines, where more than 60 percent of urban employees hold office-based jobs, these risks are reflected in rising rates of chronic illness and work-related musculoskeletal complaints.
Cardiovascular risks
Prolonged sitting, commonly defined as spending 8 or more hours per day in seated or reclined positions with minimal energy expenditure, has been shown to adversely affect cardiovascular health (Mayo Clinic Press, 2025; U.S. Department of Health and Human Services, 2018; Ajufo et al., 2025). Extended periods of sitting slow blood circulation and reduce skeletal muscle activity, contributing to impaired lipid metabolism and endothelial dysfunction. Evidence from a large prospective cohort study demonstrated that higher sedentary time was associated with an increased risk of cardiovascular events and mortality, even among individuals who met recommended physical activity guidelines (Diaz et al., 2017). Physiologically, prolonged sitting reduces fatty acid oxidation and promotes sluggish blood flow, mechanisms that may accelerate atherosclerotic plaque formation. With cardiovascular disease remaining the leading cause of death in the country, addressing prolonged sedentary behavior has become an important public health priority (Department of Health, 2023).
Metabolic syndrome
Deskbound work is also linked to metabolic syndrome, a group of interrelated conditions that include elevated blood pressure, impaired glucose regulation, excess abdominal adiposity, and abnormal lipid profiles. A systematic review found that people who sit for extended periods, typically more than eight hours per day, have a significantly higher risk of type 2 diabetes and metabolic syndrome (Wilmot et al., 2012). These risks persist even if individuals meet the recommended levels of physical activity. In Metro Manila, where sedentary office work is prevalent, the prevalence of obesity and overweight has increased, contributing to the growing burden of non-communicable diseases (National Nutrition Council, 2022).
Musculoskeletal problems
Poor posture and insufficient movement during prolonged desk work contribute significantly to the development of musculoskeletal disorders, particularly affecting the neck, shoulders, and lower back. Sustained sitting increases mechanical strain on the spine and surrounding musculature, leading to discomfort and functional impairment over time. A study reported that office workers who sit for more than 6 hours per day are more likely to experience neck and back pain compared with those who sit for shorter durations (Shariat et al., 2020). Occupational health clinics frequently report repetitive strain injuries and chronic back pain among employees in the business process outsourcing sector, where prolonged sitting is common.
Mental health consequences
Prolonged sitting affects not only physical health but also mental well-being. Evidence indicates that sedentary behavior is associated with higher levels of anxiety and depressive symptoms (Teychenne et al., 2015). Reduced movement may limit the release of neurochemicals such as endorphins and serotonin, which play a key role in mood regulation and stress reduction. Mental health concerns are increasingly reported among urban Filipino workers, particularly those engaged in long hours of desk-based employment with limited opportunities for physical activity.
Desk dilemma
The phrase 'sitting is the new smoking' was coined to highlight the severity of health risks linked to prolonged sitting. Like smoking, excessive sitting is now recognized as an independent risk factor for chronic diseases and premature death. Studies show that sitting for more than eight hours a day without physical activity has a mortality risk like that of smoking and obesity (Ekelund et al., 2019; Katzmarzyk & Lee, 2012). This comparison has prompted public health advocates to call for systemic changes in workplace design, programs, and culture.
Motion Is medicine
Physical therapist and family medicine specialist Dr Mariel Anne Coronel‑David emphasized that prolonged sitting places the body in what she describes as a “stagnant mode.” Unlike dynamic activities that demand continuous energy expenditure, extended sitting requires very little effort from the body, causing multiple physiological systems to slow down.
According to Coronel‑David, the absence of regular weight‑bearing movement is a major concern. This leads to progressive weakness of the gluteal and lower extremity muscle groups, alongside joint stiffness that, over time, can result in pain and significant mobility limitations. As these musculoskeletal changes accumulate, individuals may experience functional decline that affects both work performance and daily activities.
Beyond musculoskeletal effects, prolonged sitting also causes metabolic disorders. Coronel‑David noted that extended sedentary behavior can cause insulin insensitivity, thereby increasing the risk of developing Type 2 diabetes mellitus. Cardiovascular consequences are likewise prominent; reduced movement promotes fat accumulation, contributing to elevated blood pressure and worsening the risk for stroke, heart attack, and deep vein thrombosis (DVT). She further warned long periods of sitting may contribute to cognitive decline through reduced cerebral blood flow and associated vascular mechanisms.
To counter these risks, Coronel‑David highlighted the importance of occupational health interventions that reduce prolonged sitting in the workplace. She recommended adjusting workstations to encourage standing and walking, such as providing standing desks or creating dedicated workspaces where chairs are minimized or removed altogether.
Equally important is promoting movement in all forms throughout the workday. This includes integrating desk‑based exercises, promoting walking meetings, and conducting conferences while participants remain standing. For those seeking more active alternatives, she suggested sitting on an exercise ball to engage core muscles or using a treadmill workstation while performing desk tasks.
Ultimately, Coronel‑David stressed that breaking up prolonged sitting with regular movement is not merely a comfort measure but a critical strategy to protect long‑term musculoskeletal, metabolic, cardiovascular, and cognitive health.
Locally, some BPO companies have begun implementing wellness programs that include standing desks, yoga sessions, and ergonomic training to support employee health (Department of Labor and Employment, 2021).
Take a stand
Prolonged sitting at work is more than just uncomfortable; it represents a significant health risk. Its effects extend beyond physical discomfort to include cardiovascular disease, metabolic disorders, and mental health challenges. However, with appropriate workplace strategies such as ergonomic interventions, regular movement breaks, and health focused programs, employees can reduce these risks while maintaining productivity and overall wellness. It’s time to stand up for your health—literally.
References
Ajufo, E., Kany, S., Rämö, J. T., Churchill, T. W., Guseh, J. S., Aragam, K. G., Ellinor, P. T., & Khurshid, S. (2025). Accelerometer‑measured sedentary behavior and risk of future cardiovascular disease. Journal of the American College of Cardiology, 85(5), 473–486.
Department of Health (Philippines). (2023). Philippine Health Statistics 2022. Manila: Department of Health.
Department of Labor and Employment (DOLE). (2021). Occupational Safety and Health Standards (OSH) Updates. Manila: DOLE.
Diaz, K. M., Howard, V. J., Hutto, B., Colabianchi, N., Vena, J. E., Safford, M. M., ... & Healy, G. N. (2017). Patterns of sedentary behavior and mortality in U.S. middle-aged and older adults: A national cohort study. Journal of the American Heart Association, 6(9), e005757.
Ekelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B. H., Jefferis, B., Fagerland, M. W., & Lee, I. M. (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis. BMJ, 366, l4570.
Katzmarzyk, P. T., & Lee, I. M. (2012). Sedentary behaviour and life expectancy in the USA: A cause-deleted life table analysis. BMJ Open, 2(4), e000828.
Mayo Clinic Press. (2025). What happens when you sit too much and what to do about it. https://mcpress.mayoclinic.org/living-well/what-happens-when-you-sit-too-much-and-what-to-do-about-it/
National Nutrition Council (Philippines). (2022). Overweight and obesity prevalence in Metro Manila: Nutrition Surveillance Report. Manila: NNC.
Shariat, A., Cleland, J. A., Danaee, M., Kargarfard, M., Sangelaji, B., & Tamrin, S. B. M. (2020). Effects of stretching exercise training and ergonomic modifications on musculoskeletal discomforts of office workers: a randomized controlled trial. BMC Musculoskeletal Disorders, 21(1), 1-9.
Teychenne, M., Costigan, S. A., & Parker, K. (2015). The association between sedentary behaviour and risk of anxiety: a systematic review. Mental Health and Physical Activity, 13, 1-8.
U.S. Department of Health and Human Services. (2018). Physical activity guidelines for Americans (2nd ed.). https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf