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THURSDAY, July 22 (HealthDay News) -- The more Americans engage in one of their favorite pastimes -- sitting around -- the shorter their average life span, a new study suggests.

The effect remained even after researchers factored out obesity or the level of daily physical activity people were engaged in, according to a study of more than 120,000 American adults.

It's just one more reason to "get up and walk," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "The message here is like everything in your life. People need to recognize that the things you do every day have consequences. And if you're in a job that does require sitting, that's fine, but any time you can expend energy is good. That's the key."

The salutary effect of exercise on being overweight or obese, rates of which are at an all-time high, have been well documented.

But according to background information in the study, which is published online July 22 in the American Journal of Epidemiology, the effects of sitting per se are less well-studied. Although several studies have found a link between sitting time and obesity, type 2 diabetes, heart disease risk, and unhealthy diets in children, few had examined sitting and "total mortality," researchers noted.

The authors of the study analyzed responses from questionnaires filled out by 123,216 people (53,440 men and 69,776 women) with no history of disease who were participating in the Cancer Prevention II study conducted by the American Cancer Society.

Participants were followed for 14 years, from 1993 to 2006.

In the study, people were more likely to die of heart disease than cancer. After adjusting for a number of risk factors, including body mass index (BMI) and smoking, women who spent six hours a day sitting had a 37 percent increased risk of dying versus those who spent less than three hours a day on their bottoms. For men the increased risk was 17 percent.

Exercise, even a little per day, did tend to lower the mortality risk tied to sitting, the team noted. However, sitting's influence on death risk remained significant even when activity was factored in.

On the other hand, people who sat a lot and did not exercise or stay active had an even higher mortality risk: 94 percent for women and 48 percent for men.

Study lead author Dr. Alpa Patel, an epidemiologist with the American Cancer Society, said that the obvious reason for the connection is that "the more time you spend sitting, the less total energy expended and you can have consequences such as weight gain and increased obesity." And that affects your metabolism as well as risk factors for various diseases, she said.

But there could be other biological factors beyond simply getting fatter that explain the link.

There's a burgeoning literature evolving around "inactivity physiology," Patel said. When muscles, especially those in the legs, are "sitting," they stimulate or suppress various hormones which then affect triglycerides, cholesterol and other markers for heart and other diseases, she explained.

So-called information workers, who often sit in front of computers most of the day, pay heed. We'd better get up and move a lot more than we are!

Borchard is not afraid to tell of her own experiences; in fact, that is one of her great gifts to us! Highly recommended!

Enlarge By Mei-Chun Jau Jeff Livingston uses his iPad to show infomation from his OB/GYN practice's Facebook page to patient Dulce Martinez and her mother, Anastacia, in an exam room in Irving, Texas.

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  By Rita Rubin, USA TODAY
  Go into any obstetrician/gynecologist's office and you're likely to see a large bulletin board covered with snapshots of babies.

  But the docs at one Irving, Texas, OB-GYN practice have taken that ubiquitous display of cute kids into the 21st century. Their patients can post photos on the MacArthur OB/GYNFacebook page, where the doctors post news about their practice and the medical world at large. It has more than 600 fans.

  Jeff Livingston, who spearheaded the practice's venture into social media, also manages the @ macobgynTwitter account, which has about 1,600 followers. He sees Facebook as an educational and, perhaps just as important, marketing tool. "People are looking for information online," Livingston says. "I wanted them to look at our page."

  But few doctors have embraced social media as enthusiastically as he has. Concerns about time and patient privacy have deterred many.

  "No matter how you parse it, doctors don't avoid the Internet and social media because they're simply Luddites," Westby Fisher, an Evanston, Ill., cardiac electrophysiologist, wrote last month on his blog, Dr. Wes. "They avoid the Internet because they enjoy the benefits of anonymity, privacy, efficiency and legal protection that come with dropping off the grid."

  EHR: Few Americans use electronic health records
  MED STUDENTS: Doctors-to-be can cross the line online

  Closely keeping tabs on posts

  Those really haven't been issues for Livingston. In the two years since he launched the practice's Facebook page, he has had to take down content others had posted only three times.

  "What I'm watching for is that no private personal health information gets relayed via social media," says Livingston, who keeps close tabs on the page with his iPhone and iPad.

  Recently, Livingston wondered whether one new patient's posted question — could her fetus acquire an infection if she swam in a public pool? — was too personal.

  But then he remembered that many women ask that same question every summer, so he decided that posting an answer — "It is perfectly OK" — on Facebook would serve all his pregnant patients, not just the one who posted the query.

  And, Livingston says, "the time is really not an issue. Just make it a part of your normal day." When he comes across an interesting medical story, he posts it on Facebook and tweets it on Twitter. Still, he acknowledges, "just like breakfast, lunch and dinner can all get skipped during a busy workday," so can posts and tweets.

  As Nashua, N.H., internist Kevin Pho wrote in a USA TODAY op-ed piece in January, "there is little guidance on how physicians can incorporate (social media) into their medical practice."

  Acknowledging that problem, the American Medical Association's Council on Ethical and Judicial Affairs last month passed a resolution to "study the issue of physicians' use of social networking, as exemplified on sites such as Facebook and Twitter" and report to the AMA's House of Delegates at its meeting in November.

  Another roadblock, Pho said, is that doctors usually get paid only for talking to patients in the examining room, giving physicians little financial incentive to reach out to them over the Web.

  But, continued Pho, whose Twitter and Linked-In profiles refer to him as social media's leading physician voice, "doctors who are not active online risk being marginalized."

  Pho says his KevinMD blog gets 250,000 page views a month, and he has more than 22,000 followers of @ kevinmd on Twitter. "You need to have a diverse array of ways to reach patients," he said in an interview. "Patients are on Facebook. Patients are on Twitter. Patients are on blogs."

  Livingston's patient Kristi Francisco says his presence on Facebook and Twitter sealed her decision to pick him as her doctor when she moved from Tampa to Grapevine, Texas, less than a month before her daughter, now 15 months old, was born. "I like the fact that he is so plugged in to the way everybody communicates," says Francisco, a brand manager for Saber Holdings.

  Pho says that although "I don't use my blog to market my practice, it does have a positive impact in terms of recruiting new patients. They know that I'm Web-savvy."

  Not everyone is all a-Twitter

  In a comment on Pho's blog, Michael Laccheo, a rheumatology fellow at the University of Iowa, challenged the notion that doctors who aren't tweeting and friending and blogging away are in danger of becoming irrelevant.

  Some "amazing" doctors don't even know how to type, Laccheo said in an interview. While he calls what doctors do with social media more pontification than communication, "I think having an online presence is a good idea" for tasks such as scheduling appointments.

  Laccheo, who does blog, albeit infrequently, gives his cellphone number and e-mail address to his patients and posts them on his website. "They know they can get hold of me when they need me."

  When you talk to Livingston about his involvement in social media, he can sound more like a marketing expert than a doctor. SEO, short for search engine optimization, rolls off his tongue as easily as IUD, or intrauterine device, a birth control method.

  And yet, he says, his role model is more Marcus Welby than Sanjay Gupta.

  "If you go back two generations, doctors came to your house. They lived in your community. They probably went to the same church."

  With social media, he says, "what we're really doing is going back and creating a more personal experience with technology."

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SIC SEMPER TYRANNUS! ;-)

Live-Waving the Google I/O Day 1 Keynote