Are you sitting down? Like most Americans on most days, the answer is probably yes. We are living in an age where the average person spends most of their day (and most of their life) on their butt.

Unfortunately, all of that sitting is associated with an increased risk of illness and death. It seems like regular exercise would be the obvious solution to this problem… but even a gym session at the end of a long day at work does not completely undo the effects of an entire day in a desk chair. But before you go and cancel your gym membership, let’s take a deeper dive into why inactivity is such a problem, and what steps we can take to reverse the effects. In order to understand why inactivity kills, one of the most useful places to look is at the inner lining of our blood vessels.

All of our blood vessels are lined with a slippery smooth teflon-like coating that is called the vascular endothelium. The endothelial layer is just one cell thick… but it is responsible for several critically important roles in vascular health. Endothelial cells are in direct contact with the blood, and they have sensors that constantly monitor blood flow and then make adjustments to keep the blood flowing smoothly. They can cause arteries to contract and relax, which can adjust blood pressure depending on your activity level. A healthy endothelium also keeps blood flowing smoothly, which prevents clots from forming inside vessels. Endothelial cells do not like inactivity… at all. Sitting causes decreases in blood flow and pooling within vessels that can impair endothelial function. Needless to say, you want to do everything you can to keep your endothelium in tip-top shape.

Maintaining a healthy endothelium is easy… and it should be no surprise that the things that improve endothelial function also improve general health and longevity as well. Here are the top 5 things that you can do to optimize endothelial health:

1) Walk: I’m like a broken record and a creature of habit on this. I’m a broken record because I tell all of my patients and many thousands of readers that they need to go for a walk every day. I say it again and again. I’m a creature of habit because I go for a 45 minute walk every day myself. Every day. I do it again and again. And you should too. Your endothelium will thank you.

2) Take breaks: This is especially important for those who have desk jobs or anyone who spends the majority of the day sitting. Endothelial cells respond best to activity that is done throughout the day rather than in one big hit at the gym after work. Don’t get me wrong…hitting the gym is great, it just does not help the endothelium very much when it happens after an entire day of inactivity. This does not need to be “exercise.” Just one or two minutes of standing, stretching, or walking every hour will do the trick.

3) Quit smoking: Endothelial cells are particularly vulnerable to the effects of oxidation… which is just one of the many reasons why smoking is so damaging.

4) Eat well: Studies have shown that endothelial cells are incredibly sensitive to dietary changes, and there is a right way and a wrong way to eat for endothelial health. Even a single fast food meal can impair endothelial function for hours. The good news is that making healthy choices can improve endothelial cell function impressively. Top food choices for endothelial health are:

– Berries
– Nuts and seeds
– Wild salmon
– Black or green tea
– Herbs and spices

5) Turmeric: This Indian curry spice deserves special mention here. Turmeric is a powerful anti-inflammatory herb, and there is a of research demonstrating its health benefits as a food and as a supplement. It has also been shown specifically to be beneficial in terms of improving endothelial function. Researchers have even compared turmeric to regular exercise and found that they have comparable effects, leading to the suggestion that people who are unable to exercise could consider using turmeric as an alternative. Several studies have demonstrated this effect, and it has even been shown that turmeric plus exercise is better than either one alone.

Endothelial function is a new and exciting horizon in cardiovascular health and in medicine in general. As tests for endothelial function become more widely available, there is no doubt that the care and feeding of these special cells will become a major focus for treatment and prevention. Why not start now?

-Dr. Joshua Levitt