Daily Bulletin 2015

Getting Out of the Reading Room May Be Better for Your Health

Wednesday, Dec. 02, 2015

Presenters Sameer Mittal, M.D., and Jason Hoffmann, M.D.

Multiple studies have linked sedentary behavior to diseases including obesity, diabetes, hypertension and heart disease. For that reason, radiologists who spend the vast majority of their workday in a seated position may be at increased risk, particularly if they do not have a routine exercise program outside of work.

While working with radiation might be considered an occupational hazard, the sedentary nature of image interpretation can pose its own very real and potentially dangerous health risks, said Jason Hoffmann, M.D., assistant professor of radiology at the Winthrop-University Hospital in Mineola, NY, who presented a storyboard exhibit on the topic Tuesday.

"While fluoroscopy and sonography can have components of imaging acquisition and/or interpretation that may be a bit more active, the majority of image interpretation performed by diagnostic radiologists involves the sedentary process of image review on a computer workstation while in the seated position," Dr. Hoffmann said.

He cites a recent meta-analysis performed by Biswas, et al., associated sedentary behavior with all-cause mortality, cardiovascular disease mortality, cardiovascular disease incidence, cancer mortality, cancer incidence and Type 2 Diabetes incidence, Dr. Hoffmann said.

"Even for those who exercise regularly, spending increased time sitting can negate the healthy effects of exercise," Dr. Hoffmann said. "Moreover, prolonged periods of time spent in the seated position lead to a slowing of one's metabolism."

It is important for radiologists to address the health risks of sedentary behavior and to understand the three basic components of human daily energy expenditure: the thermic effect of food, the basal metabolic rate, and activity thermogenesis (both exercise-associated thermogenesis and non-exercise activity thermogenesis), Dr. Hoffmann said.

Activity thermogenesis is approximately 30 percent of daily energy expenditure, and is subdivided as exercise-associated thermogenesis (EAT) or as non-exercise activity thermogenesis (NEAT). NEAT refers to the energy expended during normal activities of daily living. With relatively simple changes in work environment and work habits, radiologists can implement NEAT-related behavior modifications, Dr. Hoffmann said.

A number of basic exercises can be incorporated into the radiologists' work routine, including leg lifts, seated spinal twists, side stretches and neck rolls, Dr. Hoffmann said. The radiologist can intermittently stand while dictating, incorporate fidgeting, tap foot, drink water (out of a smaller container to force walking to the water cooler), walk and park further away, take the stairs, and aim for 10,000 steps per day.

All of these improvements can be made progressively, as this will likely lead to increased adoption rate and overall compliance with the regimen, Dr. Hoffmann said.

Question of the Day:

I am treating a patient for thyroid cancer with Iodine 131. He makes pasta for a living and wants to know when he can go back to work.

Tip of the day:

Tendons and ligaments may experience "magic angle artifacts" caused by very short T2 times when the tightly bound collagen is at ~55 degrees from the main magnetic field.

The RSNA 2015 Daily Bulletin is owned and published by the Radiological Society of North America, Inc., 820 Jorie Blvd., Oak Brook, IL 60523.