In my last post, I discussed the results of a recent study that found our sedentary editing and writing jobs increase our risk for some cancers. In part two, I offer some tips that may just save your life (I like to think so anyway).
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Move during the day
“Sitting is the new smoking,” says Brigid Dineen, Life Coach, yoga instructor, and organizer for the Yogapalooza festival in Toronto. “Although you can’t quit sitting, you can take action to minimize its consequences on your health and well-being.”

Brigid suggests we take a break and get moving at least once an hour. “It will help to improve your posture, your circulation, your stress levels and mood, and your mental focus. You will also reduce your risk of back pain, weight gain and becoming a ‘zombie’ from staring at the screen for too long.”
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Any activity will do. Take a walk, do some stretches, or—Brigid’s favorite—take a dance break! Be intentional about taking a break or the day will get away from you (even set a timer to remind you). Here are some great options:

• Yoga at Your Desk
• Sun Salutations
• Dance to Pharrell Williams’ “Happy”!

Get your vitamin D
Vitamin D deficiency may be the biological pathway through which excessive sitting increases cancer risk. If you can’t get outside during the day for a walk to catch some natural vitamin D, take a supplement.

Be more active outside work hours
Sitting risk is cumulative. If you work at a desk all day and spend your evenings sitting on the couch watching TV, you are in real trouble. Spend your leisure time being more active. Take a walk. Take up a sport. Learn ballroom dancing. Just get moving!

For your workspace
Some people like to use a standing desk or sit on an exercise ball while working. Even just placing your garbage can or printer on the other side of the room will help because you will have to get up to use them during the day.

Tell us, what do you do to break up your sitting time during the day?

​I never considered editing a dangerous job. In fact, editing fulfilled all my safe job criteria: it involved a lot of sitting and could be done in my pajamas. The only danger was an occasional coffee spill. New research finds sedentary desk jobs, such as writing or editing, can increase our risk for cancer—and even exercising every day does not reduce this risk.

Sitting is the new smoking
Excessive sitting has already been found to increase our risk of obesity as well as cardiovascular disease, diabetes, hypertension and even depression. According to a recent meta-analysis of 43 observational studies that included over 4 million individuals and 68,936 cancer cases, increased sitting time each day also increases our chance of colon, endometrial and lung cancers. In addition, each two-hour per day increase in sedentary time was related to a statistically significant 8% and 10% increase in colon cancer and endometrial cancer risk, respectively (a 6% increased risk of lung cancer was borderline significant).
Several mechanisms were suggested including increased weight gain and obesity, vitamin D deficiency, and inflammatory responses triggered within the body.

All sitting is not created equal
Sitting watching TV was found to more detrimental than occupational sitting. Another prospective study reported that each two-hour per day increase in TV time was associated with a 23% increased risk of obesity, but only a 5% increased obesity risk for sitting at work time. The authors suggest that this is because we are more likely to snack on unhealthy food while watching TV.
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Exercise isn’t enough
Perhaps even more concerning was that adjusting for exercise did not affect the positive association between sedentary behavior and cancer in this most recent study. This means that the increased cancer risk is not just due to inactivity and that exercising after sitting all day isn’t enough to counteract this risk. It is like thinking that going for a jog will make up for smoking a pack of cigarettes a day.
But wait—you don’t need to change careers! Read part two to find ways to lessen your risk.

For a recent class in Advanced Writing for Health Communicators, we had to compare the websites of the Boston Ballet and the Boston Red Sox. The Boston Ballet website is sophisticated, formal, and elegant; the Red Sox website is bright, energetic, and busy. The writing and the readability of the websites are also very different indicating that they are purposefully trying to reach very different audiences. So what exactly is readability and how can you gauge the readability of your own documents? Read on to learn more.

Readability and readability tests
Readability is the ease with which your writing can be read. Readability tests are mathematical calculations typically based on the difficulty of the words used (i.e., the average number of syllables per word) and the difficulty of the sentences (i.e., the average sentence length). For this article, I will discuss only the ones that are freely available and built into Microsoft Word.

Pros and cons of readability tests
Readability tests are only predictions—they are not the definitive measure of how good your writing is. They should be used as a quick assessment during the writing/revision process. As Cheryl Stephens writes in her article All About Readability, readability tests cannot measure reader interest or enjoyment. They also cannot measure if your content is presented in a logical order, how well complex ideas are presented, or if your vocabulary is appropriate. Readability tests are best used as a screening device and they should not be the only tool you use for assessing your text. They are also good for gauging improvement in your writing if you are trying to learn how to write more clearly because they provide a quantitative number for comparison.
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Comparing ballet and baseball
For my class, I compared the readability stats of the history page of the Boston Ballet website and the 2010s history timeline of the Red Sox website. In Microsoft Word, the readability statistics are available in the Review toolbar under Spelling and Grammar. You may need to make sure that “Check grammar with spelling” is checked under Proofing in the Options menu first.
The Ballet site had more words per sentence and more characters per word than the Red Sox site (i.e., used bigger words and longer sentences). Readability testing results are listed below:

Passive sentences
The test simply finds the percentage of sentences in the document that are written in the passive voice. For writing in plain language, one of the first tips is to write in the active vs. the passive voice. In the active voice, the subject does the acting (e.g., the cat chased the dog); in the passive, the subject is acted on (e.g., the dog was chased by the cat). (I use these examples because that is the way it happens in my house.) Passive sentences flip around the sequence and natural order of the sentence and are more difficult to read. There is no strict guideline, except try to keep it as low as possible. Greater than 5% would be too high for plain writing. Surprisingly, the Red Sox site not only had more passive sentences than the Ballet site, but at 12%, it was well above an appropriate level. Not only are active sentences easier to read, they have more energy, which is exactly what they should be going for on the Red Sox site. I expected that the proportion of passive sentences would have been higher for the Ballet site—the fact that it is not shows that they had a good writer.

Flesch Reading Ease
The Flesch Reading Ease test rates text on a 100-point scale. The higher the score, the easier it is to understand the document. For most standard documents for a general audience, the score should be between 60 and 70. Neither the Ballet or Red Sox site made this cutoff (19.6 and 51.5, respectively), but the Ballet website was definitely low indicating that they were not even attempting to reach a “general” audience. The Red Sox site is obviously trying to reach this general audience but missed the mark.

Flesch-Kincaid Grade Level
The Flesch-Kincaid Grade Level test rates text on a U.S. school grade level (e.g., a score of 8.0 means that an eighth grader can understand the document). Most documents for a general audience should score between 7.0 to 8.0. Again, both websites scored outside of this ideal range for a general audience. The Red Sox site read at a grade 10 level and the Ballet site read at a senior year in university level. The Ballet site appears to be focusing on people who are university/college-educated (and who potentially have money and will buy tickets and/or donate) and the Red Sox site is geared toward those with a lower high school education.

The takeaway from these tests is that both websites are trying to reach a different audience with their writing, although the Red Sox site was the less successful of the two. The Red Sox site should be geared toward a more general audience; therefore, the passive sentences should be at a minimum, the Flesch Reading Ease test score should be well about 60, and the Flesch-Kincaid Grade Level needs to drop a few years.

Other methods of testing readability
Here are some other suggestions for testing and improving the readability of your work:

1. Use a guideline or checklist as you write, such as the US National Institutes of Health Plain Language Checklist or the PlainLanguage.gov Document Checklist for Plain Language
2. Devise your own document audit instrument or questionnaire to use
3. Ask an expert in the field who knows the needs and characteristics of your audience to review your work
4. Test your work with a sample reader or a focus group and revise based on what you have learned
5. At the very least, sleep on it and re-read it again the next day with fresh eyes

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Identify your audience
The most important thing you can do to make sure that you are reaching your audience is to determine who your audience is. Before you even start writing, ask yourself:

• Who is my audience?
• What is my purpose or message?

If you can answer these questions and keep these answers in mind while writing, you will go a long way toward reaching the audience you intend to reach.

I edit so many research papers in which the writers take the most convoluted and circuitous routes to get a simple point across. Instead of being impressive and scholarly, it is just confusing. Your writing is more effective—and your reader can actually understand it—when you use plain language.
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The “Dizzy Awards” have been given out by the Texas Heart Institute Journal for the past 30 years for excellence in “unintentionally comical, bewildering, or downright terrible” medical writing (they don’t name names). Check out this gem that was published in a prominent medical journal:

Use the active versus the passive voice
In the active voice, the subject does the acting; in the passive voice, the subject is acted on. For example, “constipation is reported in over 33 million adults…” (2009 Dizzy Award Winner) should be “33 million adults reported constipation…” (and reports can’t appear in patients!).
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Use common, everyday words
Basically, use the simplest word for the job. For example, use “use” versus “utilize.” Technical terms are fine, but be aware that your reading audience may come from different research areas or other countries that use different technical terms. Rule number two in George Orwell’s Six Rules for Writers is “never use a long word where a short one will do” and number five is “never use a foreign phrase, a scientific word, or a jargon word if you can think of an everyday English equivalent.”  Listen to George, he knows what he is talking about.

Define all of your abbreviations or acronyms on first use
Sure, it may be a common abbreviation used by everyone in your nuclear physics lab, but be aware that people from outside your lab or from other countries may use different ones. People from other specialties may use the same acronym for an entirely different term. In medicine, “CA” is the abbreviation for cancer, cardiac arrest, chronologic age, contrast angiography, and others. Avoid confusion and define your terms. And remember to define on first use in both the abstract and the body of the paper.

Avoid using abbreviations or acronyms for convenience
Many authors will devise their own sets of abbreviations or acronyms for use in a single paper. These ones are not in common use and are devised by the author so that they do not have to write certain phrases over and over again (lazy!). For clarity, keep the terms expanded. The exception to this is in tables where space is at a premium. Even then, the abbreviation(s) should be clearly defined in the caption or in a footnote. For example, in “Because it is both a common and serious condition, elderly nursing home (NH) residents are…” (2010 Dizzy Award Winner), nursing home should be left expanded—and being a resident is not a common and serious condition to top it off.

Write in the positive versus the negative
Each negative term used obscures the clarity of your message exponentially. Look at these examples:

• “Unlike salicylates, we are unaware of any case reports…” (2009 Dizzy Award Winner)
• “In contrast to the urinary tract, hepatobiliary tumors infrequently cause bleeding in the biliary tract.” (2012 Dizzy Award Winner)

It is much clearer to say “There are many case reports for salicylates…” and “…hepatobiliary tumors rarely cause bleeding…”

Avoid redundant and ambiguous words
Phrases such as fewer in number, future plans, and sum total are all redundant (i.e., both words mean the same thing). An example of redundancy is the “one solitary” used in this sentence (and is there an Alcoholic Skeletal Myopathy Journal for this to be described in?):