The Facts About Sitting, Standing and Your Health

By Dace L. Trence, MD, FACE

By Dace L. Trence, MD, FACE

The Boston Globe recently referred to sitting as the modern poor health equivalent of smoking. And yes, we are spending much more time sitting these days. Sitting in front of office computers, sitting in front of TV screens, sitting while working, sitting while driving and sitting while eating. Sitting, sitting, sitting!

Standing, and especially standing work stations or desks, are being advertised as the solution to the escalating rates of diabetes, heart disease and obesity. But they can be expensive and outright uncomfortable. And how can you run a meeting behind a standing desk – should your meeting require everyone then stand? Are we in an era of “the sitting disease”? Just what are the facts, the data, that prove this is so important?

Analyses suggest that, on the average, each of us spends nine of our 14 waking hours in an office chair or on the couch, which is indeed a very substantial portion of each day!

Many studies reported over the past decade suggest that too much sitting leads to more disability as we age. It has been associated with a doubling of the risk of developing diabetes and heart disease, and it has been suggested that spending too much time sitting could even shorten your life. A Harvard study in 2014 involving more than 92,000 women reported that the more time study participants spent sitting at work, driving, or watching TV, the greater their risk of dying from heart disease, cancer, or strokes.

While standing in one place while you are working, rather than sitting at your desk, will help you lose pounds, improve your heart health and prevent other health concerns associated with too much sitting, some occupational health specialists worry that there could also be negative effects. They remind us of why chairs were developed for the work place, suggesting that chairs help decrease varicose veins, curvature of the spine and arthritis. While standing burns a few more calories as our hearts work harder to circulate blood upward, it also puts more strain on our veins, backs and joints, especially if you are overweight.

Also, researchers have not yet made clear whether the health benefits of reduced sitting time potentially come from just moving around more or from standing still – a bit difficult to determine as you can guess, as when we stand, we do not stand at attention, but continually move. We shift positions, shift weight bearing from one side to the other, move our arms more. And results of studies about whether exercise reduces the health risks of sitting are actually not all in agreement.

A study of nearly 17,000 Canadian adults found that those who reported the most time standing had a 33 percent lower risk of dying from any cause over 12 years compared to those who stood the least. But those who exercised at least two hours each week — even if they sat the rest of the time — had the same positive impact in benefit that extended their life as those who stood the most. This would suggest that if you sit a lot, but also exercised, the sitting would not matter as much.

But, in direct contrast, the Harvard researchers in the study mentioned earlier found that regular exercise did not decrease the increased death risk associated with prolonged sitting.

In terms of calorie burn and physical exertion, standing in one place is the same as 1.3 MET (a measure of the energy cost of physical activities) compared to 1 MET for sitting. Compare this to walking at a 3-mile-per-hour pace, which is a 3.3 MET activity, and jogging as a 7 MET, translating to a 7 times energy-burning activity than the energy burned when than your body is at rest. So, if you are looking at the hard number of calories burned sitting versus standing, there’s not much of a difference. But this could be a bit misleading, in that standing at a workstation encourages us all to move around more and so indirectly burns significantly more calories. And calorie burn might not be the only benefit to better health.

In another 2014 study, 28 office workers who were given a sit/stand desk for a month reduced their time spent in a sedentary position by 38 minutes a day compared to when they used a traditional desk. Very importantly, these workers also reported a boost in their mood, increased energy and reduced fatigue. Benefits have also been reported from more engagement with others in the office: you are more likely to speak with others, touch bases, just interact. And we are just becoming aware of the health benefits of socialization, which addresses another modern-day health concern, “social isolization disease.” It is now recognized how critical social contact can be, particularly as we age.

And there is also a chemical basis to support that sitting is not healthy. A fat-burning enzyme called lipoprotein lipase increases when muscles get activated by moving around. Animal studies support the premise that keeping an organism in a fat-burning metabolic state helps improve cholesterol, blood sugar, and high blood pressure.

As to aging, just recently a study suggested that sitting shortened a cell component called telomeres, especially for women. And shortened telomeres are associated with faster aging. In this study of nurses’ health, women who did not get in a daily half-hour of exercise and those who spent more time sedentary (about 10 hours or more) had shorter telomeres than those who spent less time sitting every day. The effect of shortening this cell component was believed to be the equivalent of about eight years of aging! So, inactive women who spent more time sitting were about eight years older, on average, than those who were inactive but spent less time sedentary.

People who stand live longer and have longer telomeres, an indicator of good health and longevity. But many workers may find it too difficult to use their computers or even read while standing, even more so if their standing workstation is linked to a treadmill or a constantly moving conveyor belt. It can also be difficult to speak on the phone or respond to co-workers or colleagues while you’re walking on a treadmill. But treadmills can be stopped, and many people find that breaking up their work time between standing and sitting works better for their work flow than just standing alone.

Sit/stand desks that can be easily adjusted, or using a standing desk with a high-rise chair, can provide comfort and prevent back and joint problems. But you can also place your desk on supports to raise it, or place a small table on the desk to raise the work or computer level; both could be easily removed periodically. And stools can be an easy solution for alternating between sitting and standing.

So, what is best for your muscle and joints and your mind’s productivity?

Experts recommend that you sit for no more than 20 minutes at a time and stand still in one position for no more than 8 minutes. You should also take a two-minute moving break at least twice an hour to stretch or walk around. After all, if you don’t stand up for your health, who will?!