Sitting is the New Smoking? Health Benefits of Standing vs. Sitting

“Sitting disease” is a (non-medical) term given to the long-term effects of sitting too long and a sedentary lifestyle, in general. Recently studies have been published about the health effects of desk jobs – that is, any job for which the employee sits for most or all of the day. Chronic diseases such as cardiovascular disease, obesity, type 2 diabetes, breast and colon cancer have been linked to sedentary behavior. The health effects are so bad in fact, that Dr. James Levine of the Mayo Clinic-Arizona State University Obesity Solutions Initiative declared “sitting is the new smoking.”

Standing is something that nurses do in the normal course of a day. Well, actually, running is what many nurses do – running to and from patient rooms and all the other places they have to be in the course of providing excellent care. So because sitting is “bad” for you, nurses must be pretty healthy, right? Not necessarily. Standing too much can cause as many problems as sitting too much!

Health Effects of Too Much Standing and Too Much Sitting
Standing too long can cause short-term problems such as aching and swollen feet and legs, and stressed joints. The muscles used to keep you upright are constantly adjusting causing your legs to feel tired and your full body weight is supported by your legs and feet causing achy legs and feet. Your calf muscles can’t help your heart to pump pooled blood and lymph back up to your heart (musculovenous pumping) without muscle contractions from movement causing leg and ankle edema (Blevins, 2015).

Long-term problems resulting from too much standing still include chronic fatigue, varicose veins, deep vein thrombosis, muscle aches, and back problems (Fernandez, 2015).

Too much sitting and sedentary behaviors also cause both short-term and long-term health effects. Weight gain, metabolic abnormalities, cardiovascular disease, and cancer have been associated with prolonged sitting time (Grunseit et al., 2013).

To give you an idea of the metabolic impact of sitting versus standing and activity, calories burned when standing range from 85-110 per hour up from 50-70 calories an hour burned while sitting. Walking burns about 180-280 calories per hour and pedaling (e.g., a bike desk) will burn 200-300. While another study shows only a small increase in calories burned standing versus sitting. Obviously, gender, body weight, diet, and other variables will affect your metabolic rate. So while standing may increase your calorie burn by about 20% per hour, you can burn more calories by taking a 20-minute walk during your break (Miller, 2015).

What Does the Evidence Show?
There are many studies on the health effects of standing and treadmill desks, but the bottom line is that the evidence for standing and treadmill desks is variable and more research needs to be conducted (MacEwen, MacDonald, & Burr, 2015; Shmerling, 2016; Shresthra et al., 2016). I’ll mention just a few of the recent studies conducted on this issue.

A systematic review of standing and treadmill desks by MacEwen, MacDonald, and Burr (2015) showed that the best physiologic outcomes related to postprandial blood glucose, HDL cholesterol levels, and body shape, size, and composition were associated with the use of a treadmill desk over a standing desk. Though other studies have shown an improvement in mood and well-being, the psychological effects of a standing or treadmill desk, in this study, were not significantly different. Dunstan et al. (2012) found improved glucose metabolism in terms of a decrease in postprandial glucose and insulin levels when sitting time was interrupted with short two-minute breaks of either light or moderate walking every 20 minutes.

Grunseit, Chau, van der Ploeg, and Bauman (2013) found that having the option of an adjustable sit-stand desk reduced the average amount of time sitting at work from 85% to 60% of the day and from an average of 6.9 hours to 5.4 hours of actual sitting time. In addition, most workers found the sit-stand desk easy to use. Carr, Swift, Ferrer, and Benzo (2016) also found that workers with sit-stand desks sat less and stood more than workers without sit-stand desks. Systolic blood pressure, body weight, lean mass, and BMI decreased with increased standing.

The point is to do something other than sitting all day long. If you can break up long periods of sitting with some kind of activity or position change, that’s good. Getting steps in while you’re working, whether you’re working on a treadmill desk or walking around the office, during a break, is a worthwhile goal.

Treadmill Desks
Now, I’ve never tried a treadmill desk and many people swear by them (my sister included) – but I really wasn’t sure if I could work on my laptop and walk at the same time! I need to be able to concentrate when I’m working and I felt I would be distracted.

Plus, I use an elliptical stepper to work out and I walk the dogs every day — so I felt like I was getting enough steps without walking while working, too. And I didn’t really want to replace my desk or have an extra piece of equipment in my office.

Studies of the use of treadmill desks have shown benefits similar to standing desks including weight loss; reduced stress; improved mood, creativity, and productivity; and stronger bones.

Standing Desks
Because I sit – a lot – to do my writing and for teaching my online classes, I decided to get a standing desk to make myself less susceptible to health problems related to too much sitting.

Benefits of standing desks include relief of fatigue, joint, and low back pain; decreased risk of heart disease and diabetes; and increasing creativity, energy, and mood.

I did a lot of research first on what to buy (for those of you who are fans of Gretchen Rubin’s Happier podcast and her Four Tendencies Framework — I’m a Questioner!). Instead of replacing my office desk with a standing desk or treadmill desk, I opted for an adjustable desk that sits on my current desk.

I bought a VARIDESK using the Amazon website. I love this product! It is easy to use and smoothly changes from sitting on the desk to a comfortable standing height within seconds. (That’s my dad on my screensaver!)

My VARIDESK standing desk extended
My VARIDESK standing desk extended

When I first got the VARIDESK, I was so excited to be doing something good for myself, that I stood for more hours than I sat the first few days. I came to quickly realize that that is a big no-no; I had leg fatigue and lower back pain as a result. (Oh, and I didn’t have a good mat to stand on, either.) Learning how to use your standing desk correctly can decrease muscle problems, increase satisfaction with use, and decrease abandonment of this intervention, according to a 2013 study (Miller, 2015).

You need to ease into standing for increasing periods of time if you are used to sitting all day. Again, standing still all day has the same risks as sitting still all day. Decide on how much time you want to stand and gradually increase the time periods as the days go by. VARIDESK has an app that you can customize to remind you when it’s time to stand or sit down. Or you can use a timer or your focused-work Pomodoro Timer to signal you when it’s time to stand up or sit down.

Other suggestions for setting up and using your standing desk correctly include investing in a good gel mat to stand on and using ergonomic principles to use your computer comfortably while standing. The computer screen or monitor should be about 15-30 inches from your eyes, eyes looking straight at or slightly below the screen monitor, wrists should be flat, and your elbows should be at 90 degrees (Miller, 2015; Trafecanty, 2017). And try to stand up straight.

It’s important to still move around even when you’re using a standing desk; as I noted earlier, standing still in one place isn’t good for you either (Blevins, 2015; Miller, 2015)! “When you’re standing, that might mean using a foot rest to take the weight off of one foot and then the other. When you’re sitting, it can mean reclining so your legs and torso form a 135-degree angle – the healthiest seated position” (Miller, 2015, Mistake No. 2).

Alternate Sitting with Standing
So where is the balance?

The balance is in knowing when to sit down and when to stand up.

Standing for two hours at a time is not linked to health problems according to a researcher in this field (Mozes, 2015). But people who stand for periods longer than 2 hours are subject to fatigue and other short- and long-term health effects.

Breaks are important – whether you are sitting or standing! Plan to move around after 30 minutes or at least on the hour (maybe, again, using your Pomodoro Timer to remind you). Get up if you are sitting and sit down if you have been standing. Even a two-minute break to move around or change position can be of benefit (Collins, 2012; Dunstan et al., 2012).

Change your activity or position for a period of time. Suggestions include going to the restroom, delivering paperwork to a coworker, picking up the mail or copies from the copier, getting a beverage from the break room, or taking a short walk (Mozes, 2015).

Stretching exercises could help alleviate “the issues with prolonged sitting and prolonged standing” (Mozes, 2015, para. 13) such as hip, hamstring, and back injuries (Collins, 2012). Stretching increases flexibility and circulation to muscles and joints. Every hour, two-minute stretch breaks to reverse the sitting posture is recommended (Collins, 2012). Reversing the sitting posture by doing simple back stretching exercises can be helpful in preventing chronic pain.

Let me know in the comments if you use a standing, treadmill, or bicycle desk and how you like it.
References
Blevins, M. (2015, September 25). Why standing in one place makes your legs more sore than walking. TodayIFoundOut.com. Retrieved from http://www.todayifoundout.com/index.php/2015/09/standing-one-place-can-sometimes-make-legs-sore-walking/

Carr, L. J., Swift, M., Ferrer, A., & Benzo, R. (2016). Cross-sectional examination of long-term access to sit-stand desks in a professional office setting. American Journal of Preventive Medicine, 50(1), 96-100. doi: 10.1016/j.amepre.2015.07.013. Epub 2015 Oct 1.

Collins, S. (2012). The truth about stretching: Find out the best ways to stretch and the best times to do it. WebMD.com. Retrieved from http://www.webmd.com/fitness-exercise/features/how-to-stretch#1

Dunstan, D. W., Kingwell, B. A., Larsen, R., Healy, G. N., Cerin, E., Hamilton, M. T., … Owen, N. (2012). Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care, 35(5), 976-83. doi: 10.2337/dc11-1931. Epub 2012 Feb 28.

Fernandez, C. (2015, July 16). Now too much STANDING is bad for you: Being on your feet for long periods of time at work can lead to painful back and muscle problems in later life. DailyMail.com. Retrieved from http://www.dailymail.co.uk/news/article-3163165/Now-standing-bad-feet-long-periods-time-work-lead-painful-muscle-problems-later-life.html#ixzz4nD5x5GP2

Grunseit, A. C., Chau, J. Y., van der Ploeg, H. P., & Bauman, A. (2013). “Thinking on your feet”: A qualitative evaluation of sit-stand desks in an Australian workplace. BioMedCentral Public Health, 13, 365. doi: 10.1186/1471-2458-13-365.

MacEwen, B. T., MacDonald, D. J., & Burr, J. F. (2015). A systematic review of standing and treadmill desks in the workplace. Preventive Medicine, 70, 50-8. doi: 10.1016/j.ypmed.2014.11.011. Epub 2014 Nov 28.

Miller, A. M. (2015, February 17). 5 Ways your standing desk is doing more harm than good. US News & World Report. Retrieved from http://health.usnews.com/health-news/health-wellness/articles/2015/02/17/4-ways-your-standing-desk-is-doing-more-harm-than-good

Mozes, A. (2015, July 28). Standing all day at work may take a toll on health. WebMD.com. Retrieved from http://www.webmd.com/back-pain/news/20150728/standing-all-day-at-work-it-may-take-toll-on-health#1

Shmerling, R. H. (2016, September 27). The truth behind standing desks. Harvard Health Publications. Retrieved from http://www.health.harvard.edu/blog/the-truth-behind-standing-desks-2016092310264

Shrestha, N., Kukkonen-Harjula, K. T., Verbeek, J. H., Ijaz, S., Hermans, V., & Bhaumik, S. (2016). Workplace interventions for reducing sitting at work. The Cochrane Database of Systematic Reviews, 3, CD010912.

Trafecanty, T. B. (2017, May 18). The benefits and considerations of using a standing desk. Huffington Post.com. Retrieved from http://www.huffingtonpost.com/thomas-b-trafecanty/the-benefits-and-consider_b_9996782.html

 

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