TAKE A STAND
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Standing desks are an exciting health trend that signals that as a society, we are becoming more aware of our physical bodies and how to take care of them. Patients frequently ask me about how changing to a stand up desk, or a transitional stand up desk unit will effect their pain. The effect of standing on specific injuries is not yet well researched. However, if you know that your pain increases when you are sitting then it may behoove you to avoid your aggravating factor, especially if your aggravating factor takes place for 8 hours at a time. The research about standing desks and pain is not very developed, but there is evidence-based information about other health benefits of using a standing desk.
One hot question is whether a stand up desk can lead to increased calorie burning throughout the day. According to available evidence, the answer is yes. Dr. James Levine is an endocrinologist at the Mayo Clinic, who studies, amongst other things, how fidgeting can burn calories. His research demonstrates that standing burns 7.2 more calories per minute than sitting. This may seem inconsequential, at first glance, but when you consider that this adds up to 30 calories per hour and 120 calories for a four hour work period it seems more significant.1 Standing may burn more calories than sitting because it leads to larger muscle group activation and these larger muscle groups then break down more sugars.2
Another concern is understanding how stand up desks can effect blood sugar.
In a basic sense, your blood sugar reflects how well your body processes food efficiently. One study looked at 23 overweight sedentary men and women who worked in an office setting to determine if alternating bouts of sitting and standing would effect blood glucose response. They found that the intervention group who alternated between standing and sitting improved their glucose response by 11%. This is relatively good news in that it suggests that mixing standing and sitting is enough to improve your body’s response to an influx of sugar. 3,4
If “sitting is the new smoking”, then will standing really impact my lifespan?
There is strong evidence that standing and moving throughout your day positively impacts longevity. A prospective study with a sample of more than 222,000 participants found that people who sit for more than 4 hours per day have an increased risk of mortality than non-sitters. This variable was found to be independent of other physical activity, which means that even if you run up a hill before work, you are not counteracting the time you spent fastened to your chair.5 Another study found a positive association between standing and mortality among 16,586 Canadian adults aged 18-90.6 This is moderately strong evidence that avoiding sitting actually improves your chances of survival. This evidence speaks to the fact that our bodies are designed to move regularly throughout the day.
But why would standing actually improve your lifespan? What specifically is so much better about standing?
Evidence points to the effect of standing on telomere length. In essence, telomeres are the bookends at the end of each of your DNA strands that keep your DNA well organized. Telomeres degenerate naturally as we age, and this process can be accelerated by other diseases like obesity.7
One randomized controlled trial found a positive association between sitting and telomere degeneration in 49 68-year olds. A randomized controlled trial with this small sample size should be taken into consideration; however, the conclusion that avoiding sitting is connected with longevity is still strong. Our bodies are designed to by dynamic and mobile. On a cellular level, we start to unravel when we are not giving our bodies the opportunity to exist in their mobile state.8
Any nurse or train conductor who stands all day can tell you that standing constantly can have its own drawbacks. Is working at a stand up desk safe for all of us?
In short, the answer is no. One longitudinal study showed that people who stand or walk 75% of the time have an increased risk of hospitalization due to diseases related to varicose veins including atherosclerosis. 9 If you are living with heart disease, contact your physician to determine if a standing desk would be appropriate for you.
So you may be wondering, should I change to a stand up desk?
The answer is, it depends. First, determine if it would be appropriate for you. If sitting aggravates your pain then a standing desk could be a straightforward way to decrease your magnitude of pain. If heart disease is a concern, check with your physician to determine how much standing is appropriate for you. If you do get a stand up desk, consider alternating between sitting and standing throughout the day. Feel your posture in dynamic sitting and standing to determine how much of each position your body needs that day. Consult with a physical therapist at Century City PT to improve your standing posture before making the transition to a standing desk. Century City Physical Therapists can help you to determine how to best use a standing desk to improve your overall health.
Standing desk references:
1. Patel, Kamal. Standing desks Part I: How many calories do you burn? Paindatabase. Available at http://paindatabase.com/standing-desk-1/.
2. Eldred Shiela M. Is sitting the new smoking? Discovery news. March 1, 2012. Available at: http://news.discovery.com/human/is-sitting-the-new-smoking-120301.htm.
3. Hutchinson Alex. How Standing up at work affects blood sugar. Runner’s World. March 19, 2014. Available at: http://www.runnersworld.com/health/how-standing-up-at-work-affects-blood-sugar.
4. Thorp AA, Kingwell BA, Sethi P et al. Alternating bouts of sitting and standing attenuate postprandial glucose responses. Med Sci Sports Exerc. 2014 Nov; 46 (11) 2053-61.
5. HP van der Ploeg, Phd, T. Chey PhD, Korda RJ et al. Sitting time and All-cause mortality risk in 222 497 australian adults. Arch Int Med. 2012; 172 (6): 494-500.
6. Katzmarzyk PT. Standing and mortality in a prospective cohort of Canadian adults. Med Sci Sports Exer. 2014; 46 (5): 940-6.
7. Reynolds Gretchen. Sit Less, Live Longer? NY Times. September 17, 2014. Available at: http://well.blogs.nytimes.com/2014/09/17/sit-less-live-longer/.
8. Sjogren Per, Fischer R, Kallings L et al. Stand up for health- avoiding sedentary behaviour might lengthen your telomeres: secondary outcomes from a physical activity RCT in older people. Br J Sports Med. September 2014. Available at: http://bjsm.bmj.com/content/early/2014/07/30/bjsports-2013-093342.short?g=w_bjsm_ahead_tab.
9. Tuchsen F, Hannerz H, Burr H and Krause N. Prolonged standing at work and hospitalization due to varicose veins: a 12 year prospective study of the Danish population. Occup Environ Med. 2005 Dec; 62(12) 847-850.
