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Standing or Sitting?

To combat the negative effects of too much sitting, standing desks have been rising in popularity. But does the science support their supposed benefits?

A recent Cochrane analysis examined the impact of workplace interventions to reduce sitting at work. To perform the analysis, researchers selected 20 studies. Studies included randomized controlled trials, cluster-randomized controlled trials, and quasi-randomized controlled trials, as well as controlled before-and-after studies with a concurrent control group.

Why is the amount of time spent sitting at work important? Since the advent of the computer, physical inactivity at work, particularly sitting, has increased in recent years. Long periods of sitting increase the risk for obesity, heart disease, and overall mortality. It is unclear whether interventions that aim to reduce sitting at workplaces are effective at reducing the amount of time spent sitting.

So the purpose of this review was to find out the effects of interventions aimed at reducing sitting time at work. The literature in various databases in June 2015 were researched and they found 20 studies with a total of 2,174 participants. Nine studies evaluated physical changes in the workplace, four evaluated changes in workplace policy, seven studies evaluated information and counseling interventions and one study evaluated both physical workplace changes and information and counselling components.

Sit-stand desks alone decreased workplace sitting with about half an hour to two hours per day. When combined with information and counseling, sit-stand desks reduced sitting at work in the same range. Sit-stand desks also reduced total sitting time (both at work and outside work) and the duration of sitting episodes that last 30 minutes or longer.

Treadmill desks combined with counseling reduced sitting time at work compared to no intervention. Pedaling workstations combined with information did not reduce sitting at work compared to information alone.

In two studies, counseling decreased sitting time by 28 minutes, and in another study mindfulness training did not have any effect on sitting at work. There was no considerable increase in work engagement with counselling.

Computer prompting software did not reduce sitting time in two studies. In another study computer prompts reduced sitting time with 55 minutes compared to no intervention. One study found that prompts to stand reduced sitting 14 minutes more than prompts to step. Computer prompts did not change the number of sitting episodes that last 30 minutes or longer.

When multiple categories of interventions were combined to decrease sitting, there was reduction in workplace sitting time at 12 weeks’ and six months’ follow-up, but there was no considerable difference between intervention and control group at 12 months’ follow-up.

Study author Dr. Jos Verbeek, a health researcher at the Finnish Institute of Occupational Health, stated in an interview with NPR that, “The idea you should be standing four hours or more a day? There’s no real evidence for that.” He added, “I would say that there’s evidence that standing can be bad for your health,” in reference to a  2005 study in Denmark that showed prolonged standing at work led to a higher hospitalization risk for enlarged veins.

So, what was learned? The quality of evidence was very low for most interventions mainly because studies were very poorly designed and because they had very few participants. The study authors conclude that at present there is very low quality evidence that sit-stand desks can reduce sitting at work in the short term. There is no evidence for other types of interventions. More research is called for to assess the effectiveness of different types of interventions for decreasing sitting at workplaces in the long term.

Note from Publisher Steve Freed: Stay tuned. I am ordering a stand-up desk and will report my BP, Weight, A1c and BMI in 6 months.

Practice Pearls:

  • The evidence is still not complete to determine any benefits to using a standing desk.
  • Studies have been poorly designed and had very few participants.
  • Too much sitting increases heart failure risk and disability risk, and shortens life expectancy, studies have found.

Workplace interventions for reducing sitting at work, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010912.pub3/abstract. Cochrane Database of Systematic Reviews, March 17, 2016.

Stand To Work If You Like, But Don’t Brag About The Benefits, http://www.npr.org/sections/health-shots/2016/03/17/470713717/stand-to-work-if-you-like-but-dont-brag-about-its-benefits. NPR, March 17, 2016.