Do Sit-Stand and Walking Workstations Solve the Inactivity Issue?

The media and many researchers seem to take perverse pride in talking about the percentage of the population who are over-weight, obese, and physically inactive. Along with this, researchers and the media were quick to call prolonged sitting the “new smoking.” The fact is, the risks from smoking and sitting are dramatically different. Smoking is considered one of the most addictive activities known to man, whereas sitting is a habit. However, there are researchers who indicate the attempt to decrease sitting by using a standing desk only decreases sitting by a short period of time throughout the day.

Learning Objectives

1. Understand that sitting is not the “new smoking.”
2. Indicate how much sit-stand desks decrease sitting during the day.
3. Describe how simple ergonomic solutions can play an important role in health and work productivity.

Is Sitting Really the New Smoking?

The media often say sitting is as bad as smoking. These kinds of headlines began appearing in 2010 and have been cited in mainstream newspapers and magazines. It is estimated that news stories with “sitting is the new smoking” headline increased 12-fold from 2012 to 2016 (Vallance, et al., 2018). Similar headlines can be found in academic journals and are being promoted by institutions such as the Mayo Clinic (2014). Mula (2018) suggests that fear-based advertising, saying sitting is the health equivalent of smoking, has entered many work environments. Vallance, et al. (2018) remarked that the media and academics must be cautious about comparing an addictive behavior like smoking to a habit of sitting.

Vallance, et al. (2018) data showed there were more than 2000 deaths from any cause per 100,000 people per year among heavy smokers compared with never smokers, versus 190 deaths per 100,000 people per year when comparing people with the highest volume of sitting with the lowest volume of sitting. Vallance, et al. (2018) also indicated that it is obvious from examining the smoking research that sitting and smoking have different levels of health risk. The mass-media’s enthusiasm for labeling sitting as the new smoking has outpaced available scientific evidence that there is any comparison between sitting and smoking (Vallance, et al., 2018).

Is There a Risk of Sitting Too Much?

Biswas et al. (2015) indicated that compared with lower volumes of sitting (less than 4 hours/day), high volumes of sitting (more than 8 hours/day) have been found to be associated with adverse health factors. It appears that excessive sitting time almost doubles the risk of type-2 diabetes, but only increases incidence and mortality risk associated with other common diseases by approximately 10% - 20%. Sitting has also been found to be associated with a higher risk of depression and lower quality of life (Boberska, et al., 2018).

Research has investigated if the adverse effects of prolonged sitting can be decreased by physical activity. The largest study was an analysis of 1,005,791 individuals showing significant associations of daily sitting time and watching TV with all-cause mortality in adults with low or moderate physical activity levels. A high volume of moderate intensity activity (60–75 minutes per day) was necessary to fully decrease all-cause mortality risk associated with sitting time, but failed to completely reduce risks associated with television viewing time (Ekelund, et al., 2016). However, overall, there is insufficient objective evidence to make specific recommendations in relation to how much sitting time is hazardous (Vallance, et al., 2018).

Standing versus Sitting

Kukkonen-Harjula, et al. (2018) used a Cochrane review to investigate the effects of techniques used to reduce sitting time at work. They found 34 studies with 3,397 employees from high-income countries. Using sit-stand desks appears to reduce sitting an average of 84 - 116 minutes per day. When combined with health counseling, the reduction in sitting was the same. Sit-stand desks also decreased the length of "sitting episodes" that last 30 minutes or longer, both at work and at home. The authors indicate that office workers need to stand two - four hours a day to prevent or reverse sitting related conditions, and as such, the 84 - 116 minutes provided by the standing desk is insufficient. The researchers indicate the studies they reviewed followed subjects for three - six months, which is not long enough to assess long-term effects of sitting and/or standing.

Two studies in the review used computer software to prompt workers to stand or walk, but it did not reduce sitting times. Another study with computer prompts helped reduce sitting time by 55 minutes. Prompts that asked workers to stand up reduced sitting 14 minutes longer than prompts that asked them to walk. Researchers said computer programs to promote standing or walking had an inconsistent effect on sitting times.

Kukkonen-Harjula, et al. (2018) suggest there is low-quality evidence that using sit-stand desks reduces workplace sitting in short-term and medium-term studies. There is no evidence on the effects on sit-stand workstations over longer periods of time. Effects of other types of interventions, including workplace policy changes, health counseling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes.

Treadmill or Active Desks

In the Kukkonen-Harjula, et al. (2018), review they found that treadmill desks combined with health counseling appeared to reduce sitting time at work. The evidence is still insufficient to conclude whether cycling desks combined with health counseling can reduce sitting at work more than counseling alone.

MacEwen, MacDonald, and Burr (2015) completed a review of research to identify the effects of standing and treadmill desks on disease prevention and psychological benefits. They found treadmill desks had the greatest improvement in physiological outcomes (post meal glucose, HDL cholesterol, and anthropometric measurements). There were few physiological changes when workers used a standing desk. Standing and treadmill desks had mixed results for impacting psychological benefits, and both workstations had little impact on work productivity.

Common Sense Approaches to Increasing Activity at Work

There has to be a sensible and ergonomically sound solution to the issue of prolonged sitting. It is agreed that sitting can be bad for a person’s health, and if it is possible, to either stand, walk, bike, or move more at work. However, there is an issue of work productivity and if walking on a treadmill or riding a bike while working negatively impacts work. Plus, retro fitting sitting desks to standing, treadmill, or bikes can be expensive and many (or most) companies cannot afford the expense to change out all sitting workstations.

Some simple solutions to motivate/help workers to move more at their workstation include the following:

• There must be buy-in from management indicating a “top down” approach to increasing physical activity.
• Production may increase as the workers enjoy the fact that the company is investing time and energy towards improving their health. However, the increase in productivity may be acute.
• Encourage workers to stand up every time they talk on the phone or every time some comes into their office or work space to talk.
• Arrange an office or work space so that the worker has to stand up to answer the phone, to use a stapler, or to get paper from the printer.
• Develop a work-station stretching group so that they meet every 2 – 2.5 hours to perform some stretching exercises.
• If the office or plant is in a safe neighbourhood, that is conducive to walking, develop a walking group who meets to walk for 10 – 20 minutes at lunch.
• Encourage workers to eat lunch in a common area so they, at least, have to walk to have lunch, plus they can enjoy the camaraderie of co-works.

References

Biswas, A., et al., (2015) Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of Internal Medicine. 162(2):123-32.

Boberska, M., et al., (2018) Sedentary behaviours and health-related quality of life. A systematic review and meta-analysis. Health Psychology Review. 12(2):195-210.

Ekelund, U., et al. (2016) Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 388(10051):1302–1310

Kukkonen-Harjula, K.T., et al., (2018) Workplace interventions for reducing sitting at work. Cochrane Database of Systematic Reviews. Issue 12.

MacEwen, B.T., MacDonald, D.J., and Burr, J.F. (2015) A systematic review of standing and treadmill desks in the workplace. Preventive Medicine. 70:50-58.

Mayo Clinic Health Letter, (2014) Is sitting the new smoking? New science, old habit. 32(10):4– 5.

Vallance, J.K., et al., (2018) Evaluating the Evidence on Sitting, Smoking, and Health: Is Sitting Really the New Smoking? American Journal of Public Health. 108(11): 1478–1482.