What's the Best Way to Use a Standing Desk?

Standing desks have become popular with computer users and office workers interested in avoiding risks from sitting for prolonged periods of time. There is a long list of people who may have used a standing desk throughout history, such as Leonardo DaVinci, Lewis Carroll, Ernest Hemingway, Philip Roth and Virginia Woolf.1,2

Reports also claim Oscar Hammerstein II may have written most of the music for “Oklahoma,” “The Sound of Music” and “South Pacific” standing up.3 Additionally, Winston Churchill was well-known for his use of a standing desk, and U.S. Supreme Court Justice Oliver Wendell Holmes Jr. credited his standing desk for his writing style.

As standing desks emerged into modern times, some embraced them at work in hopes it would help fight obesity, but research4 debunked this theory, finding the best way to burn more calories is to move. However, the reason to use a standing desk is not about burning calories but, rather, about improving your health.

From Heart to Brain: The Dangers of Prolonged Sitting

Sitting for prolonged periods of time has been linked to a number of health conditions, including weight gain, heart disease and cognitive decline. But, if you find yourself parked behind a desk for the majority of your workday, you’re not alone. According to the American Heart Association,5 the percentage of sedentary job positions has increased by 83% since 1950.

In a study6 evaluating the trends of occupation-related physical activity over the past five decades, researchers found a shift away from jobs requiring moderate-intensity activity to those largely composed of sitting. The researchers qualified moderate-intensity activity as construction, manufacturing and mining.7

They found a 48% reduction in the prevalence of moderate activity jobs in 1960 to 20% of jobs in 2008.8 This rise in sedentary behavior has also correlated with an increased risk of heart disease, diabetes and premature death.9 In a meta-analysis of 47 studies,10 researchers found “prolonged sedentary time activity was independently associated with deleterious health outcomes regardless of physical activity.”

Another study also links sedentary behavior with changes in brain function crucial to memory formation. The results suggested those who had more sedentary activity experienced a reduction in medial temporal lobe thickness.11 On the flip side, aerobic fitness has shown to improve this area of the brain.12

Not All Sitting Is Created Equally

The World Health Organization13 states physical inactivity is a leading risk for death and noncommunicable disease worldwide. They warn the terms “exercise” and “physical activity” should not be confused since exercise is really a subcategory of planned, repetitive physical activity done with an aim to improve fitness.

Failure to employ an adequate level of activity increases the risk of diabetes by up to 30% and shortens life span by three to five years.14 To that end, many early adopters of standing desks bought into the idea that standing while working would help them burn more calories, lose weight and stem the tide of obesity.

But as further research demonstrated,15 standing versus sitting doesn’t burn many more calories and certainly doesn’t encourage more joint movement. The amount of sedentary time you spend includes not only the time you spend behind your desk at work, but also time commuting and enjoying leisure activities, such as watching television or using electronics.

Research data16 from an examination of 17,013 Canadians found a “dose-response association between sitting time and mortality from all causes and cardiovascular disease, Independent of leisure time physical activity." In other words, the longer people sat, the higher their risk of mortality from any cause.

TV Time May Be an Independent Sedentary Risk Factor

In 2010 when television viewing time was evaluated independently in relation to cardiovascular disease and all-cause mortality, researchers found an increased risk.17 A June 2019 study18 followed up with 3,592 participants, using self-reported data over 8.4 years. In this study, researchers found those watching more than four hours per day of TV had a greater risk of CVD events or all-cause mortality, compared to those watching less than two hours per day.

By comparison, the researchers found sitting at work did not have an association with these endpoints, suggesting minimizing leisure television viewing could be more effective in reducing negative health effects then reducing sedentary behaviors at work.

The researchers acknowledged there were some limitations to the study, but in spite of those, they believe the analysis was one of the first prospective data gathering analyses showing sedentary behavior may vary between leisure and nonleisure types.

Another study seeking to determine whether physical activity could modulate or eliminate the effects of prolonged sitting used a meta-analysis of 16 studies. In total there were 1,005,791 participants in all studies. The data showed getting 60 to 75 minutes of moderate-intensity physical activity each day seem to significantly reduce or eliminate an increased risk of death associated with prolonged sitting, but did not eliminate the risk associated with watching television.19

Avoid Prolonged Stationary Standing

Sit-to-stand desks offer significant health benefits to the user, but like most things, more is not always better. In other words, stationary standing for long periods of time may be nearly as challenging to your body as sitting for hours at a time.

In one study published in Applied Ergonomics on these desks,20 researchers found participants were standing more and sitting less. However, but the results were not enough to achieve benefits associated with reduction in obesity. The study said:21

“In order to achieve positive outcomes with sit-stand desks, we need a better understanding of how to properly use them; like any other tool, you have to use it correctly to get the full benefits out of it.

There are basic ergonomic concepts that seem to be overlooked. Many workers receive sit-stand desks and start using them without direction. I think proper usage will differ from person to person, and as we gather more research, we will be better able to suggest dosage for a variety of workers."

For example, one study found standing in one position for long periods of time leads to muscle fatigue and other types of occupational injuries such as chronic venous insufficiency, carotid atherosclerosis, musculoskeletal disorders and preterm birth.22

In fact, prolonged standing can lead to chronic venous insufficiency, carotid atherosclerosis, musculoskeletal disorders and preterm birth. Other studies23 have identified prolonged standing as a trigger for low back pain, cardiovascular problems and chronic fatigue and discomfort.

The Point: Stand Up, Sit Less, Move More

Research data still haven’t proven standing desks alone improve your overall health, likely because it’s movement that reduces your risk of heart disease, stroke, obesity and back pain. For instance, a Cochrane review of 20 studies24 from high-income nations found using a sit-to-stand desk reduced sitting time, but showed no long-term positive effects from the change.

Interestingly, one study with individuals employed in sedentary jobs found a reduction in sitting time not only was associated with reduction in upper back and neck pain, but with improved mood status.25

However, the point behind the sit-to-stand movement is not simply to move from sitting to standing but, rather, to include movement. Since your mind and body are connected, your movement has an effect on the way that you feel and think. So, adding movement while you stand may also help with depression and anxiety, as well as help you think more creatively.26

People Move More at Home When They Move at Work

Physical activity helps to lower your blood pressure, improve your blood flow and prevent bone loss, all of which contribute to a longer life span.27 In a study28 led by the University of Minnesota,29 one company provided treadmill desks for 40 of their 400 employees to measure their productivity when they were standing and walking.

After the employees became experienced at working on the treadmill their performance improved above when they were sitting.30 There was some concern that the treadmill workstations would reduce the amount of activity day enjoyed outside of work, but researchers found the participants’ activity actually increased both during and after work.31

According to the Society for Human Resource Management,32 wellness specialists are working with employers to help get workers more active. They're finding this improves concentration, reduces sick days and improves their ability to recruit quality employees. Employers are also enjoying a reduction in health care costs related to neck, elbow and back injuries.

Alan Hedge,33 director of the Human Factors and Ergonomics Research Laboratory at Cornell University, believes the addition of sit-stand desks to the office is cost-effective, and Dr. James Levine, an endocrinologist at Mayo Clinic, believes the return on investment maybe from $3 to $7 for every $1invested.

Posture Important While Sitting and Standing

Both excessive sitting and stationary standing contribute to lower back pain and muscle fatigue. One important method to reduce pain and discomfort is to use proper posture. When using a standing desk, it's important that your computer monitor and keyboard are functional for your height.34

When it comes to a standing desk, one size does not fit all, since not everyone is the same height. It's important to set the locations of your keyboard and computer screen to reduce slouching or constantly looking up. Both should be set at comfortable angles to reduce neck and head strain as well as shoulder and upper back problems.

Fletcher Zumbusch is a physical therapist from Santa Monica, California, who believes it's not the number of hours we spend sitting at a desk or standing on a desk, but the position in which it's done. An additional benefit to a standing desk is it reduces the potential for hip tightness, which increases with excessive sitting and creates stress on your adjacent joints.35

Zumbusch recommends36 that you consider asking a health care professional to help you set up your sit-stand desk, so you can make sure it’s positioned in a such a way that it will reduce strain on your muscles. In addition, you should ease into a standing and moving routine until you’re standing — and moving — as much as possible and sitting for shorter intervals.

It’s crucial to practice good posture while sitting, standing and walking as this places the least amount of strain on muscles and ligaments that support your core, back and neck. Slouching also affects your mood and emotional health. To discover tips to improve your posture see my past article, “Slouching Makes You Sad.”




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