I can’t sit for a long time, can’t I just stand?

Sitting in the office or classroom for a whole day will inevitably make you feel stiff, and your shoulders, neck, waist and back will ache. Even if you exercise hard after get off work or get out of class, it is difficult to offset the discomfort caused by sitting for a long time.

In addition to being uncomfortable, long periods of sitting can also make people gain weight and increase the risk of type 2 diabetes, cancer, and cardiovascular disease[1]. Knowing that sitting for long periods of time is harmful, more and more people are trying other postures, and even equipment designed for standing work has emerged, such as height-adjustable desks, laptop stands, and height-adjustable screen stands.

By using these devices, people can reduce their sitting time by an average of 1.3 hours per day and increase their standing time by 1.4 hours[1]. This may seem like a significant improvement, but don’t forget that reducing long periods of sitting is only a means to an end. The purpose of changing posture is to reduce the health hazards of long periods of sitting, relieve body stiffness and soreness, prevent drowsiness, or lose weight by increasing consumption. Can these goals be achieved by switching from sitting to standing?

Standing is so tiring, how can it be considered "sitting for a long time"

To know whether standing is beneficial, we must first look at why sitting for a long time is harmful. In fact, the harm of sedentary behavior is not "sitting", but the low energy consumption.

In fact, no matter whether you are sitting, leaning, lying or standing, whether you are working, playing games or riding in a car, as long as the energy expenditure in the awake state is less than 1.5 to 2 times that of sitting quietly, it is considered sedentary behavior[1].

For most people, simply standing up does not increase energy expenditure beyond that of a sedentary lifestyle, nor does it increase physical activity.[3, 4] Since standing is not a break from sedentary behavior, the benefits of standing are questionable.

It may be effective for low back pain, but not necessarily for other conditions

Those who stand up for their health may be disappointed with the following news: in most studies, standing up intermittently for several months at work does not significantly improve blood pressure, blood sugar, and blood lipid levels in healthy people. Only the blood sugar levels of obese people may improve [1, 5].

Some people may say, “I stand not to prevent disease, but because sitting all the time is too uncomfortable.” For relieving body stiffness and soreness, alternating between sitting and standing may be better than sitting for a long time, especially for people with chronic low back pain [6, 7]. Most people will experience low back pain at some stage in their lives, and long periods of sitting may aggravate symptoms [8]. Standing appropriately during breaks in long periods of sitting can significantly reduce the symptoms of low back pain in some people.

Although standing may relieve back pain, it has limited effects on discomfort and soreness in the neck, shoulders, and upper limbs [4, 9-11]. You need to try it yourself to know whether it is effective for you. For the lower limbs, standing is more likely to cause soreness than sitting.

The effect of standing to relieve pain is inconsistent, which is also related to different postures. The correct alignment of the neck, trunk and lower limbs can reduce fatigue. If you lower your head too much, bend over or always put your center of gravity on one leg, you will feel uncomfortable.

Standing keeps me awake?

In addition to body stiffness and soreness, sleepiness at work is also hard to resist. Many people see the words "improve efficiency, double vitality" on the stand and expect standing to be as refreshing as coffee.

In fact, in most studies, there is no significant difference in sleepiness or mood when people sit or stand.[12, 13] Some people feel more energetic and in a better mood after standing, while others feel more tired after standing than when they continue sitting.[14, 15]

Since it does not refresh the mind, for most people, there is no significant difference in work efficiency when standing or sitting [16, 17]. Of course, being forced to stand and listen to the lecture when you are sleepy is an exception.

Losing weight, don't count on it

In addition to improving work efficiency, standing office equipment is often advertised as “eliminating excess fat.” It is true that most people consume slightly more energy when standing than when sitting, but the difference is not that big[18]. Compared to sitting, standing for one hour only consumes 4.2 to 10 kcal more energy[1]. Even if you stand for a total of 4 hours a day, the extra calories you consume are not even as much as two small pieces of chocolate.

In addition, a small number of people are very good at standing, and their energy consumption when standing still is even lower than that when sitting. Therefore, studies that try to lose weight by standing instead of sitting have not produced any results of standing weight loss [19-21].

It's better to sit than stand for a long time

The benefits of standing are not certain, but the harm of standing for a long time has long been known. In the early years, many workers had to stand all day to work and could not sit down or walk around. Not only did they suffer from back pain, foot pain, varicose veins in the lower limbs, and leg and foot edema, but women also had an increased risk of premature birth and miscarriage due to standing for a long time [1].

For most people, the comfortable continuous standing time is no more than 15 to 30 minutes[22, 23]. If standing is done to relieve back discomfort, 15 minutes at a time is sufficient, but standing for longer periods of time can be uncomfortable[24].

When standing still for 30 minutes, blood flow to the calves and feet increases, and fatigue, discomfort, and pain begin to appear[25]. People who already have peripheral vascular disease should try to avoid standing for more than 30 minutes continuously. If your job requires you to stand for more than 2 hours continuously, you can use compression socks, floor mats, insoles, and sit-stand stools to relieve fatigue[25].

Change your posture and move more

Whether sitting or standing, prolonged static postures are bad for your health and can lead to aches and pains.

The key to improving body stiffness and muscle fatigue is to change posture frequently rather than standing for long periods of time [1]. For weight loss or the health hazards of sitting for a long time, doing activities that are more strenuous than standing will have a definite effect.

People who sit for long periods of time can start by alternating between sitting and standing at work and doing light physical activities, and gradually increase the time and intensity of their activities. Buying a table or stand is one way to do this. Walking more is more effective than standing still [26].

References

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[2] Pronk NP, Katz AS, Lowry M, et al. Reducing occupational sitting time and improving worker health: the Take-a-Stand Project, 2011. Prev Chronic Dis. 2012;9:E154.

[3] Burns J, Forde C, Dockrell S. Energy Expenditure of Standing Compared to Sitting While Conducting Office Tasks. Hum Factors. 2017;59(7):1078-1087.

[4] Ee J, Parry S, Oliveira BI, et al. Does a Classroom Standing Desk Intervention Modify Standing and Sitting Behavior and Musculoskeletal Symptoms during School Time and Physical Activity during Waking Time? Int J Environ Res Public Health. 2018;15(8).

[5] David Rempel. Do Sit-Stand Workstations Improve Cardiovascular Health? J Occup Environ Med. 2018;60(7):e319-e320.

[6] Johnston V, Gane EM, Brown W, et al. Feasibility and impact of sit-stand workstations with and without exercise in office workers at risk of low back pain: A pilot comparative effectiveness trial. Appl Ergon. 2019;76:82-89.

[7] Agarwal S, Steinmaus C, Harris-Adamson C. Sit-stand workstations and impact on low back discomfort: a systematic review and meta-analysis. Ergonomics. 2018;61(4):538-552.

[8] Sribastav SS, Long J, He P, et al. Risk Factors Associated with Pain Severity in Patients with Non-specific Low Back Pain in Southern China. Asian Spine J. 2018;12(3):533-543.

[9] Hoe VC, Urquhart DM, Kelsall HL, et al. Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers. Cochrane Database Syst Rev. 2018;10:CD008570.

[10] Brakenridge CL, Chong YY, Winkler EAH, et al. Evaluating Short-Term Musculoskeletal Pain Changes in Desk-Based Workers Receiving a Workplace Sitting-Reduction Intervention. Int J Environ Res Public Health. 2018;15(9).

[11] EF Graves L, C Murphy R, Shepherd SO, et al. Evaluation of sit-stand workstations in an office setting: a randomized controlled trial. BMC Public Health. 2015;15:1145.

[12] Schwartz B, Kapellusch JM, Schrempf A, et al. Effect of alternating postures on cognitive performance for healthy people performing sedentary work. Ergonomics. 2018;61(6):778-795.

[13] Schwartz B, Kapellusch JM, Baca A, et al. Medium-term effects of a two-desk sit/stand workstation on cognitive performance and workload for healthy people performing sedentary work: a secondary analysis of a randomized controlled trial. Ergonomics. 2019;62(6):794-810.

[14] Renaud LR, Huysmans MA, van der Ploeg HP, et al. Long-Term Access to Sit-Stand Workstations in a Large Office Population: User Profiles Reveal Differences in Sitting Time and Perceptions. Int J Environ Res Public Health. 2018;15(9).

[15] Dewitt S, Hall J, Smith L, et al. Office workers' experiences of attempts to reduce sitting-time: an exploratory, mixed-methods uncontrolled intervention pilot study. BMC Public Health. 2019;19(1):819.

[16] Ojo SO, Bailey DP, Chater AM, et al. The Impact of Active Workstations on Workplace Productivity and Performance: A Systematic Review. Int J Environ Res Public Health. 2018;15(3).

[17] Finch LE, Tomiyama AJ, Ward A. Taking a Stand: The Effects of Standing Desks on Task Performance and Engagement. Int J Environ Res Public Health. 2017;14(8).

[18] Mantzari E, Galloway C, Wijndaele K, et al. Impact of sit-stand desks at work on energy expenditure, sitting time and cardio-metabolic risk factors: Multiphase feasibility study with randomized controlled component. Prev Med Rep. 2018;13:64-72.

[19] Alkhajah TA, Reeves MM, Eakin EG, et al. Sit-stand workstations: a pilot intervention to reduce office sitting time. Am J Prev Med. 2012;43(3):298-303.

[20] Healy GN, Winkler EAH, Eakin EG, et al. A Cluster RCT to Reduce Workers' Sitting Time: Impact on Cardiometabolic Biomarkers. Med Sci Sports Exerc. 2017;49(10):2032-2039.

[21] MacEwen BT, Saunders TJ, MacDonald DJ, et al. Sit-Stand Desks To Reduce Workplace Sitting Time In Office Workers With Abdominal Obesity: A Randomized Controlled Trial. J Phys Act Health. 2017;14(9):710-715.

[22] Antle DM, Cormier L, Findlay M, et al. Lower limb blood flow and mean arterial pressure during standing and seated work: Implications for workplace posture recommendations. Prev Med Rep. 2018;10:117-122.

[23] Pei H, Yu S, Babski-Reeves K, et al. Quantification of lower extremity physical exposures in various combinations of sit/stand time duration associated with sit-stand workstation. Med Pr. 2017;68(3):315-327.

[24] Lin MY, Barbir A, Dennerlein JT. Evaluating biomechanics of user-selected sitting and standing computer workstation. Appl Ergon. 2017;65:382-388.

[25] Waters TR, Dick RB. Evidence of health risks associated with prolonged standing at work and intervention effectiveness. Rehabil Nurs. 2015;40(3):148-165.

[26] Buckley JP, Hedge A, Yates T, et al. The sedentary office: an expert statement on the growing case for change towards better health and productivity. Br J Sports Med. 2015;49(21):1357-1362.

Author: Dai Tianyi

Editor: odette