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“Yes, I know sitting is “the new smoking”; that’s why I have a standing desk”.

I’ve heard this a lot over the last few years. And it seems to make perfect sense: after all, isn’t standing the opposite of sitting?

Well, not exactly. Come to think on it, sitting and standing actually have a lot in common. Yes, when most people sit they slouch forward or lean against the back rest and arm rests and their postural muscles turn off and go dark.

But, most folks at a standing desk lock their knees and slide a hip forward to adopt a locked out posture that pretty much turns off most of their postural muscles, just like their seated coworkers. So, at the muscular level, sitting and standing aren’t that different. And thus it isn’t surprising that there’s only a modest increase in the metabolic rate when moving from sitting to standing (16%). But there is one big difference between sitting and standing. It turns out that the risk of heart disease is twice as high for those who stand most of the day compared to those who sit. This surprising result just published in the American Journal of Epidemiology is based upon observing 7,300 workers over 12 years. It’s a well done study that adjusted for a variety of factors.

Why would this be so? Lead author Dr. Peter Smith explains that biological mechanisms largely explain why standing in a fixed place for hours at a time is actually worse for your health in the long term than sitting down. “The blood tends to pool in your legs, there is an increase in venous tension and oxidative stress, all of which increase the risk for cardiovascular disease,” he noted. “Combinations of standing and sitting and walking are probably where we need to be for all types of occupations.”

Does Dr. Smith think it’s time to retire all those standing desks that HR just bought? “There is a real absence of evidence that standing for short periods does anything to reduce your risk of cardiovascular disease. The best thing to do is to be more active during the day rather than think that just standing a few extra hours will make any difference.”

So the real culprit seems not to be sitting or standing, but inactivity. And it turns out that while sitting still is bad, standing still is even worse, about twice as bad in fact.

The real solution is to inject activity into your day wherever possible. Active standing (AKA walking) is better than standing still, of course. But because we spend so much time sitting, active sitting is much, much better than sitting still.

Active sitting. It’s a thing, because it has its own Wikipedia page. But it’s a topic for another blog.

-Dr. Turner Osler

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