What is YOUR total sedentary time on an average workday? Sedentary time includes sitting, reclining, and lying down outside of your nighttime/bedtime sleep, so this includes breakfast, commute, work, lunch, commute, dinner, and evening activities. Go ahead, add it up and learn what your total is! It is likely that your total over the course of a typical workday will range between 6-12 hours, as I have discovered in numerous presentations I have given to trade associations.
Here's the problem
The research on the effects of sedentary time, which began in earnest with Mark Hamilton1 at the Pennington Biomedical Research Center in the 1990's, and others[i], have found that the danger threshold seems to be six or more hours per day of sedentary time. Let me lay out the cumulative effects for you, according to a variety of research studies:
- Within a couple of hours of sitting, your metabolism drops about 30 percent lower than walking. Plus, your good cholesterol plummets about 20 percent.
- One day of sitting: 40 percent decrease in insulin function, which means your muscles aren't taking in amino acids and fat. Additionally, your blood sugar levels go up, putting you at risk for weight gain.
- Five days of sitting: There are enzymes - especially lipoprotein lipase - responsible for grabbing & breaking down fats and triglycerides from your bloodstream. When you sit, the muscles are relaxed, and this enzyme activity drops by 90 percent to 95 percent, resulting in increased blood plasma triglycerides and LDL (bad cholesterol) and lower HDL (good cholesterol). This is a recipe for cardiovascular disease.
- Two weeks of sitting: Muscle atrophy, resulting in decreased aerobic capacity. This makes it harder to climb stairs, walk, and to lift, push, pull and carry. This is not counteracted by daily workouts. It has to do with the accumulation of sedentary time.
- One year of sitting 6+ hours per day: Weight gain and high cholesterol. Up to 1 percent loss of bone mass per year for women.[ii]
- Ten to twenty years: Regardless of exercise, men who spent over 6 hours per day of leisure time sitting had overall early death rate ~20 percent higher than those men who sat for up to 3 hours per day. For women who sat for more than 6 hours per day, the death rate was approximately 40 percent higher. [iii]
- Several studies have shown that the more sedentary time you have, the earlier you die. Period. Regardless of age, sex, education, smoking, hypertension, waist circumference, BMI, glucose tolerance status and leisure-time exercise! And it's due to all the various issues that come from being obese: Cancer, cardiovascular disease (hypertension, high LDL cholesterol, high triglycerides), and diabetes.[iv], [v], [vi], [vii], [viii], [ix], [x]
The Other Side of the Coin
In the 1990's researchers Dr. Levine and Dr. Jensen of the Mayo Clinic were trying to understand why some people seem to gain weight while others don't. They designed an extremely clever study where they controlled caloric intake and monitored physical movement. Exercise was prohibited. They ultimately learned that the people who gained weight sat 2 hours more per day than the people who maintained their weight, no matter if the participants were on the normal diet or the over-feeding diet.
It was a huge breakthrough! They re-tested in other countries and consistently found that thinner and healthier people -as well as those who live longer - basically just move more throughout the day! Thousands of minor movements will keep the fat off! Being sedentary will put it on. For example, they found that obese subjects were sedentary an average of about 10 hours daily, while Jamaican farm workers who were thin and healthy were sedentary only an average of about 5 hours daily.
Standing
Some people who've heard bits and pieces of media information about the dangers of sitting concluded that the answer must be for their employees to stand. So they went about raising employee desks and suddenly having people stand all day. Simply standing is not enough. In fact, standing a whole shift has many detrimental effects. It causes blood to pool in the legs (contributing to varicose veins) and a high degree of discomfort in the feet, legs, and low back. It also makes the heart work harder, which may be good for some and not for others.
Move More
The researcher work outlined above has lead to the understanding that the key recommendation is for employees to move more! This is where sit and stand workstations come into play. A sit/stand workstation is one that alternates between sitting and standing positions. Because you're objective is many thousands of movements throughout the day (e.g. 5,000 like the Jamaican farmers), each time you switch between sitting and standing, you're getting closer to that goal!
In addition, you'll need to encourage your employees to walk during lunch, take walking meetings, walk to a co-workers desk to ask a question instead of emailing them, taking the stairs, and pacing while talking on the phone. Exercise has dramatic health benefits for the brain, muscles, bones, and heart -- but will not make up for sedentary time.
Office Equipment to Encourage Movement
There are many methods for achieving a sit/stand workstation. Research has shown that employees prefer adjustable workstations over stationary ones, they have improved comfort and mood, they perform better, and have less pain and fewer injuries. Designing and installing sit/stand workstations is not as straightforward and simple as you might think. There are numerous employee, furniture, and facility considerations.
Be sure to have a third party professional ergonomics consultant work with your architect, interior designer, or furniture vendor. While the ideal scenario is that every employee has an electric or spring-adjusted desk, this may be beyond a company's budget. And, be sure to inquire about the height range, as they vary and you want to be sure to accommodate the heights of employees you need to accommodate. The next best solution is an after-market sit-on-top unit.
These units are simple to deploy, more affordable than electric or spring-adjusted full desks, and can work well for many employees. Most have a fixed monitor distance, don't drop the keyboard below the work surface, and don't have built-in tablet/phone/notebook/document holders. Most units are very heavy and/or awkward to move up and down, particularly for women, due to weight and awkward arm and wrist postures as well as hand force required.
The Fellowes Lotus has found a way to design both a lower weight and well-positioned hand controls to make the adjustments, making it safer for women to adjust. It also has a built-in tablet/phone/notebook/document holder which is very convenient. The next best approach is to have a fixed standing height desk with an elevated ergonomic stool that has an industrial height footrest. These types of chairs have several inherent safety risks, however.And the worst approach is to have separate keyboard trays and monitor arms that claim they are "sit to stand".
Most do not have the height range required for employees outside the middle of the stature bell curve. And, this approach requires two pieces of equipment to be adjusted each time which creates a nuisance barrier for employees and may aggravate an employee's low back when repeatedly reaching out to lift or lower the monitors.
Best Practices
The most recent consensus statement, published in the British Journal of Sports Medicine in 20159, [xi]recommends "for those occupations which are predominantly desk based, workers should aim to initially progress towards accumulating 2 hours per day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 hours per day (prorated to part-time hours).
To achieve this, seated-based work should be regularly broken up with standing-based work, the use of sit-stand desks, or the taking of short active standing breaks."Neuhaus et al (2014)[xii] found in a randomized controlled trial with height-adjustable workstations that there was a three-fold improvement of the use of sit/stand workstations in the standing position if professional education was provided.
ROI
There have been some studies that point to a positive return on investment for sit/stand workstation investment. United Parcel Service (1994)[xiii] found call center employees who alternated between sitting and standing had 62 percent reduced musculoskeletal discomfort. We all know that when we have discomfort, we take more breaks.Dainoff (2002)[xiv] found that those who stood more took shorter breaks.
Non-standers took an average of 47 percent more breaks and each break was 56 percent longer than the standers group. Kay (2011)[xv] found in a 3-year 6,200 employee study that non-adjustable workstations had 20 times the worker's compensation costs compared to user-adjustable workstations. Garrett (2016)[xvi] found that call center employees had a 46 percent increase in productivity when they had sit/stand adjustability compared to traditional seated desks.
They also found that 75 percent of employees with sit/stand adjustable workstations reported decreased body discomfort. Ognibene (2016)15[xvii] found that employees with chronic low back pain who had sit/stand workstations reported a significant reduction in current and worst low back pain in a 3-month trial.
The research has yet to show if the predictions of lower health care costs will come to bear. However, it seems to certainly be an excellent addition to an overall wellness program. It likely goes a long way toward retaining Millennial employees too.
Works Cited
[i] Hamilton et al. (2007). Role of Low Energy Expenditure and Sitting in Obesity, Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease. Diabetes, Nov; 56(11): 2655-2667.[ii] Stephens et al. (including Hamilton) (2011). Effects of 1 day of inactivity on insulin action in healthy men and women: interaction with energy intake. Metabolism.2011 Jul;60(7):941-9.[iii]Ibid[iv]Ibid[v] Dunstan DW, et al. (2012). Breaking up prolonged sitting reduces postprandial glucose and insulin responses.Diabetes Care. May;35(5):976-83.
[vi] Patel, A. et al. (2010). Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults. American Journal of Epidemiology: 172(4)[vii] Van der Ploe, C. et al. (2012). Sitting time and all-cause mortality risk in 222,497 Australian adults. Arch Intern Med.;172(6):494-500[viii] Warren, T. et al. (2010). Sedentary Behaviors Increase Risk of Cardiovascular Disease Mortality in Men. Med Sci Sports Exerc. May;42(5).
[ix] Dunstan, D. (2010). Television viewing time and mortality: the Australian Diabetes, Obesity and Lifestyle Study. Circulation.Jan 26;121(3).[x] Bronnum-Hansen, H. et al.(2007).Impact of selected risk factors on quality-adjusted life expectancy in Denmark. Scand J Public Health October;35(5).[xi] Consensus statement (2015). The sedentary office: a growing case for change towards better health and productivity. Expert statement commissioned by Public Health England and the Active Working Community Interest Company.
British Journal of Sports Medicine, June.[xii] Neuhaus et al. (2014). Workplace Sitting and Height-Adjustable Workstations: A Randomized Controlled Trial. Am J Prev Med 2014; 46(1): 30-40.[xiii] Nerhood, H. & Thompson S. (1994). Adjustable Sit-Stand Workstations in the Office. Article in Human Factors and Ergonomics Society Annual Meeting Proceedings38(10):668-672.[xiv] Dainoff, M. (2002). The Effect of Ergonomic Worktools on Productivity In Today's Automated Workstation Design.[xv] Kay, G. (2011). Ergonomics Today, August.[xvi] Garrett et al. (2016).
Call Center Productivity Over 6 Months Following a Standing Desk Intervention. IIE Transactions on Occupational Ergonomics and Human Factors.[xvii] Ognibene et al. (2016). Impact of a Sit-Stand Workstation on Chronic Low Back Pain: Results of a Randomized Trial. J Occup Environ Med. 2016 Mar;58(3):287-93.
