Longevity Briefs: Are Standing Desks Less Healthy Than We Thought?

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Longevity briefs provides a short summary of novel research in biology, medicine, or biotechnology that caught the attention of our researchers in Oxford, due to its potential to improve our health, wellbeing, and longevity.

The problem:

A number of studies suggest that prolonged periods spent sitting down are inherently bad for us, triggering inflammation and raising blood sugar. A common strategy to prevent this is to avoid sitting entirely by using a standing desk, but things might not be that simple. Earlier this year, we reported on a study showing that breaking up sitting periods with many short bouts of activity was superior to a single long bout. It also hinted that it was the act of standing up from a sitting position itself, rather than the subsequent activity, that was important for mitigating the negative effects of sitting.

Now this new study appears to suggest that people who remain standing for long periods might not be that much better off than people who remain seated.

The discovery:

In the study, researchers looked at accelerometer data from the UK Biobank. Their final analysis included over 83,000 participants who enrolled between 2006 and 2010, and were followed up until October 2021. Unsurprisingly, people who spent more time stationary were more at risk of cardiovascular disease and diseases related to the regulation of blood pressure when standing up, such as varicose veins and orthostatic hypotension (that’s a sudden drop in blood pressure when standing). In the study, these are collectively labelled as orthostatic circulatory diseases. Risk increased more rapidly beyond 10-12 hours of sedentary time per day.

The more surprising finding was that while time spent standing had no significant association with cardiovascular disease in either direction, it was correlated with higher risk of orthostatic circulatory disease. After 2 hours per day of standing, each additional 30 minutes of standing increased risk by 11%. Sitting for over 10 hours a day, meanwhile, increased risk by 13% on average per additional 30 minutes, but also increased cardiovascular disease risk by 15% for each additional hour.

Hazard ratios for orthostatic circulatory disease according to time spent standing (yellow), sedentary (sitting, black) and all stationary time (blue). The hazard ratio is the risk of disease relative to the reference point, which is assigned a hazard ratio of 1. For example, the reference point for time spent standing in this study was 2 hours. That means that a hazard ratio of 1.5 equates to a 50% increased risk of disease compared to someone who spent 2 hours standing.
*Device-measured stationary behaviour and cardiovascular and orthostatic circulatory disease incidence*

The implications:

This study lends further credence to the idea that it is movement that is more important, not so much whether you are sitting or standing. Standing still looks to be healthier than sitting, since prolonged sitting was associated with cardiovascular disease and standing was not. However, standing doesn’t appear to eliminate many of the circulatory risks associated with inactivity.

Since this wasn’t a randomised controlled trial, but rather an analysis of existing data from people going about their day, we can’t fully conclude that standing itself is to blame. For example, it is possible that people who spend more time standing still are performing jobs that might expose them to other health risks. Even so, between the authors’ efforts to control for confounding factors and the strength of the associations, this is unlikely to fully explain why more standing time was associated with orthostatic circulatory disease. It looks as though if you want to mitigate the dangers of inactivity, your best bet may be to interrupt it with regular bouts of activity, even if it’s just occasionally standing up from your chair or moving around if you have to stand still for prolonged periods.