News Column

Sedentary Office Workers Try Standing Desks

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At Groupon's Chicago office, it's easy to look up to Joel Hadley. During most of his eight-hour-plus workday, Hadley stands at his desk, his head more than a foot above seated colleagues.

Hadley says standing makes him feel alert, focused and energized. He also has less back and neck pain than when he used a chair. But it's not necessarily the standing that makes Hadley feel better. Instead, the trick may be that the 29-year-old sales analyst rarely sits down.

Thirty minutes of exercise a day used to be thought of as protection against the damaging effects of a desk job. Studies now show that even for those who work out during the day, prolonged sitting can increase the long-term risk of illness or death.

As a result, some office workers are literally standing up for their health - shunning expensive ergonomically correct chairs, building makeshift standing desks and even slowly walking on treadmill desks, also called walkstations.

Hundreds of companies, including Microsoft, Hewlett Packard, Dell and Google, offer employees standing and treadmill desk options. It's not just a Silicon Valley movement; employees at the Federal Bureau of Investigation, the National Institutes of Health, the Mayo Clinic and dozens of universities have all purchased some form of a standing or treadmill desk.

"In our society, many people are literally living with a stalled metabolic rate similar to an anesthetized patient for over 80 percent of the day," said inactivity researcher Marc Hamilton, a professor at the Pennington Biomedical Research Center in Baton Rouge, La. "No wonder we have an unsustainable health crisis."

In the past several decades, increased use of cars, computers and television has contributed to disease, experts say. Some people are either lying down or sitting 20 hours a day, raising their risk of heart disease, obesity, diabetes and some cancers, said Hamilton.

"It was a huge oversight to ever think traditional forms of exercise, such as hopping on your treadmill for a few hours a week, can provide the specific antidote to spending 140 hours a week resting," said Hamilton, who pioneered the fledgling field of "inactivity physiology." "Sitting too much isn't the same as exercising too little."

Since 2003, several of Hamilton's studies have found that physical inactivity, such as sitting, can impair key mechanisms in the body that regulate fat and cholesterol metabolism - changes that aren't reversed by exercise. Sitting also dramatically reduces contractions or electrical activity in skeletal muscles, because the chair is supporting the body's weight, Hamilton said.

"When you're standing or walking, your leg muscles are constantly working, which helps to clear glucose and fats from the bloodstream," said Hidde van der Ploeg, a senior researcher at the Department of Public and Occupational Health and the VU University Medical Center in Amsterdam. "If you're sitting, this isn't happening because the muscles aren't active."

Even if you're meeting the World Health Organization standards for 30 minutes of exercise a day, "it's still important what you do in the remaining hours of the waking day," van der Ploeg said.

Van der Ploeg's most recent study, published in the Archives of Internal Medicine, found that adults age 45 and older who sat 11 or more hours per day had a 40 percent increased risk of dying in the next three years compared with those who sat for less than four hours a day.

Though the absolute risk of death was small for everyone, the study showed that "in people who do a similar amount of physical activity, those who sit less will have a lower risk of dying, compared to those who sit more," said van der Ploeg.

It's not clear how marathon sitting sessions can increase the risk of death and illness. Hamilton's research suggests that the loss of muscle contractions that typically occurs while sitting or lying down can suppress production of an enzyme in the skeletal muscle called lipoprotein lipase, or LPL. When lab animals were slightly active, the enzyme was not suppressed, he found.

LPL helps regulate the production of triglycerides, free fatty acids and cholesterol. After a meal, for example, levels of triglycerides and glucose initially rise; then they gradually decline as the body removes and stores the nutrients delivered by circulating blood. "It's theorized that sitting may reduce the efficiency of these processes," said researcher David Dunstan, head of the physical activity laboratory at the Baker IDI Heart & Diabetes Institute in Australia.

"We move from chair to chair throughout the day, from in the home, to the car, at work, to the car and again at home," Dunstan added. "Sitting less may be at least as important as exercising more."

Sedentary behavior may also encourage weight gain - a risk factor for a host of illnesses - by reducing the amount of incidental activity in a person's life. In one recent study by Hamilton, volunteers were asked to sit for a day and fed limited calories. The participants - even those who were lean and exercised regularly - rapidly developed insulin resistance, the key cause of diabetes. The results suggest that "while exercise and healthy diet are good for some things, they do not immunize you from sitting too much," said Hamilton.

Chicago adventurer, running coach and fitness expert Jenny Hadfield routinely exercises, but when she transitioned from managing a corporate fitness center to writing full time, she found she was moving considerably less during the day.

"Whether it's writing or social media, you get so lost in what you're doing, and the next thing you know it's midnight," said Hadfield. "My body was hurting more. I had less mobility in my joints and some weight gain."

Hadfield started getting up every 30 minutes or so to do a small chore. She also placed a board she bought for $15 at Home Depot across the arms of her treadmill. Her computer rests on the board. "It's not a workout, said Hadfield. "It's literally moving one mile an hour and I'm answering email, talking on the phone."

There's no proven solution to the harm of sitting; it isn't clear what time limits would help or the best way to take a break. Learning to use standing and treadmill desks often takes several weeks, and the benefits of walking have to be weighed against the costs and practicality of a treadmill desk or other contraptions, such as an elliptical machine desk that Hammacher Schlemmer sells for $8,000.

Experts say miniature exercise bikes, which allow users to pedal under their desk while sitting in an office chair, do not solve the problem of sitting. Proper posture on stability balls, meanwhile, requires core muscle strength that many people do not have, and sitting on them for long periods of time can exacerbate musculoskeletal conditions, Dunstan said.

"Standing all day is not recommended either and certainly not necessary for better health," van der Ploeg said. "Some tasks are better done standing and some sitting. Finding a nice balance between the two could be good for your health and maybe productivity as well."

Groupon's Hadley, who said he enjoys sitting down when he thinks he has earned it - made his own standing desk nearly two years ago by propping his laptop on top of several black risers he found lying around the office. When he gets tired, he bends one leg at 90 degrees and rests that shin on the desk; then he switches sides. "When I sit down, I tend to relax," said Hadley, who has no plans to return to his chair. "This keeps me more on my game."

Hadley's enthusiasm inspired others in his row. Nima Elyassi-Rad, a senior sales intelligence analyst, also put his MacBook Pro on three risers. He says he stands about 12 hours a day; when he feels fatigued he sits on the arm of his chair. "I'm definitely more alert," he said.

But the two are still in the minority. Taylor Somach, 25, who sits next to Hadley, recently tried standing. "I got tired of it," said Somach, who sits about nine hours a day at his desk and several more at home, watching television. "Besides, I have this fancy Herman Miller chair," he said. "I feel like I should use it."

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STAND-UP ADVICE:

-Change positions every 20 or 30 minutes. Even if you don't want to get a standing desk, simply standing up can help. Sitting increases the pressure on the disks in your back, said Dr. Joel Press, medical director of the Spine and Sports Rehabilitation Center at the Rehabilitation Institute of Chicago. Movement provides nutrition to the disks by helping move fluids in and out, Press said.

-Start small. Before investing in an expensive standing desk, experiment with a low-cost homemade version. Books, monitor risers, shoe risers or even an ironing board can all work. Ronald Thisted, chairman of the Department of Health Studies at the University of Chicago, initially used stacks of academic journals before taking the plunge and mounting his computer on an adjustable sit-stand desk.

-Expect an adjustment period. You'll likely feel tired, and some things - such as typing or using a highlighter while walking on a treadmill - may be more difficult in the beginning. "The first couple weeks were a little uncomfortable, like when you start a new exercise regimen," said Ben Shive, 37, a mobile software developer in Lansdale, Pa. But Shive now has only one complaint: "I need new pants after losing an inch off my waist."

-Wear comfortable shoes. Also try a chef's mat or a standing desk mat to help with foot fatigue.

-Pay attention to your posture. A computer monitor should be at eye level. Your hands, wrists and forearms should be straight and roughly parallel to the floor. The elbows should be bent approximately 90 degrees. "Keep your body weight evenly spaced between both feet and symmetrically between your big toe, little toe and heel," said physical therapist Melissa Kolski, education program manager for the Rehabilitation Institute. "Make sure to keep your pelvis neutral, such that if it was a bucket of water it wouldn't tip forward or backward." If you need a rest break every once in a while, "try propping your foot on a stool or riser," Kolski said.

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