The American Diabetes Association spends a lot of time educating people about the benefits of being active and eating right. So, in the spring of 2012, the Minnesota office decided to take that messaging one step further by having each of its 16 staff members and interns outfitted with sit-stand work stations.
“The opportunity to have a little bit of activity by standing at work stations helps for that desk time,” said Jenni Hargraves, executive director at the association in Minnesota. “We could remove them if they didn’t work, so everyone was real game to try them at the beginning because they were new and they wanted to be healthier.”
Three months later, the standing option of the work stations is well-used, she said. Several employees have mentioned the health benefits, such as reduced back pain, or said they have more energy in doing their work. And there’s more interaction, said Hargraves.
“I hear a lot more laughter.”
There have been a few setbacks, however, such as reduced desk space and over-eager workers suffering from standing fatigue (employees now have sensible footwear at their desks along with cushioned standing mats) and, because of the different desk heights, the association had to buy new chairs (the actual work stations were provided as part of a sponsorship arrangement).
But the American Diabetes Association is still keen on the concept and plans to install a work station with a treadmill in a separate room that people can use intermittently, said Hargraves.
Research has proven the health benefits of people getting up and moving but the gains are even more apparent in a new study that says physical inactivity is similar to the established risk factors for smoking and obesity.
Physical inactivity causes six per cent to 10 per cent of the major non-communicable diseases of coronary heart disease, Type 2 diabetes and breast and colon cancers, while also causing nine per cent of premature mortality, according to Effect of Physical Inactivity on Major Non-Communicable Diseases Worldwide: An Analysis of Burden of Disease and Life Expectancy.
“We clearly see physical inactivity poses a major health hazard and, in fact, it is as important as smoking in terms of causing premature deaths throughout the world,” said I-Min Lee, professor of medicine at Harvard Medical School, professor of epidemiology at the Harvard School of Public Health in Boston and co-author of the study. “Sitting may pose a separate risk factor than physical inactivity, so they’re not mutually exclusive behaviours.”
Evidence shows even people who meet physical activity guidelines, such as those set by Health Canada, but are also highly sedentary are still at an increased risk of a whole host of diseases along with mental health issues, said Mark Tremblay, director of healthy active living and obesity research at the Children’s Hospital of Eastern Ontario (CHEO) Research Institute in Ottawa.
“This is the era that, I think, we’ve just entered, with sedentary behaviour as another risk factor. So, you’ve got smoking, hypertension, physical activity and sedentary behaviour — it’s a different shelf,” he said.
Even the most dedicated person who goes to the gym or for a run 30 to 60 minutes per day is only being active two to four per cent of a 24-hour period, said Tremblay.
“So, we’ve got the presence of a protective factor, i.e. ‘I’m doing an activity’ but also the presence of a risk factor: ‘I sit a lot,’” he said. “We’ve become glued to our chairs so just standing up from your chair several times a day is actually providing physiological overload to you, so your body responds in a way that, at least metabolically, is advantageous.”
Other research backs this up. The 2012 study Sitting Time and All-Cause Mortality Risk in 222,497 Australian Adults found prolonged sitting was a risk factor for all-cause mortality, independent of physical activity.
And in looking at 53,440 men and 69,776 women in the United States, researchers from the American Cancer Society found time spent sitting (more than six hours compared to fewer than three hours) was associated with mortality in both sexes. The increased risk was regardless of their levels of physical activity, found the 2010 Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults.
Women who sat for more than six hours during their leisure time had about a 40 per cent higher all-cause death rate, while men had about a 20 per cent higher death rate. The combination of both sitting more and being less physically active was associated with a 94 per cent and a 48 per cent increase in all-cause death rates in women and men, respectively.
“We know that if you break up prolonged episodes of sitting, there is a positive impact on the glucose metabolism, on different cardiovascular disease markers, like cholesterol, blood pressure, those types of things,” said Alpa Patel, strategic director at the American Cancer Society in Atlanta and co-author of the 2010 study.
What can employers do?
Many people don’t understand how much physical activity is needed, often thinking they have to run 30 minutes per day when it can be any activity that gets the heart rate up, such as gardening, walking the dog or playing with the kids. Commuting is another way people can boost their activity levels, by walking or bicycling, said Lee.
“What we’re hoping is for people to have this kind of (active) lifestyle incorporated into their life.”
Not every employer is able to buy standing desks for employees but there are simple choices that can be implemented, said Patel, citing as examples his reluctance to instant message anyone in the same department and his effort to purposely use printers that are far from his desk.
“If we are able to make those small changes for even five minutes in a typical workday per hour, at the end of the day, you’ve reduced your sitting time by a full hour,” said Patel.
Greater activity levels are possible without a complete rebuilding of the workplace, according to Tremblay. The Children’s Hospital, for example, now has “walking meeting rooms” for gatherings that don’t require a computer screen. Routes have been mapped out so groups of six or fewer can stroll the city streets while holding a meeting.
“Sitting isn’t a requirement — your brain doesn’t turn on the minute your bum touches the chair,” he said.
And if employees are on a phone call or conference call, they can use their headsets or speakerphones to stand or even walk in the office or meeting room. Employers can also encourage employees not to email anyone within 10 offices so they have to communicate in-person.
“It’s sort of conditioning — creating a normative behaviour that is not synonymous with sitting,” said Tremblay. “They’re all such micro interventions, they’re not really offensive to anyone… they’re still doable.”