Why standing desks are not the solution

Standing Desks Are Overrated 

You probably ask yourself: "Are sit stand desks worth it?" 

A growing body of research suggests that many of the benefits claimed by standing desk evangelists are overblown. In this article we will talk about the disadvantages of standing desks. 

Simply put, there's no substitute for good, old fashioned movement and the our bodies are not designed to stand for prolonged periods of time. Just as our bodies are also not designed to sit. As a consequence, switching between these two postures, as popularized by providers of sit/stand workstations,  is useless. Nevertheless, standing desks have become trendy and are promoted by well-meaning safety professionals and even some countries.

I want to declare a conflict of interest. My company Walkolution manufacturers and develops treadmill desks. I based the decision to build that particular product on my previous professional experience as a medical doctor and researcher. Walking is what keeps us healthy, not sitting, not pedaling and not standing. It would be easy for us to jump on the standing desk hype and sell standing desks instead of convincing people that they should rather walk at work. We subject our work to every scientific scrutiny, just as everything we say and write contains a scientific source.

Sitting is bad - but standing is not any better

At least five large, prospective studies have found that increased total sitting time, that is, combined work and leisure sitting time, increases the risk of cardiovascular disease. These studies controlled for important confounders, such as age, education, smoking, employment, leisure time physical activity, body mass index (BMI), diet, hypertension, and cholesterol. The risk increased approximately 50% among those who sat more than 10 to 12 hours per day compared with those who sat less. These and numerous other studies raised public awareness, that sitting at work (and the high amount of sitting outside of work) leads to various public health risks and alternatives needs to be offered. The solution has been found quick. Getting rid of the chair and elevate the desk. The only problem is: it's useless.

The hype in numbers

The introduction of height-adjustable desks in offices all over the world clearly reflects that there is a strong desire for health conscious work spaces. According to a 2017 survey by the Society for Human Resource Management, standing desks are the fastest growing benefits trend; 13% of employers provided or subsidised them in 2013 versus 44% in 2017. In some countries, up to 25% of offices introduced standing desks. The global standing desk market is estimated to reach $2.8 billion by 2025 (Credence Research, 2017), making it a trend that appears to be here to stay.  

The calorie burning myth

Isn't standing supposed to burn more calories than sitting? Yes, but you can count on two hands how many more calories it burns. While not sitting, a standing person is still largely inactive. Many have altered their personal work environments in the effort to make a positive impact on their health, however, what they have gotten is an outright false sense of security that has not been backed by science.

A Harvard study published in Circulation in 2016 compared findings of 44 studies with more than 1,000 participants. What they found is that the mean difference in energy expenditure between sitting and standing was only 9 calories per hour. This means, that if a user of a standing desk would stand for six hours per day, it would equate to the amount of calories in one apple. (Saeidifard et al., 2016). That  means that an attempt to lose weight by using a standing desk is little more than wishful thinking. As a comparison, walking for 1 hour burns around 400 calories, because walking requires that half of the 650 muscles of the body are active.

This finding has greater implications when considering that a motivation for many users when starting to use a standing desk is the desire to lose body weight.

The predominant association is that standing workstations are measures to promote health in work environments. The existence of subsidised programs by health insurance companies also indicates their overall positive health benefits. However, looking into this further, we find that the latest research actually points in the opposite direction.

Standing is bad for posture

The main issue with standing desks is connected to the very body position they force the user into. Standing for periods of time is unpleasant. Out of our own experience, we know that standing while waiting in a queue comes along with sensations of heaviness in the legs, back pain and generally leads to fatigue and even affects our mood.

Maintaining proper posture while standing in order to avoid the pain sensations described above proves to be challenging for many. There is a simple reason for this. The human anatomy and physiology is not optimised to facilitate such a posture for any extended period of time.

After years of sitting, the body’s soft tissue and muscles have likely sustained considerable damage, resulting in relative weakness in the core and glute muscles, with consecutive lack of stabilisation and a forward tilted pelvis. Tight hip flexor muscles, which are often considerably shortened due to sitting, also contribute to a bad posture while standing. Same as in sitting, many people who stand tend to slouch and lean to one side, still relying rather loosely on soft tissue structures.

The body easily comes off balance when standing, resulting in favouring one side or constant shifting forward and backward. The posture typically seen in office workers using standing desks, is one where the arch in the lower back is exaggerated, resulting in compression of intervertebral disk spaces and often resulting in muscular pain. Lower back pain, therefore, is one of the most complaints that I have heard from patients using standing desks, which is somewhat ironic as many have sought to use standing desks to alleviate these very same ailments.

Standing makes tired

Scientific studies have looked into the question of standing desk ergonomics. In a 2018 study, adult participants performed standing computer work to investigate possible changes in discomfort as well as cognitive function. After just two hours, most users complained of muscle fatigue, lower limb swelling and mental state deterioration, coupled with decreases in attention and reaction time (Baker et al., 2018).

Most standing desks are not used

The associated discomfort of height-adjustable desks often results in them not being used in the intended way. A large study performed in Germany looked at this question in more detail. Almost 700 participants were interviewed regarding their usage of a sit-to-stand desk. Out of the study population, 16% had access to such a desk, similar to the range of other countries. Surprisingly, only half of these individuals utilised the standing functionality of the desk, the remaining half had stopped standing and instead lowered it back to a height that allows usage with a conventional chair (Wallmann-Sperlich et al., 2017).

Having access to a standing desk also appears to fail in substantially decreasing overall sitting time, likely due to a compensation with more time spent inactive during leisure time. A systematic review that compared the results from 21 different trials, published in the Cochrane Registry in 2016, concluded that the availability of standing desks only leads to a reduction of overall sitting time of around 30 minutes to two hours (Shrestha et al., 2016).

Not good for the heart either

Standing for extended periods of time might actually cause more harm than good. A study from Canada compared standing and sitting at work across 7,000 workers; researchers reviewed the employees’ healthcare records and looked for associations of occupational standing, sitting and cases of heart disease over the past 12 years. At the beginning of the study period, all of the people were free of heart disease. The study found that those who had to stand at their workplace had twice the risk of heart disease, compared to those who spent their time predominantly seated at work. Possible falsifying factors such as other health, sociodemographic, educational and work variables were excluded.

While not entirely understood, the underlying reasons are likely the result of a combination of too much blood pooling in the legs with an associated increase of pressure in the veins and an increase of oxidative stress in blood vessels. Over an extended period of time, this permanent stress on the vessel walls could explain the paradoxically increased risk for heart disease in those who stand more (Smith et al., 2017). And the heart doesn’t appear to be the only organ that suffers from prolonged standing at work. Early studies have indicated that serious pregnancy related risks, such as preterm births and spontaneous abortions could also be a result (McCulloch et al., 2002, Waters et al, 2015).“

 

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https://www.credenceresearch.com/report/standing-desks-market

Saeidifard, Farzane, et al. “Difference of Energy Expenditure While Standing versus Sitting: A Systematic Review and Meta-Analysis.” (2017): A20539-A20539.

Baker, Richelle, et al. “A detailed description of the short-term musculoskeletal and cognitive effects of prolonged standing for office computer work.” Ergonomics 61.7 (2018): 877-890.

Wallmann-Sperlich, Birgit, et al. “Who uses height-adjustable desks?-Sociodemographic, health-related, and psycho-social variables of regular users.” International Journal of Behavioral Nutrition and Physical Activity 14.1 (2017): 26.

Shrestha, Nipun, et al. “Workplace interventions for reducing sitting at work.” The Cochrane Library (2016).

Smith, Peter, et al. “The relationship between occupational standing and sitting and incident heart disease over a 12-year period in Ontario, Canada.” American journal of epidemiology 187.1 (2017): 27-33.

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Waters, Thomas R., and Robert B. Dick. “Evidence of health risks associated with prolonged standing at work and intervention effectiveness.” Rehabilitation Nursing 40.3 (2015): 148-165.