Active Voice: Cardiometabolic Impact of Changing Sitting, Standing and Stepping in the Workplace

By Elisabeth A.H. Winkler, Ph.D., and Genevieve N. Healy, Ph.D.

Elisabeth A.H. Winkler, Ph.D. Genevieve N. Healy, Ph.D.
Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily reflect positions or policies of ACSM.

Elisabeth Winkler, Ph.D., is a data analyst at the University of Queensland, Brisbane QLD, Australia. Much of her work focuses on measurement considerations when evaluating sedentary behavior, physical activity and other lifestyle behaviors in relation to health and wellbeing, and their improvement via intervention.

Genevieve Healy, Ph.D., is a principal research fellow at the University of Queensland, Brisbane QLD, Australia. Her research on the benefits of reducing prolonged sitting time has informed both policy and practice. She has been a member of ACSM since 2007.

This commentary presents Dr. Winkler’s and Dr. Healy’s views on the topic of the research article that they co-authored with several colleagues. Their article appears in the March 2018 issue of
Medicine & Science in Sports & Exercise® (MSSE).

In several countries, including Australia and Canada, guidelines have been written that indicate adults should both reduce their sitting time and increase their physical activity in recognition that excessive sitting poses risks to health and wellbeing. The workplace is a key setting in which sitting time occurs and can be minimized through intervention.

Notably, a meta-analysis report by Neuhaus et al. (see: Obes Rev, October 2014) indicated that interventions which replace traditional desks with activity-permissive alternatives can successfully reduce occupational sitting time, as well as overall sitting time. The ensuing benefit to human health and wellbeing is comparatively less clear, as it may depend on what type of physical activity workers are performing instead of sitting. Sit-stand workstations primarily facilitate increases in standing which, according to at least one laboratory study, may not provide the full degree of cardiovascular benefit afforded by walking.

Our study, as published in the March 2018 issue of MSSE, utilized a statistical methodology (see abstract for description) recently adopted by physical activity researchers. This approach enabled us to determine how the various ways in which workers’ shifts in time use related to their degree of improvements in biomarkers indicative of cardiovascular health. Over a three-month timeframe, the study did not demonstrate much benefit of swapping sitting for more active behaviors. However, over a 12-month period, we observed a range of statistically significant benefits. These included a reduction in the overall cardiometabolic risk score, as well as improvements in selected indicators of glucose and lipid metabolism, blood pressure regulation, body weight and body fat. The effects of sitting reduction via increasing stepping tended to be more advantageous than were the effects of sitting reduction achieved via increasing standing. Importantly, however, both types of sitting reduction were associated with a statistically significant lowering of overall cardiometabolic risk.

So, what do these findings mean? Overall, our study suggests that efforts to reduce sitting in the workplace over the long term have the capacity to improve cardiovascular health, whether they primarily improve standing, or better yet, walking and other ambulatory movements. To reduce cardiometabolic risk, it pays to be ‘’upstanding’’ and, comparatively, it pays even more if you get moving while you’re up.