Active Voice: Reducing Workplace Sitting — Potential for Health Benefits

By Genevieve N. Healy, Ph.D., David W. Dunstan Ph.D., and Nyssa Hadgraft, M.P.H.

Genevieve N. Healy, Ph.D. David W. Dunstan Ph.D. Nyssa Hadgraft, M.P.H.
Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily reflect positions or policies of ACSM.

Genevieve Healy, Ph.D., is principal research fellow at the University of Queensland in 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.

David Dunstan, Ph.D., is the physical activity laboratory head at the Baker Heart and Diabetes Institute in Melbourne, Australia. His research focuses on understanding the role of reducing prolonged sitting for the prevention and management of chronic diseases. He has been a member of ACSM since 2001.

Nyssa Hadgraft, M.P.H., is a postdoctoral research fellow in public health at Swinburne University of Technology in Melbourne, Australia. Her research focuses on understanding the factors influencing sedentary behavior in the workplace, including barriers and facilitators to change, with the aim of providing practical recommendations for industry and policymakers.

This commentary presents Dr. Healy’s, Dr. Dunstan’s and Ms. Hadgraft’s views on the topic of research work that they and their colleagues completed together. The scientific article related to this commentary was published in the October 2017 issue of
Medicine & Science in Sports & Exercise® (MSSE).

The hazards of too much sitting are garnering considerable attention from the scientific community, industry and within the popular media. Guidelines for both the general population and some clinical conditions now include recommendations that adults should reduce, and regularly break up, their sitting time. For example, the 2016 Position Statement from the American Diabetes Association states that:

“All adults, and particularly those with type 2 diabetes, should decrease the amount of time spent in daily sedentary behavior. Prolonged sitting should be interrupted with bouts of light activity every 30 min for blood glucose benefits, at least in adults with type 2 diabetes.”

The desk-based workplace has become a key setting for addressing too much sitting. Desk-based workers sit an average of 75 percent of their workday, making workplace sitting the greatest contributor to overall sitting time for this occupational group. Several workplace intervention trials have demonstrated that reductions in sitting time are feasible and can be acceptable to employers and employees. Sit-stand workstations, which provide workers with the opportunity to alternate between sitting and standing postures throughout the day, are becoming increasingly common in many workplaces and home offices. Critically, however, sit-stand workstations appear to be more effective at reducing sitting time when combined with strategies that target the multiple influences on workplace activity — organizational, social and individual factors — in addition to the physical workspace.

Although we know that significant reductions in workplace sitting are achievable, little evidence is available about the potential benefits to workers’ health. Our article, which appeared in the October 2017 issue of MSSE, addresses this question. We reported a significant and beneficial intervention effect for fasting glucose and a clustered metabolic risk score (generated from multiple risk biomarkers) at 12 months following a workplace-delivered intervention to reduce sitting time (Stand Up Victoria). During the intervention, sitting was predominantly replaced with standing. This beneficial effect for fasting glucose was mainly due to deterioration in the control group over the 12-month study. Given available epidemiological evidence on the rapidly escalating rates of type 2 diabetes in modern society, not getting worse is still likely to be a clinically relevant outcome. Notably, our study was conducted in a general working population, not one specifically at risk. As such, reducing workplace sitting time may provide a novel preventive strategy to stem the rise in type 2 diabetes among middle-aged workers. With short-term laboratory studies showing that the benefits of sitting less are likely to be greater for clinical “at-risk” populations (e.g., type 2 diabetes, overweight/obese), these types of interventions may be beneficial for both the prevention and management of chronic disease.

Our findings demonstrated potential benefits for some risk markers at 12 months, but longer-term, wider-scale investigations are needed. The recently developed BeUpstanding™ program – a scaled-up version of Stand Up Victoria — will provide the opportunity to address some of the limitations of short- to medium-term research studies. BeUpstanding™ provides workplace champions with the tools to deliver and evaluate a “workplace sitting reduction intervention” within their own workplace. Through this program there is a great opportunity to build partnerships with industry and leverage off existing data (e.g., employee wellness checks, internal productivity measures). This next stage of research will enable us to better understand the long-term impact on risk markers and health outcomes of sitting less in the workplace.