To sit or to stand, that is the question. Though previous research has extensively outlined the dangers of prolonged sitting, a new study suggests standing for extended periods may not necessarily be the antidote — and may have its own negative health impacts.
The study, published in the International Journal of Epidemiology, found people who sit for more than 10 hours a day have higher risks for cardiovascular and circulatory diseases. Standing for long periods was not linked to a higher risk for cardiovascular disease. But researchers said it may increase the risk for circulatory diseases.
MORE: How long you can stand on one leg is a telltale sign of aging
"Collectively, our findings indicate increasing standing time as a prescription may not lower major CVD risk and may lead to higher orthostatic circulatory disease risk," the study authors wrote.
The study used data from more than 83,000 adults in the United Kingdom, investigating the influence of sedentary behavior on heart disease and orthostatic circulatory disease. For every hour of sitting beyond 10 hours, the risk of heart disease increased by 15% and the risk of orthostatic circulatory disease went up by 26%, the study found. After standing for 2 hours, every additional 30 minutes of standing was linked to an 11% increased risk of orthostatic circulatory disease.
Cardiovascular diseases, the leading cause of death globally, are a group of disorders affecting the heart and blood vessels. They include heart attack and stroke. Orthostatic circulatory disease refers to a group of conditions related to circulation, including orthostatic hypotension and varicose veins.
This new research on the health effects of standing may seem to run counter to the standing desk trend, which research has found to ease lower back, shoulder and neck discomfort. But the new research is not necessarily saying standing at work or elsewhere is negative – it's more focused on the dangers of prolonged inactivity.
"I do think standing is better than sitting overall, because you do tend to move a little bit more when you're standing," said Kang Han, a primary care physician with Cooper University Health Care who was not involved with the study. "But obviously just standing may not be enough to get your blood pumping and going. … You still need to move around for your blood vessels to start moving around."
Many people fall into sedentary lifestyles, because modern offices and work-form-home settings do not promote much movement, and then they relax at home in front of the TV. Here's what to know about negative health effects of being stationary for long periods of time, and simple ways to begin combatting them:
What's so bad about a sedentary lifestyle?
"Research has been very consistent on this particular topic that we are designed to be moving, and so sitting for long periods of time definitely have tons of negative outcomes, mainly related to cardiovascular disease, heart attacks, strokes, heart failure, all of the big things that we really care about in cardiology," said Kevin Curl, cardiologist and director of cardiac rehab for Virtua Health.
A study published in January found that people who mostly sit at work were 16% more likely to die of any cause – and 34% more likely to die of cardiovascular disease – than those who do not mostly sit at work. And the effects of being sedentary can be felt beyond the heart.
"(Cardiovascular health) has not only to do with the health of the circulation to the heart muscle, but it also has to do with your overall vascular health," said Sabrina Islam, associate professor of medicine at the Lewis Katz School of Medicine at Temple University. "So brain health, kidney function, liver function, as well as the health of the heart, it has to do with your longevity and your quality of life. So I think we have a better understanding that there are so many ways that your body is impacted by your physical activity and having a sedentary lifestyle can manifest not only as having something happening to the heart itself, but it has implications for all of the organ systems of your body."
Being sedentary for prolonged periods also increases the risk of weight gain, diabetes, dementia and cancer. Research has shown that a sedentary lifestyle also can impact mental health, increasing the risk for depression, anxiety and chronic stress. It can potentially affect cognitive health, too.
"In terms of later in life, whether or not you develop cognitive impairment or dementia or progression of other medical conditions; some of that can be tracked to how we've led our life earlier in life, or also how we lead our lives day to day, and how much physical activity we have," Islam said. "So even many chronic medical conditions that people might develop over their lifespan, they can be better managed through physical activity — high blood pressure, high cholesterol, diabetes, your metabolism overall, or the weight that you carry, distribution of body fat — a lot of that can also be impacted by your physical activity."
When people sit, the largest muscles in the body – located in the legs – barely contract. Since the muscles are inactive, they require minimal fuel and therefore take in smaller amounts of sugar from the bloodstream. They also do not release biochemical substances that usually help break down fatty acids in the blood. This leads to blood sugar and cholesterol build up in the bloodstream.
Stationary standing for too long can lead to issues with venous circulation, when blood is returned to the heart, Islam said. She added that the gravitational forces of the standing posture over time can lead to chronic blood-pooling, swelling or ulcers in the legs due to poor circulation.
How to combat the impacts of a sedentary life
The American Heart Association recommends adults get at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week. But only about 1 in 5 adults and teens get enough exercise to maintain good health, the AHA says.
For office workers, getting active on a daily basis can be as simple as taking a break and going on a brisk walk for 20-30 minutes. Taking the stairs or parking at the far end of the parking lot to require a longer walk into the office also provide benefits. And having a smart watch or a walking buddy can help people remember to get up and move.
If people don't have time for a walk around the block during the work day, there are other ways to stay active.
"You can also still do exercises in place; you don't have to walk," Islam said. "As long as you're using your lower extremities, that would be very helpful to help bring the blood flow back to the heart as well."
Han suggested people try "pedaling" motions with their feet. There are stationary pedaling devices or mini treadmills that people can park under their desks to kickstart circulation. For people with standing desks, even switching between sitting and standing adds a little movement into an otherwise stationary work day.
People who work remotely may experience "more difficulty" in adding in physical activity to their days, Curl said.
"If you're going to just be on a phone call, can you do that while you're walking inside on a treadmill or outside in a quiet space, and really just try to build it into your day to day?" Curl said.
Han said she tells her patients they don't have to become Olympian-level walkers; they can start at their own pace and still reap the physical and mental benefits.
"Starting slow is okay: start slow, if it's 10 minutes, 15 minutes per day, and then slowly increase," Han said. "Think of it as more lifestyle change, not 'I'm just going to do this for three months' kind of deal. I think walking also helps with your chronic stress level, because everybody has stress, so (walking is) just time to decompress and meditate. … Walking outside also helps with getting some sunshine, with vitamin D levels too, which will increase your energy and mood, reduce your stress and fatigue. So, yeah, I think it also correlates well with your mental health."
One of the most important things to keep in mind when getting active is to stay consistent, Curl said. He recommended sprinkling in physical activity throughout the course of the day.
"For each one minute of exercise that we do, we are adding at least several minutes to our lifespan," Curl said. "And so when you think about investment that we make for ourselves, there's almost no better investment than being physically active on a consistent basis."
