“Sitting is the new smoking!” “Sitting is a silent killer!” “Are you sitting your way straight to the
grave?” If you believe what the media is telling you,
you’ll never want to sit again. But what does the science have to say about
sitting vs standing desks? Let’s find out. What’s going on guys, Dr. Jubbal, I’ve been using a standing desk now for over
5 years, and when I set out to create this video, I was expecting to find substantial
research to back my decision.

But after reading over two dozen research
articles on the subject, I found myself surprised, as the data isn’t as clear cut as some would
have you believe. So what does the data have to say about sitting,
and are standing desks really the best option for your health and productivity? First, it’s important to understand the
arguments against sitting and traditional desks. So what’s so bad about sitting? The fundamental principle is that a sedentary
lifestyle and the physiologic changes that ensue are harmful to us. And there’s a lot of evidence that physical
inactivity is linked to higher morbidity and mortality, but the question is how does this
relate to sitting at our desks, and whether standing desks are a viable alternative. Mandsager and colleagues demonstrated in 2018
that poor cardiorespiratory fitness, as assessed on an exercise treadmill test, was strongly
correlated with mortality. In short, if you’re in better shape, you’re
less likely to die. It is important to note, however, that this
study, and many others, are retrospective studies and therefore by definition, they
demonstrate correlation, not causation. Additionally, it’s been noted that the negative
effects of sitting aren’t reversed by exercise.

Reason being, the metabolic changes and subsequent
deleterious effects induced by sitting aren’t simply reversed by being active. Sitting also increases the pressure to your
lower back in comparison to standing – ever notice that your back hurts more when you
sit for prolonged periods of time? So let's talk about the evidence for standing desks. Now if sitting for prolonged periods is bad for us, it’s easy to see how standing desks
would seem like a logical solution. In 2013, Buckley and colleagues demonstrated
that standing reduces postprandial glycemic variability, meaning your blood sugar varies
less after eating a meal if you’re standing.

This is good, as greater amplitudes of glycemic
variability have been linked to circulatory oxidative stress. However, Bailey et al. in 2015 had conflicting
data, suggesting that standing did not alter postprandial glycemic variation, but short
bouts of light-intensity activity did. In 2017, Gibbs and colleagues postulated that decreased
caloric expenditure could be a specific mechanism through which sedentary behavior increases
health risks, such as by contributing to an energy imbalance leading to obesity.

They also demonstrate that standing expends
more energy than sitting – no surprise there. As a whole, however, the literature regarding
the benefits of standing desk is not clear cut. Katzarzyk in 2013 suggested that increased
standing time was correlated to reduced mortality rates, but Smith and colleagues in 2017 suggested
the exact opposite; that occupations involving primarily standing were associated with a
2-fold increase in heart disease compared to occupations involving predominantly sitting. Several other studies I came across in my
research emphasized the increases in physical activity associated with standing desks, reduction
of lower back pain, and improvement in cholesterol or blood pressure. However, others suggested that the increased
physical activity at a standing desk was offset by a decrease in physical activity away from
the desk. And while some studies pointed to improvements
in psychological wellbeing, creativity, and no detrimental effects to focus or productivity,
others concluded that standing desks were associated with deterioration in reaction
time and mental state.

The data is best summarized by two systematic
reviews. In 2014, Neuhaus and colleagues concluded that
“the installation of activity-permissive workstations in office-based workplaces is
likely to be a feasible and acceptable means to reduce sedentary time, with mostly neutral
or positive impacts on adiposity and other health and work-related outcomes.” The systematic review by MacEwen and colleagues
in 2015 concluded that there wasn’t enough evidence to evaluate the utility of each type
of desk, however, treadmill desks demonstrated the most significant improvements in glucose,
cholesterol, and fat loss. Standing desks had few physiologic changes,
but improved psychological wellbeing.

And ultimately, too much standing or sitting
would result in discomfort. So Where Does It Leave Us? The key take away from my deep dive in the
literature is that… the literature on standing versus sitting desks kind of sucks. The overwhelming majority of the studies were
retrospective and did not adequately control for possible confounding variables. For example, Smith and colleagues demonstrated that
people working occupations involving primarily standing were associated with a 2-fold increase
in heart disease. But without controlling for the types of occupations,
socioeconomic variables, and other demographic factors, that information is close to meaningless. The data is quite strong though that a sedentary
lifestyle is not good for you. But I’m not convinced that a standing desk
is necessarily the solution. This is a complex problem – people are no
longer getting much exercise in their lives – and we are proposing an incredibly simple
solution, hoping it’s an easy fix. Unfortunately, even with the scientific method
we don’t get clear cut answers, and we must make decisions with imperfect information. So should you sit or stand at your desk? I’d argue that isn’t the right question
to ask.

In 2018, Caldwell and colleagues even demonstrated
that prolonged standing resulted in measurable increases in arterial stiffness. That's not good. It seems, then, that any form of inactivity,
whether standing or seated, results in negative health implications. Instead of focusing on standing or sitting
at our desks, it appears that the most important principle is to *move regularly* – some
have suggested every 20 minutes as a good rule of thumb. Our bodies are designed to move – we aren’t
designed to sit still. So even if you’re using a standing desk,
you don’t want to stay immobile all day. You should be shifting, walking, moving, stretching,
doing yoga poses, and switching between sitting and standing throughout the day. But because this is Med School Insiders, I don’t
want to leave you hanging. I want to give you actionable advice. Here are three points to act on: First, Stay Hydrated
One of my favorite methods to induce movement is to stay well hydrated. It has the benefit of, well, keeping me well
hydrated, but also the side benefit of prompting me to move regularly, as I need to use the
restroom frequently.

If you need a friendly reminder to drink more
water, the easiest thing you can do is buy a water bottle and keep it nearby. I personally opt for the BPA free Nalgene
1.5L. I bought it for $10 over 5 years ago, and it’s still serving me well. Link in the description below. Number two, Adjust Your System to Facilitate Physical
Activity Remember that your systems produce results. After watching this video, if you feel motivated
to move and exercise more, I guarantee it won’t last.

If, instead, you take that motivation and
use it to change your systems, you’ll be much more likely to see results. My favorite is a simple tweak – instead
of driving to work, or to the grocery store, or to visit your friends, try riding your
bike instead. If it’s too far, then use public transport
in the middle, but still ride your bike to and from the station.

And number three, Experiment For Yourself.
In this day and age, we want quick answers. But sometimes, the answer is best found out through
self-experimentation. From my own self-experimentation, I’ve figured
out a system that works for me. I will continue to use my standing desk, because
I see significant benefits both in my posture as well as alleviation of back pain, and
I feel that I can offset any potential detrimental effects by moving frequently, either through
regular hydration, or through a simple reminder on my smart watch. If you’d like to see how I created this
video and how I approached the research that led me to my conclusions, I have provided
behind the scenes looks with exclusive access to my notes and research documents on my Patreon
page. By becoming a patron, you’ll be supporting
us to continue producing videos like these, and you’ll get exclusive perks, including
Patreon-exclusive Q&A sessions, video commentary where I provide additional gems that I couldn’t
fit my videos, priority voting rights for upcoming videos, and even video chats with
yours truly.

Where do you stand on the standing versus
traditional desk debate? Did this video make the science more clear,
or are you just more confused? I’d love to hear from you, so leave a comment
down below. Thank you all so much for watching, make sure
you hit the subscribe button and have he notification bell enabled so that you don’t miss any
new uploads. And I will see you guys in that next one..

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