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Stand Up, Sit Less and Move More, Researchers Say; Here's How to Do It

Story at-a-glance -

  • Sitting for eight hours or more each day is associated with heart disease, cancer, type 2 diabetes and all-cause mortality
  • Swapping two hours of sitting a day with two hours of standing or stepping leads to improvements in triglycerides, waist circumference, cholesterol levels and more
  • Taking 10,000 steps a day may lead to weight loss and lower blood pressure

By Dr. Mercola

Research continues to show that sitting excessively can contribute to chronic disease, worsen your quality of life and even shorten your lifespan. Yet, many countries are still only advising their residents to get regular exercise, while ignoring the importance of increasing overall daily movement.

Exercise — the type that gets your heart rate up and causes you to break a sweat — is important, exbut we now know it's not the whole picture. It is becoming increasingly obvious that we need to exercise less and move more.

If you exercise for 30 minutes then spend the majority of your non-exercise hours sitting, well, it's the equivalent of popping a multivitamin and then eating French fries and ice cream for the rest of the day.

Australia is the first country to adopt not only physical activity guidelines but also sedentary behavior guidelines, which advise minimizing the amount of time spent in prolonged sitting, as well as breaking up long periods of sitting as often as possible.1

Other countries, like Colombia, are also being proactive about getting people up and moving; the country's government computers actually pause automatically in order to force employees to take regular (hopefully active) breaks.2

Sedentary Behavior Is the Fourth Leading Cause of Death

The World Health Organization (WHO) states physical inactivity is the fourth leading risk factor for premature death worldwide.3 If you're surprised that simply neglecting to move around enough may shorten your lifespan, consider this: even regular exercise may not undo its ill effects.

One meta-analysis of 42 studies assessing sedentary behavior in adults found prolonged sedentary time (generally defined as sitting for eight hours or more each day) was associated with a number of health risks regardless of physical activity. This included:4

  • All-cause mortality
  • Cardiovascular disease mortality
  • Cancer mortality
  • Cancer incidence
  • Type 2 diabetes incidence

" … [A] compelling body of evidence [suggests] that the chronic, unbroken periods of muscular unloading associated with prolonged sedentary time may have deleterious biological consequences," researchers further noted in the journal Exercise and Sports Sciences Review.5

Metabolic health is one area that seems to particularly suffer. Recent research published in Diabetes Care revealed, for instance, that more sedentary time was independently associated with insulin resistance, diabetes and impaired glucose tolerance.

Each additional hour per day of sedentary time was associated with 3 percent higher fasting insulin resistance. Previous research published in Diabetologia found those who sat for the longest periods of time were twice as likely to have diabetes (or heart disease) compared to those who sat the least.6

What Happens When You Replace Sitting With Standing? 

Standing is a simple alternative to sitting — but is it enough to protect your health?

According to Dr. James A. Levine, co-director of the Mayo Clinic and the Arizona State University Obesity Initiative, when you have been sitting for a long period of time and you stand up, beneficial changes occur within 90 seconds of getting off your bottom.

For instance, the muscular and cellular systems that process blood sugar, triglycerides, and cholesterol — which are mediated by insulin — are activated. Research published in the European Heart Journal further showed that swapping two hours of sitting a day with two hours of standing led to:7

  • 2 percent lower fasting plasma glucose
  • 11 percent lower triglycerides
  • 6 percent lower total/HDL-cholesterol ratio

People who stood for one-quarter of their day also had a lower risk of obesity and metabolic syndrome, according to one study, and this was further reduced when combined with physical activity.8

I was also recently surprised to learn that when you stand for 10 hours a day you are burning over 600 calories, which is the metabolic equivalent of walking six miles.

This appears to be a common thread. While standing is generally better than sitting, moving is generally better than standing. In the European Heart Journal study, for instance, when two hours of sitting a day was swapped with two hours of stepping, it led to:

  • 11 percent lower body mass index (BMI)
  • 7.5 cm (about 3 inches) lower waist circumference
  • 11 percent lower 2-hour plasma glucose
  • 14 percent lower triglycerides
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Too Much Standing May Not Be Ideal Either

For now it's safe to say that most people need to significantly reduce their time spent sitting and replace it with a combination of standing and movement. But as with sitting, it's probably wise to guard against too much standing as well. Dr. Levine stated:

"I think it's correct to say we're in the middle of a 'stand up movement,' but the emphasis needs to be on movement … I don't want people to think that they should stand up like still soldiers. That is not a good idea."

Your heart cannot pump blood very efficiently from your feet back up the length of your body while you're standing still, which is why excessive standing may lead to swelling in your feet and lower legs, as well as increase your risk of varicose veins. Back pain, which is common with too much sitting, may also increase from too much standing. Even researcher Melvyn Hillsdon of the University of Exeter, who authored a study that found risk of death was not influenced by sitting time, noted:9

"Our study overturns current thinking on the health risks of sitting and indicates that the problem lies in the absence of movement rather than the time spent sitting itself … Any stationary posture where energy expenditure is low may be detrimental to health, be it sitting or standing."

Ultimately, a combination of the three — sitting, standing and movement — is probably best. The question remains how much of each one is ideal (and this probably varies from person to person).  The "happy middle" is changing your position regularly and often throughout the day and keeping active. Ideally, I recommend sitting for no more than three hours total each day.

Alan Hedge, a design and ergonomics professor at Cornell University, suggested a slightly different approach in the Boston Globe:10

"Sit for no more than 20 minutes at a time, Hedge recommended, and stand in one position for no more than 8 minutes. You should also take a two-minute moving break at least twice an hour to stretch or walk around."

Should You Walk 10,000 Steps a Day?

We're in the midst of a "10,000 steps a day movement," which has caught on in part due to wearable fitness devices that track your daily movement. Most of these devices come set with a default goal of 10,000 steps a day, which is a number commonly associated with a basic or moderate level of fitness.

For instance, Japan's Ministry of Health, Labour and Welfare recommends walking 8,000 to 10,000 steps daily, while the UK National Obesity Forum recommends 7,000 to 10,000 daily steps to stay moderately active.

The notion of 10,000 steps daily for optimal health was first popularized in Japan after a study found burning 2,000 calories a week via exercise lowers the risk of heart disease. This amounts to burning about 300 calories a day, which is achievable for most by taking 10,000 steps.11

There are now more than 300 peer-reviewed research studies looking into the health effects of taking 10,000 daily steps.12

Among them are studies showing this simple intervention may lead to weight loss13 and lower blood pressure.14 (Although one study found 10,000 steps a day weren't enough to improve body composition in postmenopausal women; in that study, 12,500 steps were recommended to improve health among this population.)

Aiming for 10,000 Steps Helps Keep You Out of Your Chair and Moving

Personally, I don't view walking as an exercise at all but rather as an essential movement that we all require. The older you get the more important it becomes. You can be very athletically fit, but if you are sitting all day with minimal walking or movement, your health will most definitely suffer.  

Part of what makes a goal of 10,000 steps a day so important is, quite simply, that it gets you up and out of your chair and moving. I personally walk about two hours a day or about 55 miles per week. However, I also keep my sitting to a minimum (about three hours a day) and do some form of "exercise" every day as well. This includes strength training twice a week.

According to the UK's National Health Service (NHS), the average person walks only between 3,000 and 4,000 steps per day.15  I recommend using a fitness tracker to find out how far you normally walk and adjusting your movement as necessary to get close to 10,000 steps daily.

This is only a guide; if you're elderly, you might aim for a bit less. If you're young and fit, you might need more. Even children can benefit from this goal. The President's Council on Fitness recommends at least 12,000 steps a day for children ages 6 to 12.16

But remember, as far as fitness goes, walking will only help you to get physically fit if you're starting out very out of shape. Even then, as you get fitter, you will need to add exercise to your lifestyle, such as HIIT and strength training, to actually get fit.

How to Stop Sitting and Get Moving

It sounds simple enough — get up out of your chair and start moving. Yet, it's all too easy to get engrossed in your deskwork, stuck in your commute, or cuddled up on your couch — and before you know it you've amassed 8, 10 or more hours in a sedentary position.

Many progressive companies are helping employees to stand and move more during the day. For instance, some corporations encourage "walk-and-talk" meetings and email-free work zones. Others put treadmills in conference rooms and offer standing workstations to those who are interested.

Last year we purchased motorized adjustable stand up desks for all our employees. If your workplace doesn't offer this, request it. As Fast Company reported:17

"In one seven-week study of standing desk use, participants reported less fatigue, tension, confusion, and depression, and more vigor, energy, focus, and happiness — and when they went back to their old desks, their overall mood returned to baseline levels."

Simple changes throughout your day can also add up to less time spent sitting and more time moving. Walk while you're talking on the phone, stand up while you watch television (or do a few jumping jacks or burpees during the commercials), park in the outskirts of the parking lot and take the stairs whenever you can.

Finally, when you do sit, swap out your chair for an exercise ball, which requires you to engage your core muscles and helps improve balance and flexibility. If all else fails and you find yourself in a prolonged sitting situation — fidget! It appears to help offset the mortality risk that comes with excessive sitting.18