Butt in an ashtray, foot in a coffin?


You've probably heard that sitting is the new smoking, but is standing necessarily better? I think it's important to realize that a standing desk on it's own won't solve all of your problems. We try to do our due diligence by hitting the gym after a stressful day at work, but unfortunately this is not enough to offset the negative metabolic changes that are accompanied by being sedentary for the majority of the day. Tally up how much time you are sitting around, from meals, your commute, the desk, to the television... you're probably already feeling the weight of it. So what happens when we stand instead of sit? There are definitely positive physiological affects that occur such as an increase in energy expenditure of 0.15 kcal/min (1). This difference in energy expenditure translates to about 5.5 lbs of body fat in 1 year assuming we're swapping 6 hours of sitting with standing daily. However is this change enough to counteract the damage done from sitting? Some studies found that more standing was associated with less variability in blood sugar after meals while others found that it did not, but short bouts of light activity did lower variability (2,3). So the jury is still out on that. Greater changes in blood sugar means more oxidative stress, in other words, an increase in free radicals which are harmful to the body's tissues.


Additionally, many people still complain of pain in various areas from the low back, knees, or feet when making the switch to standing. The truth is no one position or posture is better than the other, but any prolonged amount of sitting or standing can result in discomfort, and eventually, injury. The main problem I see when people try to make change in their lives is that they carry forwards the same poor patterns and restrictions that have accumulated over the years. Due to countless hours sitting in chairs, our calves, hip flexors and chest muscles have all shortened. When we stand these restrictions contort the body causing, again, poor posture.


Secondly, we haven't fixed the foundation, which in my opinion are the feet and the DEEP core. Janet Travell, physician, researcher, and pioneer in the treatment of myofascial pain was of the opinion that "a compromised foot structure is a major perpetuating factor in chronic musculoskeletal pain throughout the body." It starts from the bottom up and the inside out (although that's for another discussion). In my practice it isn't at all uncommon to improve mobility of the feet and ankles in order to take pressure off of other areas of the body such as the knees and the low back. This is because the myofasica (connective tissue) is continuous throughout the body, and excess tension in one area will distort another. The vast majority of shoes on the market unfortunately compromise the natural biomechanics and stability of the foot, thus causing excess tension in the calves and contributing to pain throughout the body.


So what's my take on the standing versus sitting debate? I would recommend not too much of anything. Variability is your friend. Do your best not to stay in any one position for more than 20-30 minutes, and definitely explore different possibilities. Try sitting on a meditation pillow, lying on the ground, or work on your "resting squat"- also called the malasana pose in yoga. How you hold yourself is important, but how long you're there is even more important. So, get creative, don't be stagnant, and throw in some light exercise every now and then to help with your blood sugar and a healthy metabolism!


References:


(1) Saeidifard, F., Medina-Inojosa, J., Supervia, M., Olson, T., Somers, V., Erwin, P. and Lopez-Jimenez, F. (2018). Differences of energy expenditure while sitting versus standing: A systematic review and meta-analysis. European Journal of Preventive Cardiology, 25(5), pp.522-538.

(2) Buckley, J., Mellor, D., Morris, M. and Joseph, F. (2013). Standing-based office work shows encouraging signs of attenuating post-prandial glycaemic excursion. Occupational and Environmental Medicine, 71(2), pp.109-111.

(3) Bailey, D. and Locke, C. (2015). Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not. Journal of Science and Medicine in Sport, 18(3), pp.294-298.

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