Working standing up does not reduce cardiovascular risk or compensate for a sedentary lifestyle

In the battle against a sedentary lifestyle in recent years, there has been a proliferation of posts on websites and by influencers on social media praising the benefits and virtues of leaving the chair behind to work standing up. Experts in prevention and occupational health explain that there are even companies that have completely eliminated traditional desks from their offices and have opted for high or height-adjustable tables; and there are many teleworkers who have joined the trend in their homes, although not always with the appropriate means and knowledge.

“Often the desk is chosen for its aesthetics, for its price, but not for the functionality that the worker needs. And what doesn’t make sense is to turn regular workspaces into bad ones, because on top of that, anti-ergonomic postures are acquired: the shoulders are not at the height of the keyboard, the screen is not at eye level,” explains Santiago González, president of the Spanish Association of Specialists in Prevention and Occupational Health (AEPSAL).

Two recent studies have also concluded that standing up does not in any way benefit cardiovascular health or offset the harmful effects of a sedentary lifestyle. The first of these studies, published in the scientific journal Circulation, concluded that alternating between sitting and standing at work has no effect on lowering blood pressure. The second, published in the International Journal of Epidemiology using data from the UK Biobank of more than 80,000 adults, found that standing at work does not reduce the risk of diseases such as stroke and heart failure; and that, furthermore, standing at a work station for more than two hours a day can even increase the risk of developing problems such as varicose veins or deep vein thrombosis.

“Previous studies have examined the health benefits of sitting or standing on cardiometabolic markers such as blood pressure, triglyceride levels and insulin sensitivity. Ours is the first study to attempt to link standing work with the risk of heart disease and orthostatic circulatory conditions (thrombi and varicose veins),” Matthew N. Ahmadi, a researcher at the University of Sydney’s Faculty of Medicine and Health, told EL PAÍS. According to Ahmadi, the results show that standing is better than sitting: “Spending a lot of time sitting was associated with an increased risk of heart disease, while standing was not associated with an increased risk, but neither was it associated with a lower risk.”

“We often recommend that people stand up, but what this study shows is that doing so is not related to cardiovascular mortality, either for better or worse. We could say that with regard to serious cardiovascular pathology, standing up has no impact, so it seems clear that it is not a useful strategy to prevent cardiovascular disease,” reflects Luis Rodríguez Padial, head of the Cardiology Service at the Toledo University Hospital Complex and president of the Spanish Society of Cardiology (SEC).

The importance of movement during the work day

According to Ahmadi, the results of his study suggest that to optimally improve health and reduce the risk of heart disease, it is not enough to simply change the position from sitting to standing: this must be combined with activities that force the person to move. “To improve cardiovascular health, we have to involve the cardiovascular system and activities that make us move can do that,” says the researcher.

This reflection coincides with what has been shown by other recent studies, which have indicated that short bursts of just one minute of intense exercise during daily routines could have a great impact on the health of the most sedentary people, reducing mortality from all causes and the risk of heart disease by 40%.

“What is advisable is to intersperse short bursts of movement throughout our day, not just get up and stand without doing anything. You have to walk, climb stairs, take advantage of the opportunity to move about while you answer a call... We have data that demonstrate the benefits of this. On the one hand, because these short bursts of movement are a break from a sedentary lifestyle; and, on the other, because for those who do nothing, they are a way to move a little,” reflects Rodríguez Padial.

This opinion is shared by AEPSAL, which argues that the key idea should be movement. “If we are not moving, there is no point in standing,” says González. The expert explains that sitting for a long time and standing without moving leads to the accumulation of blood in the legs and an increase in blood pressure to compensate for the lack of circulation. It is the flexion of the calf muscles when walking or moving that generates the muscle contractions necessary to help push blood toward the heart and brain: “The veins move with the movement of the muscles. If we are still for a long time, in the end we can have problems such as heaviness in the legs, varicose veins and, in more serious cases, a thrombosis. And even more so if we are standing, since it is even more difficult for blood to return to the brain from that position.”

In this sense, if you work standing up, in addition to taking advantage of phone calls or the need to make photocopies to go for walks, González recommends other movements in the same work position such as standing on tiptoe or alternating the weight of the body from one leg to the other. “Anything that gives movement to work will be healthy. In the end, the body is dynamic, it is designed for movement, not for standing, and if we do not give it that movement, problems arise,” he concludes.

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