Sitting, Standing & Intermittent Walking

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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Sitting, Standing & Intermittent Walking

Postby JeffN » Mon Sep 08, 2014 8:46 am

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Sitting, Standing & Intermittent Walking
Jeff Novick, MS, RD
Originally posted at my website on 1/22/14
*Update September 8, 2014

Q: Do you know of any studies regarding standing at your desk vs. sitting? It's becoming more common to have workstations modified so one can stand or even walk at a slow pace rather than sit. I would be interested to hear your views.

A: The data supporting the benefits of being more active, including standing vs. sitting, is excellent. As a result, standing desks and treadmill desks have become quite popular. While I think a standing desk is fine (as long as it works for you), I am very leery of how well these treadmill desks (as opposed to standing desks) will work out and there are already some small preliminary studies showing concerns. It's one thing to stand & work but it's another to try to walk on a treadmill & work.

Falling Down on the Job? Workstations Designed to Help You Get Fit May Make You Type Poorly, Even Fall
http://online.wsj.com/article/SB1000142 ... 35048.html

Effect of using a treadmill workstation on performance of simulated office work tasks.
http://www.ncbi.nlm.nih.gov/pubmed/19953838

The effects of walking and cycling computer workstations on keyboard and mouse performance.
http://www.ncbi.nlm.nih.gov/pubmed/20415158

In the end, these are all just attempts to find ways to be more active, which for many, is also a way to compensate for their excess calories and unhealthy food choices. However, until we learn to adopt a truly healthy diet, I don't see these as true solutions as the main problem for most, is excess calories.

In addition, the amount of activity that is really required to achieve all the health benefits we get from exercise is not that much and could be accomplished in ~30 (- 45) minutes, 5-6 days/wk. I think we really need to re-evaluate our lives and our priorities if we can't make the time for that.

Time & The Double-Edged Sword of Modern Conveniences
http://www.jeffnovick.com/RD/Q_%26_As/E ... ences.html

However, if you’re looking to increase active, non-sitting time, Intermittent Walking is a safe & healthy alternative to treadmill desks. There have been several studies demonstrating the benefits of Intermittent Walking. It is a concept I use all the time.

Intermittent Walking is the practice of getting up and going for a brief period of walking, or other activity/exercise, throughout the day. Years ago, when I worked a desk job, I used to get up every hour and go walking around the location for about 5-10 minutes. (It also helped me to think clearer)

Here are the studies...

1) Breaking Up Prolonged Sitting Reduces Postprandial Glucose and Insulin Responses
http://www.ncbi.nlm.nih.gov/pmc/article ... df/976.pdf

"Overweight/obese adults (n = 19), aged 45–65 years, were recruited for a randomized three-period, three-treatment acute crossover trial: 1) uninterrupted sitting; 2) seated with 2-min bouts of light-intensity walking every 20 min; and 3) seated with 2-min bouts of moderate-intensity walking every 20 min. A standardized test drink was provided after an initial 2-h period of uninterrupted sitting. The positive incremental area under curves (iAUC) for glucose and insulin (mean [95% CI]) for the 5 h after the test drink (75 g glucose, 50 g fat) were calculated for the respective treatments.

"Interrupting sitting time with short bouts of light- or moderate-intensity walking lowers postprandial glucose and insulin levels in overweight/obese adults. This may improve glucose metabolism and potentially be an important public health and clinical intervention strategy for reducing cardiovascular risk."


(NOTE: The walking speed for the light intensity was 2 mph and for the moderate-intensity was about 3.7 mph.)


2) Postmeal Walking Significantly Improves 24-h Glycemic Control in Older People at Risk for Impaired Glucose Tolerance
http://care.diabetesjournals.org/conten ... 4.abstract

“Inactive older (≥60 years of age) participants (N = 10) were recruited from the community and were nonsmoking, with a BMI <35 kg m−2 and a fasting blood glucose concentration between 105 and 125 mg dL−1. Participants completed three randomly ordered exercise protocols spaced 4 weeks apart. Each protocol comprised a 48-h stay in a whole-room calorimeter, with the first day serving as the control day. On the second day, participants engaged in either 1) postmeal walking for 15 min or 45 min of sustained walking performed at 2) 10:30 a.m. or 3) 4:30 p.m.. All walking was on a treadmill at an absolute intensity of 3 METs."

(NOTE: This is about 2.5 mph)

"Moreover, postmeal walking was significantly (P < 0.01) more effective than 45 min of sustained morning or afternoon walking in lowering 3-h post dinner glucose between the control and experimental day."


3) Breaking prolonged sitting reduces postprandial glycemia in healthy, normal-weight adults: a randomized crossover trial
http://ajcn.nutrition.org/content/early ... 3.abstract

"Seventy adults participated in a randomized crossover study. The prolonged sitting intervention involved sitting for 9 h, the physical activity intervention involved walking for 30 min and then sitting, and the regular-activity-break intervention involved walking for 1 min 40 s every 30 min."

"Regular activity breaks were more effective than continuous physical activity at decreasing postprandial glycemia and insulinemia in healthy, normal-weight adults."


*UPDATE:
4) Effect of Prolonged Sitting and Breaks in Sitting Time on Endothelial Function.
http://www.ncbi.nlm.nih.gov/pubmed/25137367

“Twelve non-obese men participated in two randomized 3hr sitting trials. In the sitting (SIT) trial, subjects were seated on a firmly cushioned chair for 3hr without moving their lower extremities. In the breaking sitting time trial (ACT), subjects sat similar to the SIT trial, but walked on a treadmill for five min at 2 miles·hr at 30min, 1hr 30min, and 2hr 30min during the sitting interval.”

“Three hours of sitting resulted in a significant impairment in shear rate and superficial femoral artery (SFA) flow mediated dilation (FMD). When light activity breaks were introduced hourly during sitting, the decline in FMD was prevented.”


So, while they all looked at different protocols and different end points, the main message is the same, and that is that Intermittent Walking (getting up and walking either once or a few times every hour for a few minutes) and getting up and walking after a meal for 15 minutes are both helpful in controlling daily and post prandial blood sugars without requiring great effort.

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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Thu May 14, 2015 4:36 am

1) A 2-Minute Walk May Counter the Harms of Sitting
Gretchen Reynolds
May 13, 2015
NY Times

http://well.blogs.nytimes.com/2015/05/1 ... f-sitting/


2) Light-Intensity Physical Activities and Mortality in the United States General Population and CKD Subpopulation. Beddhu S, et al. Clin J Am Soc Nephrol. 2015.

http://www.ncbi.nlm.nih.gov/m/pubmed/25931456/

Abstract

BACKGROUND AND OBJECTIVES: Sedentary behavior is associated with increased mortality in the general population. Whether replacing sedentary behavior with low- or light-intensity activities confers a survival benefit in the general or CKD populations is unknown.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This observational analysis of the 2003-2004 National Health and Nutrition Examination Survey examined the associations of low- and light-intensity activities with mortality. On the basis of the number of counts/min recorded by an accelerometer, durations of sedentary (<100/min), low (100-499/min), light (500-2019/min), and moderate/vigorous (≥2020/min) activity were defined and normalized to 60 minutes. The mortality associations of 2 min/hr less sedentary duration in conjunction with 2 min/hr more (tradeoff) spent in one of the low, light, or moderate/vigorous activity durations while controlling for the other two activity durations were examined in multivariable Cox regression models in the entire cohort and in the CKD subgroup.

RESULTS: Of the 3626 participants included, 383 had CKD. The mean sedentary duration was 34.4±7.9 min/hr in the entire cohort and 40.8±6.8 in the CKD subgroup. Tradeoff of sedentary duration with low activity duration was not associated with mortality in the entire cohort or the CKD subgroup. Tradeoff of sedentary duration with light activity duration was associated with a lower hazard of death in the entire cohort (hazard ratio, 0.67; 95% confidence interval, 0.48 to 0.93) and CKD subgroup (hazard ratio, 0.59; 95% confidence interval, 0.35 to 0.98). Tradeoff of sedentary duration with moderate/vigorous activity duration had a nonsignificant lower hazard in the entire cohort and CKD subgroup.

CONCLUSIONS: Patients with CKD are sedentary nearly two thirds of the time. Interventions that replace sedentary duration with an increase in light activity duration might confer a survival benefit.

3) The impact of lifestyle intervention on sedentary time in individuals at high risk of diabetes. Rockette-Wagner B, et al. Diabetologia. 2015.

http://www.ncbi.nlm.nih.gov/m/pubmed/25851102/

Abstract

AIMS/HYPOTHESIS: The Diabetes Prevention Program (DPP) lifestyle intervention successfully achieved its goal of increasing leisure physical activity levels. This current study examines whether the lifestyle intervention also changed time spent being sedentary and the impact of sedentary time on diabetes development in this cohort.

METHODS: 3,232 DPP participants provided baseline data. Sedentary behaviour was assessed via an interviewer-administered questionnaire and reported as time spent watching television specifically (or combined with sitting at work). Mean change in sedentary time was examined using repeated measures ANCOVA. The relationship between sedentary time and diabetes incidence was determined using Cox proportional hazards models.

RESULTS: During the DPP follow-up (mean: 3.2 years), sedentary time declined more in the lifestyle than the metformin or placebo participants (p < 0.05). For the lifestyle group, the decrease in reported mean television watching time (22 [95% CI 26, 17] min/day) was greater than in the metformin or placebo groups (p < 0.001). Combining all participants together, there was a significantly increased risk of developing diabetes with increased television watching (3.4% per hour spent watching television), after controlling for age, sex, treatment arm and leisure physical activity (p < 0.01), which was attenuated when time-dependent weight was added to the model.

CONCLUSIONS/INTERPRETATION: In the DPP, the lifestyle intervention was effective at reducing sedentary time, which was not a primary goal. In addition, in all treatment arms, individuals with lower levels of sedentary time had a lower risk of developing diabetes. Future lifestyle intervention programmes should emphasise reducing television watching and other sedentary behaviours in addition to increasing physical activity.
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Sat Aug 29, 2015 6:04 am

Effects of Interrupting Children's Sedentary Behaviors With Activity on Metabolic Function: A Randomized Trial. The Journal of Clinical Endocrinology & Metabolism, 2015; jc.2015-2803 DOI: 10.1210/jc.2015-2803

http://press.endocrine.org/doi/10.1210/ ... 03Abstract

Abstract

Context:
Limited data suggest that interrupting sedentary behaviors with activity improves metabolic parameters in adults.

Objective:
We tested whether interrupting sitting with short, moderate-intensity walking bouts improved glucose tolerance in children.

Design:
Participants underwent two experimental conditions in random order on different days: continuous sitting for 3 hours or sitting interrupted by walking (3 min of moderate-intensity walking every 30 min). Insulin, C-peptide, glucose, and free fatty acids were measured every 30 minutes for 3 hours during an oral glucose tolerance test. Area under the curve (AUC) was calculated from hormone and substrate measurements. Children were given a buffet meal after each condition.

Setting:
The study was conducted at the National Institutes of Health Hatfield Clinical Research Center.

Participants:
Twenty-eight normal-weight 7–11 year olds participated.

Main Outcomes:
Patterns of substrate/hormone secretion and AUC, as well as energy intake, were examined by experimental condition.

Results:
Interrupting sitting resulted in a 32% lower insulin AUC (P < .001), 17% lower C-peptide AUC (P < .001), and 7% lower glucose AUC (P = .018) vs continuous sitting. Mixed model results indicated that insulin (P = .036) and free fatty acid concentrations (P= .009) were significantly lower in the interrupted vs the continuous sitting condition. Lunchtime buffet meal energy intake did not significantly differ between the conditions (975 ± 387 vs 963 ± 309 kcal; P = .85).

Conclusions:
Interrupting sedentary time with brief moderate-intensity walking improved short-term metabolic function in non-overweight children without increasing subsequent energy intake. These findings suggest that interrupting sedentary behavior may be a promising prevention strategy for reducing cardiometabolic risk in children.



Press Release

Science News
Interrupting sitting with walking breaks improves children's blood sugar
Science Daily

Short-term metabolic benefits could help prevent obesity, diabetes

Date:
August 27, 2015

Source:
The Endocrine Society

Summary:
Taking 3-minute breaks to walk in the middle of a TV marathon or other sedentary activity can improve children's blood sugar compared to continuously sitting, according to a new study.

http://www.sciencedaily.com/releases/20 ... 141902.htm
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Fri Sep 25, 2015 7:25 pm

The Effects of Breaking up Prolonged Sitting Time: A Review of Experimental Studies.
Benatti FB, Ried-Larsen M.
Med Sci Sports Exerc. 2015 Oct;47(10):2053-61. doi: 10.1249/MSS.0000000000000654.
PMID: 26378942

Full Text
http://journals.lww.com/acsm-msse/Fullt ... me_.6.aspx

Abstract

INTRODUCTION:

Prolonged time spent in sedentary behaviors (i.e., activities performed while sitting or reclining) has been consistently shown as an independent risk factor for increased cardiometabolic risk and all-cause mortality, whereas breaking up sedentary time is associated with improved cardiometabolic profile. However, there is still great controversy with the respect to what would be the optimal or minimum type, intensity, and frequency of physical activity necessary to revenue such positive outcomes in different populations.

OBJECTIVE:

In this review, we aimed to discuss the available evidence from prospective experimental studies regarding the beneficial effects of breaking up prolonged sitting time on cardiometabolic risk factors, and the influence of intensity, frequency, and volume of the physical activity replacing sitting.

METHODS:

A structured computer-based search on the electronic databases PUBMED and SCOPUS was independently conducted by two researchers. Only prospective intervention studies (controlled and uncontrolled) evaluating the effects of explicitly replacing sitting time with physical activity (including standing) on metabolic parameters as outcomes were included.

RESULTS:

Seventeen studies were included in the review.

DISCUSSION:

The currently available prospective experimental studies do advocate that breaking up sitting time and replacing it with light-intensity ambulatory physical activity and standing may be a stimulus sufficient enough to induce acute favorable changes in the postprandial metabolic parameters in physically inactive and type 2 diabetic subjects, whereas a higher intensity or volume seems to be more effective in rendering such positive outcomes in young habitually physically active subjects.

CONCLUSION:

Prospective experimental studies provide considerable evidence of the positive effects of breaking up prolonged time spent sitting on metabolic outcomes. However, it seems that the type, intensity, and frequency of physical activity necessary to effectively counteract the detrimental effects of prolonged sitting may differ according to the subjects' characteristics, especially with respect to the subjects' habitual physical activity level.
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Tue Nov 03, 2015 3:28 pm

One more for Intermittent Walking over a Standing Desk...


Sitting at work is bad, but is standing actually better?
By Deborah Kotz
NOVEMBER 03, 2014

https://www.bostonglobe.com/lifestyle/h ... story.html

If too much sitting is the modern health equivalent of smoking and more people are spending longer hours sitting in front of their office computers, are standing desks the solution to rising rates of diabetes, heart disease, and obesity? Or does simply replacing sitting all day with standing all day miss the mark?

The makers of standing desks — which cost a few hundred to several thousand dollars — have sold many consumers and companies on the notion that their products will reverse “sitting disease” and the health ills caused by spending an average of nine of our 14 waking hours in an office chair or on the couch.

...

What’s best for your muscle and joints and your mind’s productivity? 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.
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Wed Jun 22, 2016 5:54 am

Standing is only slightly better then sitting. We have to (at least) walk (and walk briskly)!

How Many Calories We Burn When We Sit, Stand or Walk.
http://well.blogs.nytimes.com/2016/06/2 ... d-or-walk/

"Unsurprisingly, sitting was not very taxing. The volunteers generally burned about 20 calories during their 15 minutes of sitting, whether they were typing or staring at a television screen.

More unexpected, standing up was barely more demanding. While standing for 15 minutes, the volunteers burned about 2 additional calories compared to when they sat down. It didn’t matter whether they stood up and then sat down or sat down and then stood up. The total caloric expenditure was about the same and was not sizable.

Over all, in fact, the researchers concluded, someone who stood up while working instead of sitting would burn about 8 or 9 extra calories per hour. (Just for comparison, a single cup of coffee with cream and sugar contains around 50 calories.)

But walking was a different matter. When the volunteers walked for 15 minutes, even at a fairly easy pace, they burned about three times as many calories as when they sat or stood. If they walked for an hour, the researchers calculated, they would incinerate about 130 more calories than if they stayed in their chairs or stood up at their desks, an added energy expenditure that might be sufficient, they write, to help people avoid creeping, yearly weight gain. "
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Wed Dec 28, 2016 6:05 pm

Effect of frequent interruptions of prolonged sitting on self-perceived levels of energy, mood, food cravings and cognitive function
Audrey BergouignanEmail authorView ORCID ID profile, Kristina T. Legget, Nathan De Jong, Elizabeth Kealey, Janet Nikolovski, Jack L. Groppel, Chris Jordan, Raphaela O’Day, James O. Hill and Daniel H. Bessesen

International Journal of Behavioral Nutrition and Physical Activity201613:113
DOI: 10.1186/s12966-016-0437-z© The Author(s). 2016
Received: 29 March 2016Accepted: 17 October 2016Published: 3 November 2016

http://ijbnpa.biomedcentral.com/article ... 016-0437-z

Abstract

Background
While physical activity has been shown to improve cognitive performance and well-being, office workers are essentially sedentary. We compared the effects of physical activity performed as (i) one bout in the morning or (ii) as microbouts spread out across the day to (iii) a day spent sitting, on mood and energy levels and cognitive function.

Methods
In a randomized crossover trial, 30 sedentary adults completed each of three conditions: 6 h of uninterrupted sitting (SIT), SIT plus 30 min of moderate-intensity treadmill walking in the morning (ONE), and SIT plus six hourly 5-min microbouts of moderate-intensity treadmill walking (MICRO). Self-perceived energy, mood, and appetite were assessed with visual analog scales. Vigor and fatigue were assessed with the Profile of Mood State questionnaire. Cognitive function was measured using a flanker task and the Comprehensive Trail Making Test. Intervention effects were tested using linear mixed models.

Results
Both ONE and MICRO increased self-perceived energy and vigor compared to SIT (p < 0.05 for all). MICRO, but not ONE, improved mood, decreased levels of fatigue and reduced food cravings at the end of the day compared to SIT (p < 0.05 for all). Cognitive function was not significantly affected by condition.

Conclusions
In addition to the beneficial impact of physical activity on levels of energy and vigor, spreading out physical activity throughout the day improved mood, decreased feelings of fatigue and affected appetite. Introducing short bouts of activity during the workday of sedentary office workers is a promising approach to improve overall well-being at work without negatively impacting cognitive performance.


Mass Media Article

Work. Walk 5 Minutes. Work.
Phys Ed
NY Times
By GRETCHEN REYNOLDS DEC. 28, 2016

http://www.nytimes.com/2016/12/28/well/ ... ss&emc=rss
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Wed Oct 25, 2017 2:06 pm

It doesn't take much to get a benefit and only a little more to get a bigger benefit

In Health
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Walking in Relation to Mortality in a Large Prospective Cohort of Older U.S. Adults.
Patel AV, Hildebrand JS, Leach CR, Campbell PT, Doyle C, Shuval K, Wang Y, Gapstur SM.
Am J Prev Med. 2017 Oct 11. pii: S0749-3797(17)30460-9.
doi: 10.1016/j.amepre.2017.08.019. [Epub ahead of print]
PMID: 29056372

http://www.ajpmonline.org/article/S0749-3797(17)30460-9/fulltext

Abstract
INTRODUCTION:
Engaging in >150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity weekly is recommended for optimal health. The relationship between walking, the most common activity especially for older adults, and total mortality is not well documented.

METHODS:
Data from a large U.S. prospective cohort study including 62,178 men (mean age 70.7 years) and 77,077 women (mean age 68.9 years), among whom 24,688 men and 18,933 women died during 13 years of follow-up (1999-2012), were used to compute multivariable-adjusted hazard rate ratios and 95% CIs for walking as the sole form of activity or adjusted for other moderate- or vigorous-intensity physical activity in relation to total and cause-specific mortality (data analysis 2015-2016).

RESULTS:
Inactivity compared with walking only at less than recommended levels was associated with higher all-cause mortality (hazard rate ratio=1.26, 95% CI=1.21, 1.31). Meeting one to two times the recommendations through walking only was associated with lower all-cause mortality (hazard rate ratio=0.80, 95% CI=0.78, 0.83). Associations with walking adjusted for other moderate- or vigorous-intensity physical activity were similar to walking only. Walking was most strongly associated with respiratory disease mortality followed by cardiovascular disease mortality and then cancer mortality.

CONCLUSIONS:
In older adults, walking below minimum recommended levels is associated with lower all-cause mortality compared with inactivity. Walking at or above physical activity recommendations is associated with even greater decreased risk. Walking is simple, free, and does not require any training, and thus is an ideal activity for most Americans, especially as they age.
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Fri Oct 27, 2017 6:18 am

Intermittent walking, but not standing, improves postprandial insulin and glucose relative to sustained sitting: A randomised cross-over study in inactive middle-aged men
Pulsford, Richard M. et al.
Journal of Science and Medicine in Sport , Volume 20 , Issue 3 , 278 - 283
DOI: http://dx.doi.org/10.1016/j.jsams.2016.08.012 |

Abstract
Objectives
Interrupting prolonged periods of sitting may improve postprandial insulin and glucose although it is unclear whether interruptions need to involve physical activity or simply a change in posture (from sitting to standing) to benefit adults without metabolic impairment. This study examined effects of interrupting sitting with intermittent walking, and intermittent standing on dynamic insulin and glucose responses in men without known metabolic impairment.

Design
A randomised three-arm, cross-over experimental study comprising three seven-hour days of sustained sitting.

Methods
Twenty-five inactive men (aged 40.2 ± 12.2 years) took part. The three interventions were; SIT-ONLY (uninterrupted sitting), SIT-STAND (sitting interrupted with 2 min standing bouts every 20 min) and SIT-WALK (sitting interrupted with 2 min light-intensity walking bouts every 20 min). An oral glucose tolerance test was administered at baseline and a standardised mixed test meal at hour three. Comparisons of Matsuda Index, and area under the curve (AUC) for insulin and glucose were made between interventions using generalised estimating equation models.

Results
Matsuda index was 16% higher (mean difference 1.2 [95%CI 0.1, 2.2] p = 0.02), AUC for glucose 9% lower (−2.5 mmol/L × 7 h [−3.7, −1.3 mmol/L × 7 h] p < 0.001) and AUC for insulin 21% lower (−546.5 pmol/L × 7 h [−723.6, −369.3 pmol/L × 7 h] p < 0.001) in SIT-WALK compared to SIT-ONLY. There were no significant differences between SIT-STAND and SIT-ONLY in any main outcome measure.

Conclusions
Interrupting sustained sitting with brief repeated bouts of light-intensity walking but not standing reduced insulin demand and improved glucose uptake during a simulated sedentary working day. The benefits of such minor behavioural changes could inform future workplace health interventions.
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Mon Mar 05, 2018 7:00 am

The problem with standing desks. We were meant to move

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(2018) A detailed description of the short-term musculoskeletal and cognitive effects of prolonged standing for office computer work, Ergonomics, DOI: 10.1080/00140139.2017.1420825

Abstract
Due to concerns about excessive sedentary exposure for office workers, alternate work positions such as standing are being trialled. However, prolonged standing may have health and productivity impacts, which this study assessed. Twenty adult participants undertook two hours of laboratory-based standing computer work to investigate changes in discomfort and cognitive function, along with muscle fatigue, movement, lower limb swelling and mental state. Over time, discomfort increased in all body areas (total body IRR [95% confidence interval]: 1.47[1.36–1.59]). Sustained attention reaction time (β = 18.25[8.00–28.51]) deteriorated, while creative problem solving improved (β = 0.89[0.29–1.49]). There was no change in erector spinae, rectus femoris, biceps femoris or tibialis anterior muscle fatigue; low back angle changed towards less lordosis, pelvis movement increased, lower limb swelling increased and mental state decreased. Body discomfort was positively correlated with mental state. The observed changes suggest replacing office work sitting with standing should be done with caution.

Practitioner Summary:
Standing is being used to replace sitting by office workers; however, there are health risks associated with prolonged standing. In a laboratory study involving 2 h prolonged standing discomfort increased (all body areas), reaction time and mental state deteriorated while creative problem-solving improved. Prolonged standing should be undertaken with caution.
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Wed Mar 28, 2018 6:27 am

Intermittent Walking works!

Moderate‐to‐Vigorous Physical Activity and All‐Cause Mortality: Do Bouts Matter?
Journal of the American Heart Association. 2018;7:e007678
Originally published March 22, 2018

https://doi.org/10.1161/JAHA.117.007678

Abstract

Background
The 2008 Physical Activity Guidelines for Americans recommends that adults accumulate moderate‐to‐vigorous physical activity (MVPA) in bouts of ≥10 minutes for substantial health benefits. To what extent the same amount of MVPA accumulated in bouts versus sporadically reduces mortality risk remains unclear.

Methods and Results
We analyzed data from the National Health and Nutrition Examination Survey 2003–2006 and death records available through 2011 (follow‐up period of ≈6.6 years; 700 deaths) to examine the associations between objectively measured physical activity accumulated with and without a bout criteria and all‐cause mortality in a representative sample of US adults 40 years and older (n=4840). Physical activity data were processed to generate minutes per day of total and bouted MVPA. Bouted MVPA was defined as MVPA accumulated in bouts of a minimum duration of either 5 or 10 minutes allowing for 1‐ to 2‐minute interruptions. Hazard ratios for all‐cause mortality associated with total and bouted MVPA were similar and ranged from 0.24 for the third quartile of total to 0.44 for the second quartile of 10‐minute bouts. The examination of jointly classified quartiles of total MVPA and tertiles of proportion of bouted activity revealed that greater amounts of bouted MVPA did not result in additional risk reductions for mortality.

Conclusions
These results provide evidence that mortality risk reductions associated with MVPA are independent of how activity is accumulated and can impact the development of physical activity guidelines and inform clinical practice.


Clinical Perspective

What Is New?

- This study examines whether moderate‐to‐vigorous physical activity needs to be accumulated in bouts to provide mortality benefits.

- Accelerometer‐measured physical activity data collected in 2003–2006 from a representative sample of US adults (n=4840) were classified as being accumulated sporadically or in bouts and linked to mortality records available through 2011.

- Sporadic and bouted moderate‐to‐vigorous physical activity was similarly and strongly associated with mortality risk.

- Mortality risk reductions associated with moderate‐to‐vigorous physical activity are independent of how activity is accumulated.


What Are the Clinical Implications?

- This finding can inform future physical activity guidelines and guide clinical practice when advising individuals about the benefits of physical activity.

- The key message based on the results presented is that total physical activity (ie, of any bout duration) provides important health benefits.

- Practitioners can promote either long single or multiple shorter bouts of activity in advising adults how to progress toward 150 min/wk of moderate‐to‐vigorous physical activity.

- This flexibility may be particularly valuable for individuals who are among the least active and likely at greater risk for developing chronic conditions.
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Wed Aug 15, 2018 2:05 pm

In this study, the most effective protocol was 2 minutes of light intensity waking breaks every 30 minutes.

In Health
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Regular walking breaks prevent the decline in cerebral blood flow associated with prolonged sitting.
J Appl Physiol (1985). 2018 Jun 7. doi: 10.1152/japplphysiol.00310.2018. [Epub ahead of print]

Abstract
Decreased cerebrovascular blood flow and function are associated with lower cognitive functioning and increased risk of neurodegenerative diseases. Prolonged sitting impairs peripheral blood flow and function, but its effects on the cerebrovasculature are unknown. This study explored the effect of uninterrupted sitting and breaking up sitting time on cerebrovascular blood flow and function of healthy desk workers. Fifteen participants (10 male, 35.8±10.2 years, BMI: 25.5±3.2 kg∙m-2) completed, on separate days, three 4-hr conditions in a randomised order: a) uninterrupted sitting (SIT), b) sitting with 2-min light intensity walking breaks every 30-min (2WALK) or c) sitting with 8-min light intensity walking breaks every 2-hrs (8WALK). At baseline and 4-hrs, middle cerebral artery blood flow velocity (MCAv), carbon dioxide reactivity (CVR) of the MCA and carotid artery were measured using transcranial Doppler (TCD) and duplex ultrasound respectively. Cerebral autoregulation (CA) was assessed with TCD using a squat-stand protocol and analysed to generate values of gain and phase in the very low, low, and high frequencies. There was a significant decline in SIT MCAv (-3.2±1.2 cm.s-1) compared to 2WALK (0.6±1.5 cm.s-1, p=0.02), but not between SIT and 8WALK (-1.2±1.0 cm.s-1, p=0.14). For CA, the change in 2WALK very low frequency phase (4.47±4.07 degrees) was significantly greater than SIT (-3.38±2.82 degrees, p=0.02). There was no significant change in MCA or carotid artery CVR (p>0.05). Results indicate that prolonged, uninterrupted sitting in healthy desk workers reduces cerebral blood flow, however this is offset when frequent, short-duration walking breaks are incorporated.
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Wed Apr 24, 2019 8:43 am

As with food, our activity/exercise habits are not getting any better. Fortunately, simple solution like Intermittent Walking and Take The Stairs, can really help.

Trends in Sedentary Behavior Among the US Population, 2001-2016
JAMA. 2019;321(16):1587-1597. doi:10.1001/jama.2019.3636
April 23/30, 2019

Key Points
Question
What were the levels and changes of sedentary behaviors among the US population from 2001 through 2016?

Findings
In this serial cross-sectional study that included 51 896 participants, the estimated prevalence of sitting watching television or videos at least 2 h/d was high in 2015-2016 (ranging from 59% to 65%); the estimated prevalence of computer use outside school or work for at least 1 h/d increased from 2001 to 2016 (from 43% to 56% for children, from 53% to 57% among adolescents, and from 29% to 50% for adults); and estimated total sitting time increased from 2007 to 2016 (from 7.0 to 8.2 h/d among adolescents and from 5.5 to 6.4 h/d among adults).

Meaning
In the US population, sedentary behaviors generally remained stable and high or increased from 2001 through 2016, depending on the specific activity.

Abstract
Importance
Prolonged sitting, particularly watching television or videos, has been associated with increased risk of multiple diseases and mortality. However, changes in sedentary behaviors over time have not been well described in the United States.

Objective
To evaluate patterns and temporal trends in sedentary behaviors and sociodemographic and lifestyle correlates in the US population.

Design,
Setting, and Participants A serial, cross-sectional analysis of the US nationally representative data from the National Health and Nutrition Examination Survey (NHANES) among children aged 5 through 11 years (2001-2016); adolescents, 12 through 19 years (2003-2016); and adults, 20 years or older (2003-2016).

Exposures
Survey cycle.

Main Outcomes and Measures
Prevalence of sitting watching television or videos for 2 h/d or more, computer use outside work or school for 1 h/d or more, and total sitting time (h/d in those aged ≥12 years).

Results
Data on 51 896 individuals (mean, 37.2 years [SE, 0.19]; 25 968 [50%] female) were analyzed from 2001-2016 NHANES data, including 10 359 children, 9639 adolescents, and 31 898 adults. The estimated prevalence of sitting watching television or videos for 2 h/d or more was high among all ages (children, 62% [95% CI, 57% to 67%]; adolescents, 59% [95% CI, 54% to 65%]; adults, 65% [95% CI, 61% to 69%]; adults aged 20-64 years, 62% [95% CI, 58% to 66%]; and ≥65 years, 84% [95% CI, 81% to 88%] in the 2015-2016 cycle). From 2001 through 2016, the trends decreased among children over time (difference, −3.4% [95% CI, −11% to 4.5%]; P for trend =.004), driven by non-Hispanic white children; were stable among adolescents (−4.8% [95% CI, −12% to 2.3%]; P for trend =.60) and among adults aged 20 through 64 years (−0.7% [95% CI, −5.6% to 4.1%]; P for trend =.82); but increased among adults aged 65 years or older (difference, 3.5% [95% CI, −1.2% to 8.1%]; P for trend =.03). The estimated prevalence of computer use outside school or work for 1 h/d or more increased in all ages (children, 43% [95% CI, 40% to 46%] to 56% [95% CI, 49% to 63%] from 2001 to 2016; difference, 13% [95% CI, 5.6% to 21%]; P for trend <.001; adolescents, 53% [95% CI, 47% to 58%] to 57% [95% CI, 53% to 62%] from 2003 to 2016, difference, 4.8% [95% CI, −1.8% to 11%]; P for trend =.002; adults, 29% [27% to 32%] to 50% [48% to 53%] from 2003 to 2016, difference, 21% [95% CI, 18% to 25%]; P for trend <.001). From 2007 to 2016, total hours per day of sitting time increased among adolescents (7.0 [95% CI, 6.7 to 7.4] to 8.2 [95% CI, 7.9 to 8.4], difference, 1.1 [95% CI, 0.7 to 1.5]) and adults (5.5 [95% CI, 5.2 to 5.7] to 6.4 [95% CI, 6.2 to 6.6]; difference, 1.0 [95% CI, 0.7 to 1.3]; P for trend <.001 for both).

Conclusions and Relevance
In this nationally representative survey of the US population from 2001 through 2016, the estimated prevalence of sitting watching television or videos for at least 2 hours per day generally remained high and stable. The estimated prevalence of computer use during leisure-time increased among all age groups, and the estimated total sitting time increased among adolescents and adult
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Thu Apr 02, 2020 7:14 am

Keep walking! Even if it is around your home!

Association of Daily Step Count and Step Intensity With Mortality Among US Adults
Barry I. Graubard, PhD1; Susan A. Carlson, PhD4; Eric J. Shiroma, ScD5; Janet E. Fulton, PhD4; Charles E. Matthewsh
JAMA. 2020;323(12):1151-1160. doi:10.1001/jama.2020.1382

https://jamanetwork.com/journals/jama/a ... ct/2763292

Question
What are the associations between daily step counts and step intensity with mortality among US adults?

Findings
In this observational study that included 4840 participants, a greater number of steps per day was significantly associated with lower all-cause mortality (adjusted hazard ratio for 8000 steps/d vs 4000 steps/d, 0.49). There was no significant association between step intensity and all-cause mortality after adjusting for the total number of steps per day.

Meaning
Greater numbers of steps per day were associated with lower risk of all-cause mortality.

Abstract
Importance
It is unclear whether the number of steps per day and the intensity of stepping are associated with lower mortality.

Objective
Describe the dose-response relationship between step count and intensity and mortality.

Design, Setting, and Participants
Representative sample of US adults aged at least 40 years in the National Health and Nutrition Examination Survey who wore an accelerometer for up to 7 days ( from 2003-2006). Mortality was ascertained through December 2015.

Exposures
Accelerometer-measured number of steps per day and 3 step intensity measures (extended bout cadence, peak 30-minute cadence, and peak 1-minute cadence [steps/min]). Accelerometer data were based on measurements obtained during a 7-day period at baseline.

Main Outcomes and Measures
The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular disease (CVD) and cancer mortality. Hazard ratios (HRs), mortality rates, and 95% CIs were estimated using cubic splines and quartile classifications adjusting for age; sex; race/ethnicity; education; diet; smoking status; body mass index; self-reported health; mobility limitations; and diagnoses of diabetes, stroke, heart disease, heart failure, cancer, chronic bronchitis, and emphysema.

Results
A total of 4840 participants (mean age, 56.8 years; 2435 [54%] women; 1732 [36%] individuals with obesity) wore accelerometers for a mean of 5.7 days for a mean of 14.4 hours per day. The mean number of steps per day was 9124. There were 1165 deaths over a mean 10.1 years of follow-up, including 406 CVD and 283 cancer deaths. The unadjusted incidence density for all-cause mortality was 76.7 per 1000 person-years (419 deaths) for the 655 individuals who took less than 4000 steps per day; 21.4 per 1000 person-years (488 deaths) for the 1727 individuals who took 4000 to 7999 steps per day; 6.9 per 1000 person-years (176 deaths) for the 1539 individuals who took 8000 to 11 999 steps per day; and 4.8 per 1000 person-years (82 deaths) for the 919 individuals who took at least 12 000 steps per day. Compared with taking 4000 steps per day, taking 8000 steps per day was associated with significantly lower all-cause mortality (HR, 0.49 [95% CI, 0.44-0.55]), as was taking 12 000 steps per day (HR, 0.35 [95% CI, 0.28-0.45]). Unadjusted incidence density for all-cause mortality by peak 30 cadence was 32.9 per 1000 person-years (406 deaths) for the 1080 individuals who took 18.5 to 56.0 steps per minute; 12.6 per 1000 person-years (207 deaths) for the 1153 individuals who took 56.1 to 69.2 steps per minute; 6.8 per 1000 person-years (124 deaths) for the 1074 individuals who took 69.3 to 82.8 steps per minute; and 5.3 per 1000 person-years (108 deaths) for the 1037 individuals who took 82.9 to 149.5 steps per minute. Greater step intensity was not significantly associated with lower mortality after adjustment for total steps per day (eg, highest vs lowest quartile of peak 30 cadence: HR, 0.90 [95% CI, 0.65-1.27]; P value for trend = .34).

Conclusions and Relevance
Based on a representative sample of US adults, a greater number of daily steps was significantly associated with lower all-cause mortality. There was no significant association between step intensity and mortality after adjusting for total steps per day.

Mass Media Article

Stuck Inside? Keep Walking
Taking an extra 4,000 steps a day, even if it’s around your living room, may lower your risk of dying prematurely.
NY Times

https://www.nytimes.com/2020/04/01/well ... ealth.html

This is another great example of diminishing returns.

If you are under 4000 steps per day your average risk is 76.7 per 1000 person-years
If you go from below 4000 step to over 4000 steps, your benefit drops to 21.4 per 1000 person-years (55.3 benefit)
if you add in another 4000 and go over 8000 steps, your benefit drops to 6.9 per 1000 person-years (14.5 benefit)
If you add in another 4000 and go over 1200 steps, your benefit drops to 4.8 per 1000 person years (2.1 benefit)
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Re: Sitting, Standing & Intermittent Walking

Postby JeffN » Thu Sep 16, 2021 8:28 am

They called it Interrupted sitting and "frequent activity breaks from sitting (FABS) :)

This was also the equivalent of 6 minutes per hour (3 minutes ever 30 minutes) and acknowledged in the study that "Our intervention may represent the minimum effective dose for breaking sedentary behavior, with larger volumes of total activity required to elicit greater health benefits. "


Three weeks of interrupting sitting lowers fasting glucose and glycemic variability, but not glucose tolerance, in free-living women and men with obesity
https://doi.org/10.1152/ajpendo.00599.2020
27 JUL 2021

https://journals.physiology.org/doi/ful ... 00599.2020

We aimed to determine whether interrupting prolonged sitting improves glycemic control and the metabolic profile of free-living adults with obesity. Sixteen sedentary individuals {10 women/6 men; median [interquartile range (IQR)] age 50 (44–53) yr, body mass index (BMI) 32 (32–35.8) kg/m2} were fitted with continuous glucose and activity monitors for 4 wk. After a 1-wk baseline period, participants were randomized into habitual lifestyle (Control) or frequent activity breaks from sitting (FABS) intervention groups. Each day, between 0800 and 1800 h, FABS received smartwatch notifications to break sitting with 3 min of low-to-moderate-intensity physical activity every 30 min. Glycemic control was assessed by oral glucose tolerance test (OGTT) and continuous glucose monitoring. Blood samples and vastus lateralis biopsies were taken for assessment of clinical chemistry and the skeletal muscle lipidome, respectively. Compared with baseline, FABS increased median steps by 744 [IQR (483–951)] and walking time by 10.4 [IQR (2.2–24.6)] min/day. Other indices of activity/sedentary behavior were unchanged. Glucose tolerance and average 24-h glucose curves were also unaffected. However, mean (±SD) fasting glucose levels [−0.34 (±0.37) mmol/L] and daily glucose variation [%CV; −2% (±2.2%)] reduced in FABS, suggesting a modest benefit for glycemic control that was most robust at higher volumes of daily activity. Clinical chemistry and the skeletal muscle lipidome were largely unperturbed, although two long-chain triglycerides increased 1.25-fold in FABS, postintervention. All parameters remained stable in control. Under free-living conditions, FABS lowered fasting glucose and glucose variability. Larger volumes of activity breaks from sitting may be required to promote greater health benefits.

NEW & NOTEWORTHY Under free-living conditions, breaking sitting modestly increased activity behavior. Breaking sitting was insufficient to modulate glucose tolerance or the skeletal muscle lipidome. Activity breaks reduced fasting blood glucose levels and daily glucose variation compared with baseline, with a tendency to also decrease fasting LDLc. This intervention may represent the minimal dose for breaking sedentary behavior, with larger volumes of activity possibly required to promote greater health benefits.
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