This article summaries a research review article that explored whether using a standing desk can help a person lose weight. In describing the research study, the story says “researchers sifted through the almost 700 studies that have sought to measure the health benefits of standing desks. Of those, 46 were rigorous enough to be included in their review.”
There’s just one problem: That’s not what the research review looked at. Only 8 of those 46 studies had study volunteers using a sit-stand workstation. The other studies measured energy expenditure of volunteers who were sitting, resting or standing in an array of situations, and included groups such as farmers in Burkina Faso, female carpet weavers and villagers in the U.K. and inpatients and outpatients in a stroke rehabilitation center in the Netherlands.
The article does a good job of explaining that questions remain about whether it is better to stand than sit. But we have concerns about the way it extrapolated energy expenditure from standing to come up with a projected weight loss after 4 years.
There is an obesity epidemic in the U.S. Standing desks are omnipresent at businesses and schools, having been proposed as a healthier option—and one that could lead to weight loss—for people with desk jobs. All recommendations should be evidence-based, especially when there is a cost, which in this case could include the purchase of a standing desk.
Dietary changes are more potent than exercise for weight loss. Giving up the cookie may be more effective than standing at your desk all day long.
The story doesn’t mention the cost of standing desks. The story concludes that “it can’t hurt” to have a standing desk. But it could hurt your pocketbook. Standing desk stations cost about $400. This assumes that the cost is in addition to the standard sitting desk at work. If offices replaced sitting with standing desks, then the cost would be the relative difference between the two.
The 22-pound statistic seems to be based on a simplistic and erroneous calculation — 54 calories per day for 4 years adds up to 78,840 calories. Since it is widely believed that there are 3,500 calories in a pound of bodyweight, a 78,000 calorie deficit will result in a loss of 22 pounds. This kind of thinking has been debunked; the problems with it are described here and here. It seems highly questionable whether a 50-calorie increase in expenditure would have any impact whatsoever.
Harms aren’t mentioned in the story. In their discussion of the published report, the researchers state, “…there are no studies assessing the potential adverse effects of prolonged motionless standing, such as worsening of varicose veins and or peripheral edema in some people, and also the adaptation of muscles to the new position leading to a decrease in the amount of [energy expenditure] to levels similar to sitting.” This should have been noted in the story.
To its credit, the story explains that the researchers analyzed data from 46 studies.
But not all studies are of equal quality. The researchers themselves note that none of the studies fully met their 25-point criteria, explaining that 19 had excellent quality, 11 had good quality and the rest had fair quality. The researchers also point out that only seven of the studies separated out data for women and men.
Also, as noted previously, only 8 of the studies, which included a total of 143 participants, involved a standing-sitting work station. The research review included a potentially misleading subgroup analysis that compared these studies to the other studies. It found that the difference between sitting and standing while working was is 0.04kcal/min higher than the difference between sitting and standing motionless. Over six hours that would be 14 calories.
In terms of the research analysis itself, the story doesn’t note the limitations of research reviews, or point out that the data you get from the review is only as good as the data that goes into the analysis—which in this case wasn’t that strong.
The story says “our sedentary lifestyles [are] killing us” and “sitting too long has been associated with diabetes, hypertension, some forms of cancer, anxiety and a generally greater probability of early death.”
As we’ve repeatedly noted, association is not causation. And while some studies have found this association, others have not.
At the same time, the underlying point the article is trying to make is correct: To address the obesity epidemic people need to get moving more and moving more often. There is no question that someone who is sitting—unless they are doing exercises while sitting—is not moving.
The story quotes only one person, and he is one of the study’s authors. He is also quoted as an advocate for standing desks at work.
The story includes a quote from the study’s author saying that he recommends people stand periodically throughout the day and avoid sitting continuously, which does not require a standing desk. But the story could also have mentioned many other activities such as walking/exercising during lunch breaks or taking stairs instead of elevators. More importantly, it doesn’t address dietary change as likely being a more potent way to lose weight.
Some people stand all day at their jobs. For those who don’t, taking a break to stand up or walk around a bit is typically fairly easy to do.
The story points out there’s been a lot of effort to get people to stand instead of sit. It also points out that there has been debate about the true benefit of standing.
The reporter spoke with the researcher and the story includes quotes not in the news release issued by the Mayo Clinic.
Systematic, Criteria-Driven
With the discontinuation of @HealthNewsRevu, there's a genuine concern that well-written and researched "reality checks" in healthcare are not economically interesting. This should be disconcerting to anyone, and yet I'm only seeing more and more piling into "promising findings"
Thanks for ALL you do and have done, Gary. https://t.co/93K4hzQXZj
Thanks for sharing this with all of us today, @garyschwitzer @HealthNewsRevu
A nice gift.
#healthcare #healthcarenews #journalism #reporting #factsmatter #truthmatters https://t.co/hNHdZDl2rc
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