Pictured: Oversold? Photo by TheStandingDesk on Unsplash

The idea behind standing desks in the workplace as a health intervention is fairly simple — we know that a sedentary lifestyle, with lots of sitting, is bad for us. That’s been demonstrated over and over again in dozens if not hundreds of studies at this point. It is undoubtedly true that sitting down a lot, and not getting much exercise, is bad for your health.

So, the idea goes, just stand! If you’re in front of a desk all day, you can just get a raised desk (or one that goes up and down), and stand up. That’ll reduce your risk of all those nasty outcomes, because you’ll be mitigating the main risk factor that we’ve identified for the problem.

Pictured: A SOLUTION! Photo by ergonofis on Unsplash

Except, as with most health interventions, it turns out that the reality is somewhat more complex than that. While standing desks, and workplace standing interventions, probably do make you stand more — which, let’s be honest, is not a shocking fact — they may not improve health or wellbeing by an appreciable amount.

Let’s look at the evidence.

Standing Science

The first thing to note is that standing desks — and standing interventions in general — definitely do make you stand more. This is a change to when I last wrote about the subject in 2018, when the studies didn’t really show much of an effect. There are now several large, well-conducted trials out there showing that workplaces which spent a great deal of time and money buying standing desks and telling their employees to stand up as much as possible saw improvements, increasing standing time by somewhere in the range of 30–60 minutes a day.

Now, that sounds good — as I said, sitting is bad for us, so not sitting must be better. Except, this is where it gets complex.

Stock photo results for ‘complex’ seem to be mostly close-ups of watches. Photo by Lucas Santos on Unsplash

The thing is, we don’t really care at all about sitting time per se. Sitting is what’s called a surrogate outcome — a marker for other things that we see as problematic and want to improve. From the employer’s perspective, there’s some evidence that sitting down too much can impact productivity and potentially have impacts on operational health and safety. From an individual’s point of view, the issue is that sitting down too long may cause worse health outcomes like weight gain and heart issues down the line.

We measure sitting, because we think that it’s associated with these long-term risks, and by preventing the sitting we’re preventing the other issues as well, but that’s not necessarily true.

Take a large randomized trial that was just published in the British Medical Journal (BMJ) looking at the impact of standing interventions in the workplace. The authors found that multi-component intervention including standing desks demonstrably increased standing time for employees by about an hour a day over 12 months. They had a big sample, with dozens of workplaces, the study itself was well-conducted, and it’s a believable increase generally — if you followed their procedure, people working in such an environment would almost certainly stand more every day.

Pictured: SCIENCE, apparently. Photo by TheStandingDesk on Unsplash

But as well as measuring how much time people spent standing, the authors also measured health, wellbeing, and productivity outcomes in their participants. For example, they looked to see whether people lost weight, had better sleep, reported better workplace productivity, were in pain, etc. And across literally dozens of secondary outcomes, the study found that there were no appreciable differences between people who took part in the standing intervention and got the standing desks, and those who didn’t.

The study found a big benefit in the surrogate outcome of standing, but no noticeable benefits in any of the key health and other outcomes that we actually care about.

This is a huge problem, because as I said, standing is only important if it improves other things. If standing doesn’t reduce pain, help with weight-loss, or have other benefits, then we’re spending all of this money on desks and education simply to slightly change people’s posture at work.

Sitting Vs Standing

Now, the issue with this piece of research — and much of the standing desk literature more broadly — is that it wasn’t really geared to prove anything about health outcomes in the first place. If you look at the studies conducted to look at whether standing desks help, they are all fairly similar — very small samples, primarily aimed at proving that standing desks make people stand more, and only rarely examining health or productivity outcomes anyway. Even trials that did specifically look at health outcomes were often very small and unable to detect an effect. Some studies found benefits, others didn’t, but all were insufficient to establish whether standing really improved health.

Pictured: Understudied, unfortunately. Photo by Trinity Nguyen on Unsplash

In other words, it’s not so much that we have proven that standing desks and standing interventions are a waste of time, but that so far we haven’t conducted studies that would show us if they are or not. To look at these vitally important health and productivity outcomes, we’d need much bigger studies incorporating very large groups of people, which we just haven’t really done yet.

That being said, as far as I can tell the new BMJ paper is by far the biggest trial of these interventions to date, and there was no major difference in any outcome of importance between the intervention and control groups. There were insignificant improvements in a handful of things, but mostly it looked like standing more, and standing desks, had no benefit on health or wellbeing.

What this means is that if we do find benefits in a future large trial, they are likely to be fairly small. We can’t exclude standing desks improving health — the confidence intervals are too wide for that — but we can say that spending a great deal of time and money getting people in a workplace to stand for 60 minutes more every day for a year probably doesn’t have much of a benefit for things we really care about. Yes, it’ll make people stand more, but the $500-odd per person for the desks plus the additional cost of staff trainings and rewards to incentivize employees may not result in the sort of health benefits that are used to sell the product in the first place.

Pictured: Fancy. Also, maybe not worth it. Hard to say. Photo by Standsome Worklifestyle on Unsplash

This isn’t a hard-and-fast answer by any means, because as I said the studies are limited. Personally, I do quite like the standing desks I’ve used in the past — at the very least, you can alternate sitting and standing to break up the day. But there’s a big question mark over the main reason that we might want standing desks in the first place. Yes, they’ll make you stand more, but it’s not clear whether standing in and of itself improves your health.