How Many Hours a Day Should You Spend on Your Feet
London’s bright-red double-decker buses are one of the city’s hallmarks. Seventy years ago, those buses and their operators were at the center of one of the first occupational studies to examine the role of sitting on health.
Back then, each bus had a driver and a conductor. For a 1954 study, researchers at London’s transportation department examined the heart-disease incidence among these and other transit workers.
The researchers found that conductors, who spent most of the day on their feet collecting fares, were about 25% less likely than the seated drivers to develop heart disease. The conductors also tended to experience milder forms of heart trouble.
By today’s standards, that study was riddled with methodological flaws. But it was one of the first papers to suggest that a sedentary occupation could lead to health problems. These days, many more people spend the workday behind a desk, and the risks of immobility are now far better mapped.
Researchers have found that spending most of your day seated increases your risk for heart disease, death, some cancers, and metabolic diseases such as obesity and Type 2 diabetes. If you have a chronic pain condition — such as rheumatoid arthritis — too much sitting can make it worse. Sedentary behaviors have also been linked to mood disorders.
Among experts, there’s some ongoing disagreement about whether sitting is really the problem; some argue that sedentary time is just a marker of inactivity and that too little exercise is the real culprit. While not all the research on sitting is consistent, taken together, this body of evidence strongly suggests that too much time in a chair is risky even if you get regular exercise.
I was working at Men’s Health magazine when the “sitting is the new smoking” research started to get widespread attention. For a lot of us in that office, the solution was obvious: buy a standing desk.
But even that turned out to be problematic. Studies of health care workers and other people who spend all day on their feet have linked “prolonged standing” to heart trouble, chronic pain, and other health problems.
Personally, I found that standing all day long gave me muscle cramps and achy joints. Like a lot of standing-desk early adopters, I eventually switched to a sit-stand setup. But it’s never been clear to me just how much of the day I should spend up on my feet.
New research provides some clarification.
For a study published August 14 in the Journal of Science and Medicine in Sport, researchers in Finland found that standing may improve insulin sensitivity in ways that reduce a person’s risk for heart disease and Type 2 diabetes.
“We found that standing is associated with better insulin sensitivity independent of fitness levels, weight status, or the amount of time spent sedentary or physically active,” says Taru Garthwaite, the first author of the study and a graduate researcher at the University of Turku in Finland.
This is one of the few papers to conclude that standing, by itself, may be beneficial to one’s health. (Another, a 2020 study led by a team at the University of California, San Diego, linked standing to lower rates of mortality among older women.)
In the new study, Garthwaite and her colleagues speculate that the lower-body muscle contractions required for standing might lead to increased glucose uptake and improved insulin sensitivity. But she says the precise underlying mechanisms aren’t certain.
“It is not possible to say based on this study what minimum amount of standing may be required for potential improvements in insulin sensitivity,” she adds. “There was, however, a dose-response relationship between standing time and insulin sensitivity. It seems that insulin sensitivity is better with daily standing time over two hours, when compared to standing less than 1.5 hours a day.”
This two-hour minimum has come up in other research efforts. A 2015 study commissioned by Public Health England found that desk-based office workers should aim to spend a minimum of two hours a day on their feet with a goal of four hours a day may be optimal.
They also concluded that frequent sit-stand switches are helpful. “Seated-based work should be regularly broken up with standing-based work and vice versa,” they wrote, “and thus sit-stand adjustable desk stations are highly recommended.”
This aligns with advice I’ve received from other researchers. Some have told me that even small, brief movements — fidgeting, standing up for a few seconds, stretching — may help counteract the harms associated with long bouts of inactivity. Also, work on non-exercise activity thermogenesis (NEAT) has found that these sorts of light activities can add up in ways that significantly reduce daily sedentary time while also bolstering energy expenditure.
I know people who have treadmill desks. I’ve also heard about those wobbly standing boards that keep your leg muscles active while you’re standing in place. Maybe one day I’ll give those a shot.
In the meantime, it seems like my sit-stand approach will get the job done. I just need to switch often between the two positions and spend at least two hours a day (and ideally four) on my feet.