Ground-breaking research on the impact of sitting on our health from the University of Leicester has shaped clinical guidelines across the globe, has been adopted by wearable technology leaders Fitbit, and has led to the creation of the UK’s first evidence-based free resource kit to encourage desk-based workers to sit less and move more often throughout the day.
We all know that it’s important to remain active in order to stay healthy, but is the act of sitting bad for our health? After all, our lives revolve around sitting: we sit down to travel to work, we sit when we are at work – some of us all day - and when we get home in the evening, we sit down for dinner and then move to the couch.
There’s no doubt that sitting is ingrained in our culture, but it wasn’t until fairly recently that researchers across the globe started to investigate the impact sitting has on our health. In 2019, it was suggested that spending a large proportion of the day sitting down was estimated to cost the NHS around £700 million per year.
Spearheading global research into sitting is the University of Leicester’s Sedentary Behaviour Research (LSBR) team, led by Associate Professor Dr Charlotte Edwardson and Professor Thomas Yates. They have spent the last decade conducting a programme of research to better understand the role of sitting time on morbidity and mortality, and to examine the health effects of replacing some of the time we spent sitting with simple light intensity physical activity, such as standing, arm exercises and moving around more.
“When we measure how much time people spend sitting each day with small body-worn accelerometers, we find on average people sit for around 9-10 hours per day. Our research has shown that people who spend a large proportion of their day sitting are at a greater risk of developing chronic diseases such as cardiovascular disease and type 2 diabetes and dying early compared to those who don’t," Dr Edwardson explains.
"Initially it was thought that this was independent of the amount of exercise people did, which was worrying. More recently we’ve come to understand that doing moderate-to-vigorous physical activity may reduce the risk associated with high sitting time, but it may require anywhere between 30-75 minutes of moderate-to-vigorous activity every day.”
Whilst this is good news and we should encourage people to do more moderate-to-vigorous physical activity, for many of us doing this amount of exercise within our daily routines is not possible, so Dr Edwardson and her team began looking at alternatives to alleviate some of the risks associated with sitting.
Through a series of acute experimental studies, LSBR was able to confirm that reducing sitting time by incorporating short (five minutes) but frequent (every thirty minutes) bouts of light activity, such as standing, walking or arm exercises, considerably improved markers of cardiometabolic health such as glucose, insulin and blood pressure. Their research also identified key groups that would most benefit from regularly breaking up their sitting. For example, people with a high BMI, females and South Asians have a worse cardiometabolic response to prolonged sitting but then had a greater beneficial cardiometabolic response to the short, frequent light activity breaks in prolonged sitting.
Ground-breaking research on the health impact of sitting has shaped clinical guidelines across the globe
Building on this evidence, LSBR collaborated with researchers at Loughborough University to develop a sitting reduction intervention, SMART Work (Stand More AT Work). This intervention was developed with input from office workers and its effectiveness was tested with a randomised controlled trial, the gold standard method for testing if something works or not. The 12-month long study involving 146 participants aimed to reduce sitting time by 60 minutes per day and targeted one of the most sedentary populations – office workers.
“We decided to target a population that spends most of their time sitting and give them an environmental change, in this case, height-adjustable desks,” Dr Edwardson says.
“We provided the intervention group with a brief seminar on the consequences of sitting too much and the benefits of reducing and regularly breaking up sitting time, goal setting and action planning, ways to monitor their own sitting time, motivational posters, coaching session and a height-adjustable desk, while the control group continued working as they normally do,” she adds.
The trial was a tremendous success and the study showed that the group that received the SMART Work intervention sat 80 minutes less per day compared to the control group by the end of the 12 months. This sitting time was mainly replaced by accumulating more standing throughout the day.
The team succeeded in reducing sitting time and also measured other aspects of working life, such as work engagement, job performance, occupational fatigue, muscular-skeletal issues, sickness absence and quality of life. Improvements were seen across all categories: people were more engaged at work, they thought their job performance had improved, issues with neck and back pain reduced, fatigue levels went down and their quality of life went up.
Not only were the team able to demonstrate the health benefits from incorporating standing a little bit more throughout the day, they did a cost-benefit analysis of SMART Work that showed a potential return on investment of £3 on every £1 spent as a result of increased productivity, resulting in a net-saving of £1,770.32 per employee.
The creation of the free online SMART Work Programme
Dr Edwardson and the LSBR began working with key stakeholders to turn the SMART Work programme into a free online resource kit which is easily accessible to organisations and individuals. The SMART programme now has its own website and allows anyone to sign up to access the resource kit, whether they are an individual, a workplace champion or an organisation itself. SMART Work is a great resource to use alongside height-adjustable desks or office environment change or as a stand-alone toolkit to encourage less sitting. Learn more about the programme.