If you’ve read somewhere that sitting down is the new smoking, here’s news: Standing might not be the health booster you hoped for.
According to a new study on over 83,000 participants from the UK, prolonged standing may not improve heart health and could, instead, increase the risk of circulatory issues such as varicose veins.
The study’s aim was to examine the duration of daily sitting and standing with the association of cardiovascular disease (or CVD; including coronary artery disease, heart failure and stroke) as well as orthostatic circulatory disease (OCD), which counts orthostatic hypotension, varicose veins, chronic venous insufficiency and venous ulcers.
To collate data on their daily activity such as identifying their body positions (sitting or standing), the participants – average age of 61 and almost evenly split down the middle in terms of gender – wore tracking devices on their wrists for more than 16 hours a day, every day, for almost seven years.
(Photo: iStock/Liubomyr Vorona)
When it comes to sitting, the result was similar to what the other experts have been warning us about: You could die from being on your butt too much the way a smoker or an obese person could die from a greater risk of heart disease, stroke or cancer.
What this study further found is that sitting for more than 10 hours a day was linked to a higher risk of heart disease and stroke.
But if you think standing more could cancel out the ill effects of sitting, think again. The study noted that standing for more than two hours a day was “directly associated with increased OCD incidence risk”.
Another bummer: Standing had no effect on the risk of CVD.
Getting off the couch is a good move but as it turns out, you need to do more than just stand there.
“Standing does activate certain muscle groups, including those of the legs, hips and back, which is beneficial in general,” said Professor Chong Tze Tec, the head and a senior consultant with Singapore General Hospital’s Department Of Vascular Surgery.
(Photo: iStock/Jacob Wackerhausen)
However, simply standing at your desk isn’t enough as it can still “increase the venous pooling in the legs and lead to venous disorders”, he said. “Moving around is probably better” as the “activation of the calf muscles can decrease ankle venous pressure”.
Moreover, said Dr Wang, standing does not activate "the different muscular groups involved in ambulating or exercise” and because of that, standing “does not lead to the beneficial metabolic shifts that can contribute towards lowering cardiovascular disease risks”. Put simply, standing is not enough when compared to walking or exercise, he said.
Does this give you an excuse not to get up since standing is not all that helpful? “The article in isolation should probably be interpreted with caution and should not be taken to mean that standing is discouraged,” said Adjunct Assistant Professor Ch'ng Jack Kian, the head and a senior consultant with Sengkang General Hospital’s Vascular And Endovascular Service.
“The study merely reports that prolonged standing does not significantly alter the risk of cardiovascular disease, compared to remaining stationary or sitting for prolonged periods,” he said.
What does this leave you then? “Standing with movement intermittently should be the goal,” said Prof Chong. “In line with Health Promotion Board’s efforts, activity is always encouraged. If that cannot be achieved through intentional dedicated exercise, then we should find opportunities to do so throughout the work day."
(Photo: iStock/ake1150sb)
“Standing for two hours a day is the average duration most people spend standing and not everyone will develop complications,” said Dr John Wang, a vascular and general surgeon at PanAsia Surgery Group.
He pointed out that the study showed only 2.5 per cent of the participants developed OCD. The study also does not differentiate patients, who may already be prone to OCD, such as pre-existing varicose veins or a family history, he continued.
“To extrapolate these findings to all patients of all age groups and set a standing limit of two hours a day is a bit of an over-stretch. People’s vocation and livelihoods can be affected with misinterpretation of this data,” said Dr Wang.
The difference in calorie expenditure between sitting (80 calories per hour) and standing (88 calories per hour) is a mere eight calories per hour, according to this study.
“That difference is about the energy contained in two baby carrots,” said Dr Wang. However, “a lot of people assume that standing takes significantly more effort than sitting and consume more calories in order to maintain posture and to remain upright”, he said.
OCD can manifest in mild forms such as spider veins (fine, thready, red veins) and reticular veins (blue or green tinge, 1mm to 3mm in diameter), said Dr Wang. “The affected limb may swell as the day progresses and the muscular part of the calves may experience heaviness, easily tire, or cramp.”
(Photo: iStock/Staras)
Varicose veins, the most common OCD seen, are often caused by venous hypertension, said Prof Chong. This happens when blood pools in the “ankle regions secondary to the valves in the veins not optimally functioning”, he said. Varicose veins can lead to symptoms of leg heaviness, aches, itch and possibly swelling.
“During the later stages, (OCD) may start to develop skin pigmentation and thickening, and eventually develop ulcer around the gaiter area,” said Adj Asst Prof Ch’ng.
Besides being constantly on your feet, other factors can bring on these venous issues, too. “We know that age does increase the prevalence of venous reflux disease,” said Prof Chong. “Women are more prone than men; however, both sexes are affected. Multiple pregnancies also increase the risk of chronic venous insufficiency.”
If you have “a history of previous deep vein thromboses, you may also be prone to residual scarring or certain genetic conditions” that increase your risk, added Adj Asst Prof Ch’ng.
(Photo: iStock/nito100)
If you are in a situation or profession that requires you to stand longer than two hours, said Dr Wang, take breaks when possible. Also, consider proven therapies such as wearing compression stockings when you are on your feet, he said.
When it comes to standing-friendly footwear, there isn’t a specific type, said Dr Wang. But you’ll do well to choose shoes with good cushion, arch support and allow for feet expansion. “With leg or feet swelling, normal-fitting shoes may prove to be one or two sizes too small as the day progresses, leading to blister and wound formation.”
What to avoid are high heels as their “elevated heel position renders the ankles in a semi-flexed position”, said Dr Wang. This reduces your calf muscle’s “pump” ability to return blood back towards the heart.
“Common supplements that have been touted to help OCD or varicose veins include aescin in horsechestnut, flavonoids in grape seed extract, gotu kola herb, and Butcher’s broom,” he said. “Some patients find them helpful; however, there is no large clinical trials that have proven their efficacy in prescribed therapy.”
Continue reading...
According to a new study on over 83,000 participants from the UK, prolonged standing may not improve heart health and could, instead, increase the risk of circulatory issues such as varicose veins.
The study’s aim was to examine the duration of daily sitting and standing with the association of cardiovascular disease (or CVD; including coronary artery disease, heart failure and stroke) as well as orthostatic circulatory disease (OCD), which counts orthostatic hypotension, varicose veins, chronic venous insufficiency and venous ulcers.
WHAT THE STUDY FOUND
To collate data on their daily activity such as identifying their body positions (sitting or standing), the participants – average age of 61 and almost evenly split down the middle in terms of gender – wore tracking devices on their wrists for more than 16 hours a day, every day, for almost seven years.
(Photo: iStock/Liubomyr Vorona)
When it comes to sitting, the result was similar to what the other experts have been warning us about: You could die from being on your butt too much the way a smoker or an obese person could die from a greater risk of heart disease, stroke or cancer.
What this study further found is that sitting for more than 10 hours a day was linked to a higher risk of heart disease and stroke.
But if you think standing more could cancel out the ill effects of sitting, think again. The study noted that standing for more than two hours a day was “directly associated with increased OCD incidence risk”.
Another bummer: Standing had no effect on the risk of CVD.
WHAT DOES IT ALL MEAN?
Getting off the couch is a good move but as it turns out, you need to do more than just stand there.
“Standing does activate certain muscle groups, including those of the legs, hips and back, which is beneficial in general,” said Professor Chong Tze Tec, the head and a senior consultant with Singapore General Hospital’s Department Of Vascular Surgery.
(Photo: iStock/Jacob Wackerhausen)
However, simply standing at your desk isn’t enough as it can still “increase the venous pooling in the legs and lead to venous disorders”, he said. “Moving around is probably better” as the “activation of the calf muscles can decrease ankle venous pressure”.
Moreover, said Dr Wang, standing does not activate "the different muscular groups involved in ambulating or exercise” and because of that, standing “does not lead to the beneficial metabolic shifts that can contribute towards lowering cardiovascular disease risks”. Put simply, standing is not enough when compared to walking or exercise, he said.
Does this give you an excuse not to get up since standing is not all that helpful? “The article in isolation should probably be interpreted with caution and should not be taken to mean that standing is discouraged,” said Adjunct Assistant Professor Ch'ng Jack Kian, the head and a senior consultant with Sengkang General Hospital’s Vascular And Endovascular Service.
“The study merely reports that prolonged standing does not significantly alter the risk of cardiovascular disease, compared to remaining stationary or sitting for prolonged periods,” he said.
What does this leave you then? “Standing with movement intermittently should be the goal,” said Prof Chong. “In line with Health Promotion Board’s efforts, activity is always encouraged. If that cannot be achieved through intentional dedicated exercise, then we should find opportunities to do so throughout the work day."
(Photo: iStock/ake1150sb)
SO, SHOULD I LIMIT MY STANDING TO TWO HOURS A DAY?
“Standing for two hours a day is the average duration most people spend standing and not everyone will develop complications,” said Dr John Wang, a vascular and general surgeon at PanAsia Surgery Group.
He pointed out that the study showed only 2.5 per cent of the participants developed OCD. The study also does not differentiate patients, who may already be prone to OCD, such as pre-existing varicose veins or a family history, he continued.
“To extrapolate these findings to all patients of all age groups and set a standing limit of two hours a day is a bit of an over-stretch. People’s vocation and livelihoods can be affected with misinterpretation of this data,” said Dr Wang.
DOES STANDING BURN MORE CALORIES THAN SITTING?
The difference in calorie expenditure between sitting (80 calories per hour) and standing (88 calories per hour) is a mere eight calories per hour, according to this study.
“That difference is about the energy contained in two baby carrots,” said Dr Wang. However, “a lot of people assume that standing takes significantly more effort than sitting and consume more calories in order to maintain posture and to remain upright”, he said.
HOW DO I TELL I HAVE A PROBLEM FROM STANDING TOO MUCH?
OCD can manifest in mild forms such as spider veins (fine, thready, red veins) and reticular veins (blue or green tinge, 1mm to 3mm in diameter), said Dr Wang. “The affected limb may swell as the day progresses and the muscular part of the calves may experience heaviness, easily tire, or cramp.”
(Photo: iStock/Staras)
Varicose veins, the most common OCD seen, are often caused by venous hypertension, said Prof Chong. This happens when blood pools in the “ankle regions secondary to the valves in the veins not optimally functioning”, he said. Varicose veins can lead to symptoms of leg heaviness, aches, itch and possibly swelling.
“During the later stages, (OCD) may start to develop skin pigmentation and thickening, and eventually develop ulcer around the gaiter area,” said Adj Asst Prof Ch’ng.
Besides being constantly on your feet, other factors can bring on these venous issues, too. “We know that age does increase the prevalence of venous reflux disease,” said Prof Chong. “Women are more prone than men; however, both sexes are affected. Multiple pregnancies also increase the risk of chronic venous insufficiency.”
If you have “a history of previous deep vein thromboses, you may also be prone to residual scarring or certain genetic conditions” that increase your risk, added Adj Asst Prof Ch’ng.
(Photo: iStock/nito100)
WHAT CAN I DO AFTER A DAY OF STANDING?
If you are in a situation or profession that requires you to stand longer than two hours, said Dr Wang, take breaks when possible. Also, consider proven therapies such as wearing compression stockings when you are on your feet, he said.
When it comes to standing-friendly footwear, there isn’t a specific type, said Dr Wang. But you’ll do well to choose shoes with good cushion, arch support and allow for feet expansion. “With leg or feet swelling, normal-fitting shoes may prove to be one or two sizes too small as the day progresses, leading to blister and wound formation.”
What to avoid are high heels as their “elevated heel position renders the ankles in a semi-flexed position”, said Dr Wang. This reduces your calf muscle’s “pump” ability to return blood back towards the heart.
“Common supplements that have been touted to help OCD or varicose veins include aescin in horsechestnut, flavonoids in grape seed extract, gotu kola herb, and Butcher’s broom,” he said. “Some patients find them helpful; however, there is no large clinical trials that have proven their efficacy in prescribed therapy.”
Continue reading...