Savill P. Standing more and sitting less may benefit cardiometabolic health. Practitioner 2015; 259 (1785):10

Standing more and sitting less may benefit cardiometabolic health

24 Sep 2015


Cardiovascular disease

Dr Peter Savill, GP Watercress Medical, Medstead, GPwSI Cardiology, Southampton


Spending less time sitting and more time standing, stepping, or both, improves markers of cardiometabolic health, a study from Australia has shown.

The researchers studied participants from the 2011/12 Australian Diabetes, Obesity, and Lifestyle Study who wore the posture-based activPAL3 monitor. This activity monitor has been shown to be highly accurate and directly measures posture from the thigh position. There were 698 adults in this subsample aged 36-80 years (mean 57.9) of which 57% were women.

Using data collected from postural sensors the authors modelled cross-sectional associations with cardiometabolic risk biomarkers of reallocating time (2h/day) from sitting to standing or to stepping.

Association of activPAL3 derived mean daily time sitting, standing and stepping with the following parameters was examined: BMI, waist circumference, BP, HbA1c, fasting glucose and lipids (HDL cholesterol, LDL cholesterol, total:HDL cholesterol ratio, and triglycerides), and 2-hour plasma glucose.

After adjusting for confounding factors, each 2h/day sitting to standing reallocation was significantly associated with:

• 2% lower fasting plasma glucose

• 11% lower triglycerides

• 6% lower total:HDL cholesterol ratio

• 0.06 mmol/L higher HDL cholesterol

Each 2 h/day sitting to stepping reallocation was significantly associated with:

• 11% lower BMI

• 7.5 cm smaller waist circumference

• 11% lower 2-h plasma glucose

• 14% lower triglycerides

• 0.10 mmol/L higher HDL cholesterol

Standing to stepping reallocations were significantly associated with:

• 10% lower BMI

• 7 cm smaller waist circumference

• 11% lower 2-h plasma glucose

The healthy lifestyle message is generally well understood and our patients know that they should avoid smoking, exercise frequently and eat healthily. However, our lives are increasingly sedentary and perhaps the risk of excessive sitting time is less well documented.

The authors conclude that sitting reduction strategies targeting increased standing, stepping, or both, may benefit cardiometabolic health. Standing is a feasible alternative to sitting and they feel this warrants further examination in prospective and intervention studies.

This is a simple message and should encourage us all to get out of our chairs more even if just to stand while making that phone call.


Dr Peter Savill


• Healy GN, Winkler EAH, Owen N et al. Replacing sitting time with standing or stepping: associations with cardio-metabolic risk biomarkers. Eur Heart J. DOI: http://dx.doi.org/10.1093/eurheartj/ehv308