For years, we've been warned that sitting is the new smoking, and in response, many of us have swapped our office chairs for standing desks. But have we really solved the problem?

The reality is that Americans are moving less than ever before, and it's taking a toll on public health. However, simply replacing sitting with standing in place all day isn't the answer either. The key to better workplace health isn't just whether we sit or stand, it's about how much we move throughout the day.

Inactivity is a public health concern.

Advances in technology and automation have transformed how we work, shifting many jobs away from physical labor to desk-based tasks. At the same time, our commuting and leisure activities have become more sedentary, further reducing daily movement.

While indoor desk jobs do provide some health benefits, such as reducing exposure to physically demanding work that can lead to overuse injuries, sedentary work comes with its own risks. Prolonged inactivity has been linked to weight gain, Type 2 diabetes, heart disease, and musculoskeletal issues such as back and neck pain.

In addition to increased sedentary activity, only 24% of U.S. adults meet the minimum federal physical activity guidelines according to a recent National Health Interview survey. Current guidelines from the American College of Sports Medicine and the Centers for Disease Control and Prevention emphasize the importance of both structured exercise—jogging, cycling, or strength training—and nonstructured movement—walking, taking the stairs, or doing chores.

Recommended physical activity guidelines:

• Moderate aerobic activity: At least 150 minutes per week—e.g., 30 minutes, five days a week.
• Vigorous aerobic activity: At least 75 minutes per week—e.g., 25 minutes, three days a week.
• Muscle strengthening: Two or more days per week, focusing on major muscle groups.
• Flexibility exercises: Exercises for the major muscle groups, at least two times a week.

Though the American College of Sports Medicine doesn't set explicit guidelines for nonstructured movement, even among individuals who meet the recommended physical activity guidelines, prolonged sedentary behavior poses significant health risks. 

Research has consistently shown that excessive sitting or standing for extended periods without movement is associated with an increased risk of cardiovascular disease, Type 2 diabetes, obesity, and all-cause mortality, independent of structured exercise routines. 

Beyond the risks that come with sedentary behavior, sitting for prolonged periods creates additional health concerns:

• Poor circulation: Blood flow slows, increasing the risk of deep vein thrombosis.
• Metabolic slowdown: Prolonged sitting decreases calorie expenditure and insulin sensitivity, contributing to weight gain and diabetes risk.
• Postural strain: Remaining seated for hours can lead to tight hip flexors, weakened core muscles, and chronic back pain.

Standing desk boom

Recognizing these risks, many businesses and individuals have embraced standing desks as a workplace wellness solution.

According to Statista, 60% of U.S. employees now have access to a standing desk, up from just 20% in 2014. While standing may reduce some risks associated with prolonged sitting, recent research confirms it doesn't eliminate the dangers of inactivity.

A 2024 study published in the International Journal of Epidemiology analyzing data from over 80,000 adults found that standing desks do not reduce the risk of cardiovascular diseases such as stroke and heart failure.

Dr. David Thorp, professor of human physiology at Gonzaga University, says, "There are also downsides to prolonged standing such as blood pooling in the legs, which can lead to leg pain, and vascular issues such as varicose veins, and compromised blood flow. Standing can also lead to lower back pain, and just discomfort in general."

The science of NEAT

A significant factor in overall energy expenditure is non-exercise activity thermogenesis, or NEAT, which describes the calories burned from daily activities that aren't structured exercise. This includes activities such as walking to get coffee, fidgeting, taking the stairs, or carrying groceries.

Studies suggest that NEAT can vary by up to 2,000 calories per day between highly active and highly sedentary individuals, making it a critical factor in weight management and metabolic health—stable blood sugar levels, healthy blood pressure, balanced cholesterol levels, and an appropriate waist circumference.

While standing desks may slightly increase NEAT, research shows that intentional movement throughout the day is far more beneficial than simply standing still.

So, if modern work requires at least some level of desk work, and neither sitting all day nor standing all day is a good option, what should we do?

The solution isn't choosing between sitting or standing, it's incorporating more movement into the workday.

Thorp explains, "More dynamic workstations can be of greater benefit. Walking workstations, for example, can have a dramatic effect on energy expenditure and have been shown to have a positive impact on body composition, blood lipid and glucose levels, and several metabolic indices. Seated pedal workstations have also been shown to improve energy expenditure above sitting or standing. These dynamic solutions also encourage better blood flow alleviating some of the vascular issues associated with standing alone."

Kristen Kavon, program director in the physical education activities program at Gonzaga, says, "I have a lightweight walking pad that I walk on when my monitors are elevated. Studies have found that most people can walk at 1 to 2 mph and still perform a variety of work tasks without disruption."

Practical strategies can be placed in two categories: employer-driven solutions and employee-controlled challenges. 

Employer-driven solutions involve:

• Invest in dynamic workstations—treadmill desks, balance boards, active seating.
• Encourage walking meetings instead of seated conference rooms.
• Offer sit-stand workstations but promote movement breaks.
• Design office spaces encouraging movement—centralized printers, stair-friendly layouts.
• Implement movement challenges—step competitions, movement tracking apps.

Employee-controlled challenges include:

• Set reminders to stand, stretch, or walk every 30 to 60 minutes.
• Use the Pomodoro technique—work for 25 minutes, take a 5-minute movement break.
• Walk instead of emailing colleagues when possible.
• Incorporate active commuting—walking or biking.
• Use a fitness tracker to monitor daily movement and set activity goals.

Standing desks are a step in the right direction, but movement throughout the day is the real game changer for workplace health. Small intentional changes such as walking meetings, movement-friendly office designs, and integrating NEAT throughout the day can have a lasting impact on health and productivity.

A healthier workplace isn't just about choosing between sitting and standing, it's about redefining work habits to include more movement. After all, our bodies are built to move.

Robin Pickering is a professor and chair of Public Health at the Gonzaga University School of Health Sciences.