The Glucose Effect of Standing

March 09, 2015

The Glucose Effect of Standing 

 Reference: Thorpe Med Sci Sports 2014, Alter, Annals Internal Med 2015

Glucose is the problem.   There is pretty clear evidence from the Whitehall study and others that you start making vascular lesions when your fasting blood glucose is more than 86.   That’s a tall order. Most of our doctors tell us our blood glucose is normal when it is under 100, and that all we need to do is exercise more and lose weight if our glucose is under 124.   We aren’t officially “diabetic” until our fasting glucose is over 124, twice. 

 Then, we find out that 50% of us are going to have Alzheimer’s by the time we get to age 85.   Pleasant thought, isn’t it? That may be all right with you, but seeing the misery my own mother is in, it’s not so good with me. And if my mother is in it, my turn is next. I don’t want to wait for that to happen, I want to do something that makes my risk different. Well, Alzheimer’s is now being called Type III diabetes. The argument here is that our brains get used to glucose, then gradually resistant to it over time.   Perhaps the key concept here is prolonged exposure to glucose over time. 

 Well, that raises the question, is there benefit to lowering my glucose?   Considering the demonstrated effectiveness of lower glucose on heart disease, I suspect it’s not unreasonable to posit the same effect for our brains. I make the leap that disordered glucose is damaging, wherever it is and vascular disease just happens to be where it shows up first. But expose the human brain to it for long enough and it will give way too. 

 So, what is the standing thing all about?   In this study, the researchers took 29 overweight office workers (mean age 49, BMI 29) and put them in a work environment that had them either sitting all day long, or sitting and standing all day, 30 minutes at a time at an electric, height adjusted standing desk.   (Nifty idea!). Guess what happened! Their blood sugar dropped 11 percent.   That’s huge! Just from standing for 30 minutes at a time. 

 Now, there is increasing research showing that going to a gym for 20 minutes has t’s benefit largely erased by 8 hours of sitting. Dr Alter did a review of all the research out there and shows that prolonged sitting is independently associated with bad health outcomes, regardless of exercise.   Exercise helps over no exercise, but prolonged sitting adds risk back and largely negates the benefit. What should be a louder clarion call is for all of us who get little exercise and have prolonged sitting as part of our jobs. 

 That leaves the high priest of sitting behavior (The CEO of Apple Computer) saying that prolonged sitting is the new cancer.   And right he is. 

 WWW. What will work for me?   I’ve got a job that involves prolonged sitting.   All-day long, I sit. I get up to greet folks and walk a little bit here and there, but mostly I sit.   I have put my greaseboard up for demonstrations, and used it once or twice. And I’m having a small podium built so that I can put my computer up and stand when I need to.   And as I typed this letter, I realized I was sitting. I’ve typed the last half of it standing.   I’m determined to learn different habits.   Join me.   

 Pop Quiz

  1. Prolonged sitting each day is independently associated with bad health outcomes. T or F         Answer:    True
  1. If I stand half the day, my blood sugar may be as much as 5 % lower. T or F                Answer:  Nope, 11%.
  1. Modestly high blood sugar with subsequent brain resistance to it may be the ultimate mechanism for Alzheimer’s.                    Answer:   That’s the current thinking.
  1. The majority of Americans sit most of the day.                    Answer:  Yup! That would be me and you, (mostly)
  1. Many of us can make modest adjustments in our workplace that would allow us to stand. T or F                          Answer:  Took me one minute to lift my laptop off the table and stand up. I put a few books underneath it to raise it up for me.