邱吉爾知道,海明威知道,達文西知道,從矽谷到北歐,所有設計時尚的辦公室內的上班族也都知道:站著工作大有好處。最時髦的辦公室甚至還設有跑步機辦公桌,鼓勵員工邊走邊工作;這聽起來像是一時的熱潮,但它確實擁有科學基礎。
數十年來,衛生單位一直在鼓勵民眾運動,令人意外的是,不管你花了多少時間進行慢跑等高強度運動,如果長時間不活動仍舊對身體有害。最新的研究顯示,你需要的是持續性的低度活動,活動度低到你可能覺得那根本算不上是運動,就連只是站著都可以。
過去幾年,一系列流行病學研究 雖然全都指向同一個方向,但仍不足以成為明確的證據。因此,萊斯特大學的威爾莫特(Emma Wilmot)決定進行後設分析,利用統計方法整合各項研究數據,推論出有意義的結論。威爾莫特博士結合了其中18項研究的數據,結果發現,在日常生活中活動量最少的人,得到糖尿病和死於心臟病的機會是活動量最多的人的兩倍,罹患心血管疾病的機會則是2.5倍。最重要的是,這似乎與強度較高的運動無關。
當然,這僅能證明兩者具有相關性,並不表示有因果關係。但有其他證據顯示,這些疾病問題確實是因為缺乏活動所引起。其中一項證據就是,坐著看電視、或閱讀,只會導致吃進更多的卡路里,卻不會增加卡路里的消耗。
另一系列研究則顯示,就算不看電視或閱讀,單只是不活動,也會改變新陳代謝速度,進而傷害健康。其中有項研究,讓老鼠一整天無法活動,結果發現老鼠骨骼肌的三酸甘油酯吸收量大幅下滑,導致三酸甘油酯在體內其他地方堆積,引發健康問題。此外,老鼠體內的高密度膽固醇水準亦大幅下降,而高密度膽固醇水準過低會提高心臟疾病的發生機率。
以人類為研究對象的報告也發現了類似的現像。幸運的是,本次研究亦顯示,只要進行小量且輕鬆的運動,就能改變此情況。例如,貝克IDI心臟與糖尿病研究所的鄧斯坦(David Dunstan)去年發表的研究即發現,每坐20分鐘就走路2分鐘,情況就會大為不同。
邱吉爾知道,海明威知道,達文西知道,從矽谷到北歐,所有設計時尚的辦公室內的上班族也都知道:站著工作大有好處。最時髦的辦公室甚至還設有跑步機辦公桌,鼓勵員工邊走邊工作;這聽起來像是一時的熱潮,但它確實擁有科學基礎。
數十年來,衛生單位一直在鼓勵民眾運動,令人意外的是,不管你花了多少時間進行慢跑等高強度運動,如果長時間不活動仍舊對身體有害。最新的研究顯示,你需要的是持續性的低度活動,活動度低到你可能覺得那根本算不上是運動,就連只是站著都可以。
過去幾年,一系列流行病學研究 雖然全都指向同一個方向,但仍不足以成為明確的證據。因此,萊斯特大學的威爾莫特(Emma Wilmot)決定進行後設分析,利用統計方法整合各項研究數據,推論出有意義的結論。威爾莫特博士結合了其中18項研究的數據,結果發現,在日常生活中活動量最少的人,得到糖尿病和死於心臟病的機會是活動量最多的人的兩倍,罹患心血管疾病的機會則是2.5倍。最重要的是,這似乎與強度較高的運動無關。
當然,這僅能證明兩者具有相關性,並不表示有因果關係。但有其他證據顯示,這些疾病問題確實是因為缺乏活動所引起。其中一項證據就是,坐著看電視、或閱讀,只會導致吃進更多的卡路里,卻不會增加卡路里的消耗。
另一系列研究則顯示,就算不看電視或閱讀,單只是不活動,也會改變新陳代謝速度,進而傷害健康。其中有項研究,讓老鼠一整天無法活動,結果發現老鼠骨骼肌的三酸甘油酯吸收量大幅下滑,導致三酸甘油酯在體內其他地方堆積,引發健康問題。此外,老鼠體內的高密度膽固醇水準亦大幅下降,而高密度膽固醇水準過低會提高心臟疾病的發生機率。
以人類為研究對象的報告也發現了類似的現像。幸運的是,本次研究亦顯示,只要進行小量且輕鬆的運動,就能改變此情況。例如,貝克IDI心臟與糖尿病研究所的鄧斯坦(David Dunstan)去年發表的研究即發現,每坐20分鐘就走路2分鐘,情況就會大為不同。
對某些科學家來說,上述綜合流行病學、動物及人體實驗的研究結果顯示,輕度到中度運動,例如站立、散步等活動,在質性上與高強度運動有所不同。但並非每個人都這麼認為,因為許多人體實驗的規模太小,而且並非每項研究都有發現缺乏活動所造成的負面影響。不過,顯然有不少人已不想等待確切的證據出現。站立式辦公桌的銷售商利用最新研究結果大肆為產品宣傳。總有一天,困在辦公隔間座椅上的上班族,必定會起身走進法庭,為自己的健康爭取應有的權益。(黃維德譯)
The perils of sitting down
Standing orders
Real science lies behind the fad for standing up at work
WINSTON CHURCHILL knew it. Ernest Hemingway knew it. Leonardo da Vinci knew it. Every trendy office from Silicon Valley to Scandinavia now knows it too: there is virtue in working standing up. And not merely standing. The trendiest offices of all have treadmill desks, which encourage people to walk while working. It sounds like a fad. But it does have a basis in science.
Sloth is rampant in the rich world. A typical car-driving, television-watching cubicle slave would have to walk an extra 19km a day to match the physical-activity levels of the few remaining people who still live as hunter-gatherers. Though all organisms tend to conserve energy when possible, evidence is building up that doing it to the extent most Westerners do is bad for you—so bad that it can kill you.
That, by itself, may not surprise. Health ministries have been nagging people for decades to do more exercise. What is surprising is that prolonged periods of inactivity are bad regardless of how much time you also spend on officially approved high-impact stuff like jogging or pounding treadmills in the gym. What you need instead, the latest research suggests, is constant low-level activity. This can be so low-level that you might not think of it as activity at all. Even just standing up counts, for it invokes muscles that sitting does not.
Researchers in this field trace the history of the idea that standing up is good for you back to 1953, when a study published in the Lancet found that bus conductors, who spend their days standing, had a risk of heart attack half that of bus drivers, who spend their shifts on their backsides. But as the health benefits of exercise and vigorous physical activity began to become clear in the 1970s, says David Dunstan, a researcher at the Baker IDI Heart & Diabetes Institute in Melbourne, Australia, interest in the effects of low-intensity activity—like walking and standing—waned.
Arse longa, vita brevis
Over the past few years, however, interest has waxed again. A series of epidemiological studies, none big enough to be probative, but all pointing in the same direction, persuaded Emma Wilmot of the University of Leicester, in Britain, to carry out a meta-analysis. This is a technique that combines diverse studies in a statistically meaningful way. Dr Wilmot combined 18 of them, covering almost 800,000 people, in 2012 and concluded that those individuals who are least active in their normal daily lives are twice as likely to develop diabetes as those who are most active. She also found that the immobile are twice as likely to die from a heart attack and two-and-a-half times as likely to suffer cardiovascular disease as the most ambulatory. Crucially, all this seemed independent of the amount of vigorous, gym-style exercise that volunteers did.
Correlation is not, of course, causation. But there is other evidence suggesting inactivity really is to blame for these problems. One exhibit is the finding that sitting down and attending to a task—anything from watching television to playing video games to reading—serves to increase the amount of calories people eat without increasing the quantity that they burn. Why that should be is unclear—as is whether low-level exercise like standing would deal with the snacking.
A different set of studies suggests that simple inactivity by itself—without any distractions like TV or reading—causes harm by altering the metabolism. One experiment, in which rats were immobilised for a day (not easy; the researchers had to suspend the animals’ hind legs to keep them still) found big falls in the amount of fats called triglycerides taken up by their skeletal muscles. This meant the triglycerides were available to cause trouble elsewhere. The rats’ levels of high-density lipoprotein (HDL) fell dramatically as well. HDL is a way of packaging cholesterol, and low levels of it promote heart disease. Other studies have shown the activity of lipoprotein lipase—an enzyme that regulates levels of triglycerides and HDL—drops sharply after just a few hours of inactivity, and that sloth is accompanied by changes in the activity levels of over 100 genes.
Papers which focus on people rather than laboratory animals have found similar effects. Happily, this research also suggests the changes can be reversed by small amounts of fairly relaxed activity. A study published last year by Dr Dunstan found that breaking up prolonged periods of sitting with two minutes of walking every 20 minutes made a big difference. After feeding his volunteers a sugary meal, he discovered that people who had been walking in this way had blood-glucose levels almost 30% lower than those of people who had remained seated.
For some scientists, this combination of epidemiology, animal experiments and human trials suggests that light-to-moderate exercise—standing up, walking around and the like—is something qualitatively different from an energetic, high-intensity workout. But not everyone is convinced. Many of the human studies are small-scale. (Dr Dunstan’s paper, for example, involved just 19 participants.) And not every study that has gone looking for the ill effects of inactivity has found them.
Still, the potential size of the problem means not everyone is prepared to wait for definitive proof. Sellers of standing desks are, naturally, jumping on the latest research findings to advertise their wares. And it is surely only a matter of time before the first law suit from a sickly cubicle slave reaches court.
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