# Exercise as it relates to Disease/Benefits of Standing Desks on Childhood Obesity
## What is the background to this research?

Globally, childhood obesity has been progressively increasing in prevalence in recent years. Figures from the Australian Bureau of Statistics Australian Health Survey 2011-12, revealed that 1 in 4 children are now overweight or obese. The relationship between low physical activity levels, also called sedentary behaviour and the incidence of obesity is undeniable. Additional factors such as diet, genetics, socio-economic status and hormonal influences can also contribute to the manifestation of obesity. Covering these factors is not in the scope of this fact sheet, but they can be inferred in their relationship with obesity.
Childhood obesity leads to adult obesity and its related co-morbidities
Stemming from obesity research, this quote very simply describes the predicament that we as a society are in. Help our children, or set them up for a lifetime of chronic diseases that are linked with obesity. Diseases such as obstructive sleep apnea, hypertension, dyslipidemia, metabolic syndrome, cardiovascular disease, diabetes mellitus type II and certain cancers.
Initiative needs to be taken to create novel ways to increase physical activity and energy expenditure amongst children. School-based activity programs have been a helpful method in increasing physical activity levels. However, these activity programs are relatively brief in time when compared to the traditional amount of sitting that children will undertake during the remainder of the school hours.
One method that will help with prolonged exposure to increased energy expenditure in children is to install standing desks in the classroom to replace traditional sitting tables and chairs. The change from sitting to standing desks has potential positive benefits for health outcomes, especially regarding the control of obesity.

## Where is the research from?

The research for this fact sheet was attained from the article titled The Impact of Stand-Biased Desks in Classrooms on Calorie Expenditure in Children published in the American Journal of Public Health, 2011. The authors M. Benden, J. Blake, M. Wendel and J. Huber conducted the pilot study in a Central Texas (US) Primary School.

## What kind of research was this?

The research was a pilot study targeting childhood obesity through increasing passive energy expenditure in the classroom.

## What did the research involve?

The study compared the energy expenditure and physical activity levels between two groups of students that either used the traditional sitting desks or standing biased desks.
The two treatment classrooms had all the desks converted to stand-sit workstations with standing height stools. The children were given no specific instruction on how much they must stand or sit. In the two control classrooms the traditional desks remained unaltered for the entire school year.
Each student was measured on the following data points; gender, age, initial and final height and weight, Body Mass Index, body fat percentage and calorie expenditure measured by a BodyBugg Armband worn on the upper left arm.
Measurement periods were as follows:
* Four times during the school year
* Over five consecutive school days
* Between 8:00-10:00am in the mornings
Four classrooms were randomly selected with 20 students in each classroom. Of the 80 students contacted for inclusion in study, 71 students received parental consent. Of those 71 students, the 58 that finished had full data sets (31 treatment, 27 control). Of the 13 students that failed to complete the study, 9 were due to excessive absence and 4 relocated to other schools.

## Results and Interpretations

Key results from the study revealed that the treatment group on average burned 0.18 kilocalories per minute more than the control group. Leading to an increase in the treatment group burning an average of 17% more calories than the control group. In the students above the 85th percentile in weight for their age and gender there was an increase to 32% of calories burned in the treatment group when compared to the control group.
Of the two graphics displaying the results of the study, the LOWESS curve (Figure 1) provided a more simplistic and understandable visual view of the raw data. It clearly depicts the treatment group as having a higher calories per minute energy expenditure.
The researchers interpreted the results as a positive correlation with increased calorie expenditure in the treatment group when compared to the control group.

## Conclusions and Implications

If childhood obesity can lead to obesity in adulthood. An inference can be made that by increasing energy expenditure and physical activity levels through the use of Standing Desks in classrooms, they can in turn help reduce the incidence and severity of disease states such as obesity and its co-morbidities. Also children with higher initial levels of obesity typically respond faster and benefit more than their non-overweight counterparts.
The Standing Desk research has opened an exciting new way to have a prolonged and positive impact on the health of a significant number of school age children.
Research into Standing Desks and their effects on Energy expenditure may flow into other areas such as;
* Lifestyle Habits at home
* Chronic conditions
* Disruptive Behavioural Disorders
* Academic Performance
* Postural Abnormalities
With the correct implementation strategy, standing workstations can be successfully integrated into the classroom environment and decrease overall sedentariness. With further reliable and credible research undertaken in this area, local, state and federal governments may be forced to react and implement new policies for school desks modification, changes to configuration of classrooms and daily structure of the school curriculum. Health care costs of managing rising levels of obesity are a challenge for all government Decisions that, although they may incur an additional cost in the form of new classroom furniture in the beginning would in theory, be far outweighed by the huge financial saving that improved health and less chronic disease will create for society as a whole.

## References

* ↑ Australian Bureau of Statistics, National Health Survey: Summary of Results, 2011-2012. Canberra: ABS; 2012.
* ↑ Lakshman R, Elks C, Ong K, Childhood Obesity, Circulation. 2012;126:1770-1779
* ↑ Daniels S, Arnett D, Eckel R, Gidding S, Hayman L, Kumanyika S. et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 2005: 111 1999–2012
* ↑ Benden M, Blake J, Wendel M, Huber J, The Impact of Stand-Biased Desks in Classrooms on Calorie Expenditure in Children. American Journal of Public Health 2011: 101(8): 1433-1436
* ↑ Hinckson E, Aminian S, Ikeda E, Stewart T, Oliver M, Duncan S, Scholfield G, Acceptability of Standing Workstations in Elementary Schools: A Pilot Study. Preventive Medicine 2013: 56(1), 82-85
* ↑ Comans T et al, The cost-effectiveness and consumer acceptability of taxation strategies to reduce rates of overweight and obesity among children in Australia: study protocol. BMC Public Health 2013: 13:1182