Benefits of Standing Desks. Podcast with Kelly and Juliet Starrett

I have to admit, I love this story. Two parents saw a problem affecting their children and did something about it. But not only did they try to help their children and their children’s friends, they are now trying to help every child in the United States. How? By making standing desks the norm in schools.

Guests

My guests in the latest episode of humanOS Radio are Kelly and Juliet Starrett. Kelly is a Doctor of Physical Therapy and the author of the following books: Deskbound, Supple Leopard, and Ready to Run. Juliet has a history as a competitive athlete, rowing at UC Berkeley and paddling for the US Women’s Whitewater Team from 1997 to 2000. Together, they founded San Francisco CrossFit in 2005 (one of the first 50 CrossFit Affiliates ever), and they run the healthy-movement website Mobility WOD. Most recently, they started StandUpKids.org, the mission of which is to put standing desks in every public school in America. I’m honored to be on the Board of Directors, which I mentioned in this previous post, to help this great organization achieve its mission.

You may have heard me talk about standing desks in previous podcasts with Professor Matt Buman and Professor Travis Saunders. Why? Because we’re realizing it’s a very important subject, and we’re still learning more about it every day. It’s also a slightly controversial subject. Quite often I see headlines extolling the virtues of standing more, but the next new article states that they’re total BS!

To me, the subject is less controversial than the media might make it seem. I believe the data absolutely support that standing more across the day (versus sitting all day) is a good thing to do. This is why I have worked it into my daily habits for years now. Generally speaking, standing more across the day is good for our musculoskeletal systems and even for our mental clarity. For children, it’s a simple way to counteract too much sedentary behavior and the myriad negative outcomes that come from it – issues that can potentially last a lifetime.

Listen below to learn about how the idea germinated between this husband and wife team. Aside from being an inspiring story itself, it also just might inspire you to take action on some cause you think needs attention. And of course, we’re still raising money to help with our mission. So, if you’re feeling inclined to help in some way, please click donate below to give a few bucks!

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Otherwise, enjoy the interview below!

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Transcript

Dan - 00:00: Should kids use standing desks in schools? There's not a lot of evidence demanding that they should, although there is some, and it's compelling. Let's ask this question another way. Is it natural for kids to sit 8 to 10 hours a day at school and then with homework? If you look at our distant and not-so-distant ancestors, we know that kids sitting this much is unusual, to say the least.

00:24: Probably 10 or 15 years ago, a new field in exercise physiology emerged called inactivity physiology. This field looks at what happens to the human body when we don't get enough exercise in our lives. Mixed into this idea of not getting enough exercise is also the idea of sedentary behavior, which is not just not getting enough exercise, but it's how long you're sitting. Previously, most public health recommendations gave physical activity guidance that told us how much exercise we need to stay healthy.

00:54: For instance, I did an assessment of 10 different organizations, including the American Heart Association, the American Diabetic Association, the President's council of physical fitness in sports, the US Center of Disease Control and Prevention, and Harvard Public School of Health. All the recommendations state that humans should strive to get about 30 minutes of moderate to vigorous physical activity, somewhere between three to five times per week. Some also recommend doing muscle and bone strengthening exercises, but few of them, up until this point, have discussed guidance on how much we should or shouldn't sit.

01:26: However, in 2016, the Canadian Society for Exercise Physiology provided the first evidence-based guidelines to address to the whole day. The focus in these guidelines shifted in a very innovative way. Instead of making these specific recommendations just for exercise they wanted to look at the entire day. They gave guidance on how much physical activity we need, sedentary behavior, and even sleep.

01:50: What they stated is that for optimal health we want to give guidelines around sweating, stepping, sleeping, and sitting. I won't go into all of them since we're really focusing on standing now, but the idea is that we shouldn't be watching television or using screen times for recreational use for more than two hours. We should also break up long periods of sedentary behavior. The guidelines aren't very specific, and that's because there is just not enough time since we became aware that this is an issue to test all the different interventions.

02:17: Generally, don't sit for very long, and try not to spend more than two hours doing a very common recreational activity, which is watching television. We also saw, in the last year, Public Health England released a paper that said people should stand for two hours, to start, but then move towards four hours per day. Also, of note, at this time there is a task force that is convened by the Department of Health and Human Services that is working on the next version of the physical activity guidelines for Americans. This team is co-chaired by Professor Abby King, at Stanford, and also by Ken Powell who works at the CDC and the Georgia Department of Human Resources.

02:53: My guess is that these 2018 guidelines will absolutely include some guidance on sedentary behavior, but until then we can still make decisions around sitting time and our overall physical activity practice, which includes all the ways that we move in order to try to be healthy. Towards this end, today's guests are husband and wife team, Kelly and Juliet Starrett. Both of these folks have really serious backgrounds as competitive athletes, and in 2005 they founded one of the first 50 CrossFits in the world. It's still one of the most well known CrossFit gyms for producing field setting guidance and education, as much as it is for producing competitive athletes.

03:31: They also founded a brand called MobilityWOD, which has really expanded over the years to help people understand how to promote healthy joint mobility, and also promote healthy functional patterns in how we move. More recently, though, in watching their children's classmates move at a fun, outdoor event, they identified there was a big issue around limited range of motion, even in very young kids. From there their wheels started to spin and they realized that this problem might be because we are confining young children to being sedentary at a very young age. This germinated the idea of an organization called StandUp Kids. Without any further ado, I bring you my conversation with Juliet and Kelly Starrett.

Juliet - 04:07: Thanks for having us, and nice to meet you. Thank you for all your work thus far on StandUp Kids. You and Aaron were just thrown right into the mix.

Dan - 04:14: Yeah, well this is something that I've been thinking about for a long time myself, so when Drew told me about it I was really eager to participate. Kudos to you guys for putting this together because I think it's one of the single best ways to address this massive problem that we're dealing with, whether it's poor health or poor concentration, all of it. Nice.

Kelly - 04:32: What we know is that if it's, honestly, if it's not a [inaudible 00:04:35], or a collective of us doing it, no one's going to do it. Literally no one's going to do it, we're going to wait around and it's not going to be done. A and B, don't give Juliet any credit, it's all me.

Juliet - 04:44: Oh my God.

Dan - 04:46: Juliet, when you first thought of this idea ... When did the idea start?

Juliet - 04:54: Let's see, I honestly have to give Kelly a little bit of credit here, just a little. He actually did a talk at Google in 2010, called Desk Bound. The backstory behind that talk was that he was seeing all of these athletes, and weekend warriors, and universities, pro teams, you name it, people were consulting with him, or appearing in our physical therapy clinic with a lot of injuries that, in the end, after evaluation, Kelly concluded were a result of people sitting 10, 12 hours a day, and then trying to get up out of their chair, or they were sitting at 90 degree angles all day and be explosive, and powerful, and athletic.

05:35: He always likes to say that it wasn't his dream in life to lecture adults about posture and standing desks, but we come to this from the human performance world. Then the specific start point of StandUp Kids ... After Kelly did that 2010 Google talk, we really started thinking, and talking, and advising our clients and people that we worked with, literally across the board from corporations, to professional athletes, to elite military units. We would recommend that they minimize sitting and maximize standing, and we were fans of standing desks. This was just part of our regular professional life for years, and our recommendations.

06:14: I think it was in 2013, we volunteered at our daughter's field day. We like to do the sack race event because we think it's the most athletic and most fun. It's either that or the rope pull we do. Back when we were doing the sack races, and we were really disturbed to see that the kids could not get in and out of the sack. If you can imagine the process it would take to get into a sack in a sack race, you lift your knee to your chest and put the sack on one foot, and then get in the other foot, and start jumping. The kids were having trouble physically getting into the sack, and then they were horrible at jumping. Basic jumping in a sack, they were falling down, they didn't have the skills to just be able to jump across a field inside a burlap sack.

07:00: I'm certainly not a physical therapist, but even with my untrained eye I was able to see that these kids were super messed up, and I'll point out that we do not live in a place where we have a high rate of childhood obesity, it's pretty low. We're probably on the very low end because we're up in Marin County. It's not as though these kids were having this difficulty because they were overweight, it was literally, our conclusion was that these kids are stuck sitting at 90 degree angles all the time, and they couldn't move. Kelly's going to add.

Dan - 07:29: Yeah.

Kelly - 07:30: There's this other component. When we wrote "Ready to Run" one of the things that we kept obsessing about was, in our physical therapy practice and in our performance practice, we discovered, we saw something we ended up calling a pattern violation. A pattern fault is if I do a movement, then that movement should remain robust at scale, at speed, at load. I shouldn't have to reconstitute a brand new motor pattern. For example, I don't write slowly with my left hand and write quickly with my left hand, right? I don't dribble the ball only with my right foot when I'm going slow, and then left foot when I go fast. What we see is that it doesn't matter what I throw, my throwing mechanics remain stable. It doesn't matter if it's orange, it doesn't matter if it's heavy or light, the general principles remain constant.

08:16: One of the things that we see around running, for example, is that most people either fall into two categories. Well, all people fall into two categories. They either run the same way they would run barefoot, and the same way that they would sprint, or they fall into a heel striking category. If you look at young kids, kindergarten, even beginning first grade, they all run like Usain Bolt. They all fall, they all strike, they don't heel strike, they land on the four aspects of their foot. That running pattern remains constant independent of speed. Whether they're going slow or going fast, running is the same. Doesn't matter what's on their feet, if they're barefoot, wearing any kind of shoe, they run the same.

08:54: Halfway through the first grade, literally you can see the cohort split and half the kids start heel striking. When you see it, that means that about, what? Six or seven? You're fundamentally altering a primary motor pattern. When we started looking around, we're like, "What could possible be the underlying cause of this primary change in an essential movement pattern?" It turns out the only thing that we feel like we can point to is the sitting.

09:23: At some point there's a sitting load that kids can no longer buffer, and so their tissues begin to adapt, and because they spend time in this anterior, front at the hip, calf shortened position they have to alter their fundamental running mechanics. Now we start to see it once again. Because the human being is so robust at managing these different adaptation errors, these compensations, we don't see the downstream implications of that poor motor pattern for a long, long time.

Dan - 09:50: It's normal, everybody's doing it.

Kelly - 09:52: That's right. I think that it's okay to heel strike, sure, but you can't heel strike barefoot. For us we're like, "Okay, that doesn't hold true in that statement. Can I heel strike at speed? No, I can't sprint and heel strike, so maybe it doesn't hold true in that condition." What we really want to get to the bottom of is that we came after this sitting/standing/moving aspect of as a mechanical issue. What we're seeing is a decrease in function. None of these kids were injured, but what we saw was that they had decreased functionality.

10:21: To reframe this global conversation, one, it's not about sitting versus standing, it's about moving versus not moving. Being sedentary and being not sedentary. I think that's an important distinction, that when you sit down it falls into a category of behaviors of being sedentary. As soon as you stand up you immediately step out of, literally and figuratively, the category of being sedentary.

10:44: The same thing is true that when we want to reframe the conversation about, "Sitting is going to kill you, your head explodes, God forbid, your pelvic floor, you prolapse." What we want to say is, "Hey, look, we know you can buffer a lot of that, but you're going to see a compromise in function." Your breathing pattern is going to change, your ability to stabilize your spine is going to change, your ability to extend your hip is going to change. You can get by with a little tiny movement window, because you go to Soul Cycle, and you sit, and you never put your arms over your head, but the conversation has to be understanding the long game, and that if I'm fundamentally changing and altering my physiology, combined with the fact that I'm seeing massive decreases of functionality of the human, then we can start having an enlightened conversation, not, "Hey, we should do this because it's fear."

Dan - 11:30: Right.

Juliet - 11:31: Then just to actually go back to the original question, we saw this at field day, Kelly saw this while he was working on "Ready to Run", and we just, on a lark, decided to approach the principal of our kids' school, present her with some data and information we collected, thinking that maybe this would be a two or three year process before we could get through the administrative hurdles and get some standing desks going in our school. Turns out she was pretty much on board immediately, and they actually had a classroom that was without furniture, and a new teacher who was excited and game for the idea.

12:04: We started with one classroom of 25 desks, fourth graders. It was so successful and people were so excited about it that by the January of that same school year, so this is now 2014, we added another three classrooms worth. We did two more fourth grades and a first grade, and then by the following year, so the August, 2015, we got 450 desks for the school as part of this massive crowdfunding campaign we did with the help of Tim Ferris and a bunch of other major people who helped us make this happen. We raised $110,000 in like six weeks, and got the 450 desks for the school as our pilot school.

12:44: What we wanted to do was show that there was one school where every kid from kindergarten, all the way through fifth grade, could successfully work at a standing desk. Our proof of concept, and it's been working.

Dan - 12:57: That's incredible. To add a little recap, you noticed that these young children were all of a sudden demonstrating this aberrant movement pattern at a really young age, thinking that it's probably because they're, from a very early age, sitting all of a sudden, and because you understand the mechanics of running so well, you started to get the noodle turning, and then you thought, "Okay, well how can we get some standing desks into schools?" Started with the fourth grade class, expanded to the whole school, and it's been so positive that now you're thinking, "How do we take this across the nation?"

Juliet - 13:24: Yes, after our pilot school was so successful, we actually realized there was something to this, and we set up a full on nonprofit, which you are, of course, a part of, and we started working with an amazing nonprofit called Donors Choose that helps teachers get anything from pencils to 3-D printers in their classrooms. We partnered with Donors Choose, and we think through Donors Choose to date we have about 35,000 kids standing, or at least with access to a standing desk at their school. As you know, we also were lucky enough to be invited to partner with Michelle Obama's Let's Move active schools program.

Dan - 14:02: Woohoo.

Juliet - 14:02: They invited us, last February, to be one of their curated partners, and we are the only nonprofit out there that's focused specifically on standing desks. One of the reasons we think it's such a powerful intervention is that it's so simple. It's literally a switch of furniture, a small amount of education to teachers, and parents, and kids, which can all be done by video, and then you're done. Most of the other interventions in schools around physical activity and childhood obesity are high touch. When you're talking about changing a school lunch program, or bringing in before or after school physical activity programs, or adding more PE, those are all really high touch programs. A standing desk is literally a change to the physical environment, one and done.

Dan - 14:45: Right. For me, I'm very interested in human behavior and there's a lot of different ways to affect it. The most widespread way to affect the behavior is just to change the environment in which people live in, particularly if it's within a classroom, people can just start to use what's there. All the health benefits that you'd want to encourage them to be more interested in physical activity, to make time for it, cutting out other classes, it's not just a part of their learning environment and you have health benefits from that. The really interesting thing to me is the cognitive benefits that can come from it as well. Talk to me about what you've seen, and have you been able to measure, so far, any improvements in terms of how the kids are performing in school?

Kelly - 15:22: I think the way to think about this ... You've framed it right. This is a behavior change. We know that changing patterns is difficult. The external manifestations of cognition is called movement, and internal, meta memory and meta awareness. We know that once you've set these neural patterns they become myelinated, and reinforced, and it's difficult.

15:42: One of the things that we do in our strength and conditioning world is that we try to engage in what we call blocked behavior. If I'm working with a young kid and I'm trying to keep them from landing with a bad knee position I simply set a movement standard. I say, "Hey, look, I want you to jump and land with your feet together." By setting that standard, by blocking the behavior, I took away all the other choices, I immediately start to get a much improved mechanic.

16:07: The same thing happens with the desk. Remember that these are individually fitted, standing, moving environments for a human. They're individually sized to each child, there's movement richness built in, there's a fidget bar down below, the kid can lean, the kid props, they have an individualized support for them. More importantly, we take away the decision so there's not an option of sit versus stand, the option is the environment automatically fits me, and the environmental clues illicit the correct behavior, or a better behavior.

16:39: If I give 50 kids laptops and ask them to start plugging away at a normal desk you're going to see an ergonomic disaster. You're going to see [inaudible 00:16:47] spines, and head forward, and shoulders. Any ergonomist would be, "These are the kids we're not hiring because the RSI down the line." We're going to have certain [inaudible 00:16:56]. If you give a laptop or an iPad to a child at an appropriate environment, you don't actually every cue better ergonomics, because those are already built in.

17:08: It's important to understand around the behavior that one of the things that we're confronted with is that the environment has changed around us. The Henry J. Kaiser Foundation is seeing that kids from 8 to 18 are spending about seven and a half hours a day in front of a screen, which means that the screen is part of our lexicon, it's part of our day to day environment. I think it's really disingenuous to say, "Hey, we can change that, we can go Captain Fantastic style and get out of there."

17:35: In fact, the average adult is spending two and a half to four hours a day on their smartphones. I think we're not looking at the collective implications of this change in environment behavior. If we're going to clean it up then what we want to do is say, "Hey, look, where are the contact points where we can improve the function and the physiology of the human, and giving people this option to stand?" What's interesting now is that we're starting to capture the science behind this, and it turns out, of course, that everyone studying ADHD forever and ever has always seen a correlation between movement and cognition.

18:12: For us to separate out our cognitive, brainy cells from our movement cells really is a type one error, and that all of the metrics that we measure, whether it's engagement or productivity, test scores, behavior disruption, all of those things are attenuated, or improved, depending on what you're looking at when you have a human being not sit. That sedentary behavior literally starts to throw off light switches and down regulate the function of the human being.

18:41: Of course you can come at this many ways. If Juliet stands at her desk, there's a little calculator on her side, and she burns an additional 100,000 calories a year. She could either run 33 marathons, or for me, I could eat over 100,000 calories of ice cream. If that's what value, that's fantastic.

18:58: When we work for companies and that they see that there's a massive improvement in their productivity, massive. One company's study that came out last year showed a 40 million dollar change in six months in a call center productivity just because people were more engaged when they weren't sitting down. What you start to see is that we can actually cluster a whole group of behaviors.

19:17: One of our friends has an advertising firm and they have access to moving, dynamic desks, and they have a policy called ...

Juliet - 19:25: Walk, Talk, Click.

Kelly - 19:27: The first option is if you needed to speak to someone is that you go walk and talk to them, and it creates an automatic better communication before you call them, before you email them. The first line of defense, the first behavior cue that people are already blocked into is that I need to get up and leave my solitary, sedentary work environment and go interact with someone.

19:45: What's interesting is that when we start to pan back and gather all of the data and experience, there was some really good research that looked at how people who were smokers were actually much healthier than their nonsmoking counterparts, office workers, because the smokers got up every 30 minutes or so, walked and went outside and had a cigarette, and walked back. That activity was enough to be a considerable change in the function and health of the human being.

Dan - 20:13: Yeah.

Juliet - 20:13: I wanted to add, too, since your original question was about cognition, I think the science continues to emerge, but interestingly there was a really important book that came out a few years ago by a guy named Michael Thompson, called "Raising Cain" and it's about the emotional life of boys. One of the things that he talks about is how girls are crushing boys in all ways that you can measure success in school, and the early years of life, we're talking about grades, graduation rates, test scores, admission to college, graduation from college. If you just go through that entire list girls are crushing boys. He theorized that one of the reasons is that the environment is particularly poorly set up for boys.

20:52: Of course our view is that all kids need to move more, girls and boys alike, but boys have a particularly high genetic drive to move, especially elementary school boys. There was actually just an article that came out in Time Magazine this month featuring a study that was done that showed first grade boys who sat less and were more physically active learned to read more [crosstalk 00:21:14] and more completely. The boys who sat more were slower to pick up on this. We're showing this real, tight connection between your body's ability to move, and fidget, and learn.

21:30: One of the things that's really important is it's, I think a lot of people, sometimes, they go, "Okay, so the only way I can learn to read is if I'm jogging around the track." That's not the case at all. What we're talking about here is light movement, even fidgeting a little bit, moving from one position to another in your desk is enough movement to turn that brain on. What's hard about a sitting desk is you just plain can't move around enough. The nice thing about a standing desk, especially for kids, is it just gives them an option. It creates this movement rich environment for them.

Dan - 22:00: Right. I remember when I was a kid I could not sit still. I was fidgeting constantly, and I couldn't wait for recess, I couldn't wait to get outside and play basketball, and that's pretty much what I was looking forward to. I think it was a biological need, I needed to get out there and get some energy. I always remember the class after recess I was more calm, I could take in what the teacher was talking about. It's sad to me, it's bittersweet, but I have a three and a half year old boy, and now trying to think about the lessons learned and how we can help apply it to his learning experience. I think one thing that we neglect of the learning experience isn't just about remember facts, but it's also about developing the brain. A huge part of that is how you challenge yourself, et cetera, but it's also that environment. Going back to this elegant solution of the standing desk, it's just with the child from morning to night, and you can't beat that.

Juliet - 22:48: Yeah, I'll tell you one of the things that's so powerful about this is we have so many parents like you who have come up to us and said, "Oh my God, I learned to dislike school because I was always getting in trouble because I couldn't sit still, so I don't think I really enjoyed school, and I always found it a place where I was getting sent to the principal's office, and getting in trouble," and this is all just anecdotal but I can't tell you how many parents just like you have said similar things to us.

23:14: Just looking back on it, and the other thing I'll say is that we've had some people suggest that, "Hey, I grew up in the '70s and I sat at school and I'm fine," and first of all they're probably not fine. Second of all, you can't understate the huge impact that technology has had in terms of our overall sitting time. We didn't really start sitting a lot as Americans until the '80s when everybody had a television, and then television became so predominant, and then of course the moment everybody got a computer, which was by the late '90s everyone had a computer. We basically just sat down and didn't get up as a culture.

23:46: What we know is that technology is not going away. Kelly and I are on our computers and our phones all day because that's how we get work done, but what we're trying to do is figure out simple ways for people to both use and enjoy the amazing benefits of all this technology without crushing our bodies and we think the environment is one really simple way to do that.

Dan - 24:06: I think like Kelly was saying, it's a much better solution than thinking that people are going to give it all up. Some people might choose to do that but the vast majority are not. I do a lot of speaking on sleep and one of the anecdotes that I mention is how the iPad was released by Apple, I think in 2010. Within a few years there was 500 million copies that had been sold, and that enabled computing, of going from your laptop, which was still a lot more mobile of a technology than the old desktop, but now you could much more easily do it in bed. You could have this screen inches from your face right before bed and that could easily keep you up another 45 minutes before you actually feel the urge to go to sleep, even though if you were sitting in dark you would have been sleeping a long while ago.

Juliet - 24:46: Right, within five minutes, right?

Dan - 24:48: Right.

Juliet - 24:48: Yeah, and it's interesting you say that because, of course I don't expect many people to do this, but Kelly and I, many years ago, actually abandoned our iPads and our phones and went back to reading actual books for this reason. Instead of having the iPad we're book hoarders at our house, but we sleep great, and we both fall asleep within five minutes every night.

Dan - 25:08: That's another very interesting thing. Somebody that I've had on the show before, a colleague of mine, Matt Bumen, he's a professor at Arizona State University. He looks at the relationship between sleep, time, and then physical activity propensity the next day. He showed this reciprocal relationship. The more physically active you are during the day the better you sleep. The better you sleep the more likely you are to be physically active the next day. He's looked at it both directions.

Juliet - 25:29: Right, it's a big loop.

Dan - 25:31: It's a big loop.

Juliet - 25:32: Yeah, it's so interesting. I mean this is not scientific, but we did a really simple survey of the students at our kids' school, the pilot school, just about the standing desks, and again we are not scientists, this is really just N of one, but one of the things we asked is how many hours ... Again, this is self reported, but how many hours did the kids sleep on average, when did they go to sleep, when did they wake up, and then moving on, did they like the standing desks and were they tired at their standing desks? As you would expect, the kids who got the least sleep were also the kids who reported being the most tired standing at a standing desk. Go figure.

Dan - 26:06: I like to think of my work day, I want to be done with work that I'm working on, but also my physical works. I actually feel tired by the end of my day. I mix it in, I stand, I sit as well but I'm very in tune with my body and it's such a nice relationship to have with it so you're not being forced to do either, but you get to choose, and you get to say what feels right to me in the moment. I think, also, that sort of self regulation is really important to train in young people as well.

Juliet - 26:28: We've really come to believe that this physical activity piece ... If we had to choose between actual exercise and getting tons of physical activity every day, walking and moving around a lot, we actually have come to believe that we would choose the physical activity over the formal training. We think it's just a big hole in how we're telling people about how to be healthy. I like to talk about this graph I found that showed that obesity rates and gym memberships have tracked almost one to one since the early '90s. What that tells me is that people really are trying to do the right thing, and they're trying to follow the advice they're being given which is they need to work out because we're all getting fat.

27:07: That's obviously not enough, because what the unsaid message there was, "Well, if you go get your workout on for an hour and then you sit for 12 hours you're still going to be awesome." That, of course, turns out not to be the case.

Kelly - 27:19: One of the things that I think you bring up that's really important is that kids can self regulate. One of the things that, the feedback we get from teachers and even from the kids is that the low self control shifted it back onto the child, that if the child is tired they sit on the ground. What's interesting about that is that you've just suddenly created a lot of movement richness in the environment. That you've taken the hip through the full range of motion, you've changed the position, the mechanics, you're exercising, for lack of a better word, in terms of aka moving.

27:46: One of the things that we know is that in cultures that toilet on the ground, sit on the ground, there's very low lumbar disease and there's very low hip disease, and the fall risk in their nursing homes drops to almost zero, because they're just using it. They don't fear getting up off the ground. People get up off the ground 20 or 30 times a day into their 80's. If you asked your mom or your grandmother to get up off the ground 30 to 40 times a day they'd be like, "You're crazy, this is madness." That flexibility is really interesting.

28:13: There was even a really good study that came out that's been well validated, showing that the more points of content you need to get up off the ground correlates well with your early mortality rate.

Dan - 28:23: Interesting.

Kelly - 28:23: If you can't just sit cross-legged and pop up then you're going to see that you're likely to die early because your balance is off, your leg power is off, your flexibility is off. It also brings us back to another point, about that self regulation piece, is that most adults are very unconscious about when they get tired. If they need to sit down sit down, they need to rest. Instead what happens is we override that with coffee, with Five Hour Energy, and we're blasting ourselves. What most people don't realize is they're falling into this deep, stimulant/depressant cycle that gets expressed in the highest level of sport with athletes I know taking lots of Adderall, and they can't sleep so they have to take Ambien, and then it's Bulletproof and Adderall.

29:03: Most adults, if you were like, "Hey, I'm not a professional baseball player," but you have a pot of coffee in the morning to get going, and then you sneak a little coffee at 4 PM, and then you have to have two drinks to unwind at night. That's that same cycle.

29:14: What we're trying to do is bring consciousness and awareness, that if kids are tired they sit. There's even a stool in the classroom and if kids are sick or injured they just lean. What we've done is given them the option and given the permission to listen to what's going on in their bodies, which is a part of this physical education.

Dan - 29:30: Yeah. I have an interesting anecdote to share with you guys, it's from the sleep world but I think you'll get a chuckle out of it. There's a famous sleep researcher named David Dinges and he works with almost every major organization, Department of Transportation and NASA, but they were doing an 80 hour sleep deprivation study in a guy, and the guy was doing really well. He had a good mood or whatever, but he had to sit down to take his last test, this vigilance test, this reaction time test, and as soon as he sat down he started to accuse the researchers of putting gas in the room, they were trying to gas him. They were looking at each other, the researchers, and thinking, "Wait, what's going on here? Is he hallucinating?" They realized that when the kid had so much sleep pressure from not having had any sleep over the last couple days, when he sat down he removed the last stimulus to keep his brain alert.

30:11: It highlights a really important point, that one aspect of cognition or critical arousal is muscle activity. When you're sitting at a chair you're not really using any of your muscles, and you're withdrawing one of those activity stimuli that keeps the brain firing. Standing, even that little bit of muscle tone, is one of the aspects that can keep us feeling sharp across the day.

Kelly - 30:31: I love that, and what's more important is that I have quoted that study 1,000 times, not because of the study, but because that participant in that research came to the gym and told me that story.

Dan - 30:43: Really? Oh my gosh, that's hilarious.

Kelly - 30:45: He was actually in the gym, he was like, "I sat down and I felt like I was on drugs, and I was like, 'They gassed me.'" He got really belligerent and then he blacked out. That's the other part they didn't tell you, he literally passed out. Please, when we got off this you have to send me that study because more than that guy and his experience, he's like, "There's something to it, you can keep going as long as you can stay on your feet." Love it.

Dan - 31:06: Right. Oh my gosh, that's amazing.

Juliet - 31:08: As you were talking Kelly's face was like, "I know this guy!"

Dan - 31:11: That's insane. I'll have to look up the study but David Dinges came and gave a Grand Rounds lecture at Stanford, and in that Grands Round he told that story and it stayed with me because it's pretty funny.

Juliet - 31:20: It stayed with Kelly too, because I have heard him repeat that story 50 times over the years because it really blew his mind.

Dan - 31:27: That's amazing. Well Kelly, between you, me, and David Dinges, we might be the three people that are telling that story occasionally. Another thing, I think you were talking about Greg Garrett's work from Texas A&M who was looking at the call center people, and I thought that was a really interesting study. They were only standing about another hour and a half per day with that stand and sit option, but the other thing that was so notable in my opinion is that three-fourths of the people reported decreased discomfort over time, and a couple minutes ago you said the kids really like it. If you've been sitting for a long time and you stand up you might have a little discomfort but you get used to it. Then you prefer it. That was a really important point, because if you're uncomfortable sitting then that's going to inhibit your productivity as well.

Juliet - 32:06: Right, well you bring up what I think is really the most important takeaway for any adults listening to this. Take it slow. We read an article that compared switching to a standing desk to running a marathon. Of course anyone running a marathon would hire a coach, meticulously follow the programming and do the shorter runs, and then progressively longer and longer runs. Somehow everyone thinks that if they've been sitting for 20 years they can just pop up to a standing desk and go from sitting for 12 hours a day to standing for nine hours when they're at their office and it's going to be no big deal.

32:37: What we tell people is just to take little baby steps. If you've been sitting for a long time, get a standing desk with a perching stool and start off by sitting for 20 or 30 minutes on the first day. Then add up to 40 minutes. Put yourself on a little learning curve, so to speak, of standing. Then you're more likely to be successful, because what we've seen is that people get so excited, and they're believers, they get up out of their chair, they stand, and then their feet hurt, and their back hurts, and they're like, "Oh, this standing thing is hard." They lower their desk and sit back down and never stand up again.

33:09: That's really the fault to me, you've got to have your desk adjusted correctly and you've got to take it slowly. If there's no option to stand, or if you can't get a standing desk, we recommend that every 20 minutes you get up and walk around for two minutes. That's a really simple thing.

33:23: We like to tell the story about how Chevron, which you would not necessarily think would be the most progressive company, they actually have installed this software on all their employee's computers, that at 55 minutes on the hour their computers literally turn off. I think at first they reported that people went temporarily insane because they were midway through an email, or midway through a thought, or whatever they were doing, and then in the end it's been both better for their health, because guess what? Everybody gets up out of their desk and goes and gets a cup of water in the break room, or moves around their office, or gets up and takes a stretch.

33:55: I think Chevron knew it would be better for their employee's health, and I think the unanticipated benefit was guess what? Everybody got up and moved around and they actually talked to each other, so people also report feeling happier and more content at work because they were actually interacting with one another as opposed to just in their cubicle, alone, not talking to any humans. That's why the office working smokers are healthier, which is really frightening.

Dan - 34:18: Right. I'm so interested in how technology can solve the problem that technology has created, or at least contribute to part of the solution. I've actually been impressed with what FitBit has recently done. I've been waiting for an inclinometer, or something that can measure standing time, and they just haven't come out. They have them in research settings where you essentially affix it to the leg like a bandaid, and then it can tell you if you're standing or sitting. We haven't seen it in any sort of commercial application, but FitBit did something pretty innovative where they used 250 steps as a proxy for standing. If you can accumulate at least 250 steps during each our then you get credit for standing some of that hour. It's a little frustrating because I'm at my standing desk, it might make it seem like I'm being sedentary, but I'll just move around a little bit. It tells you 15 minutes of the hour, "Okay, hey, you need another 87 steps." I think that was pretty smart of them.

Juliet - 35:03: Yeah, you're right, and Kelly and I are always open to try out any new technological device. I use something called the Withings, because it has an eight month battery life, and for me, just from a purely habit standpoint, I cannot seem to manage to keep my iPhone and a FitBit or one of those things charged in a 24 hour period. I really like the Withings because it has this eight month battery life, but I can just see ...

35:26: Ultimately the goal here is to get people moving more. That is the goal. Whether it's by a standing desk, whether it's getting up and walking around more, whether it's just being conscious of whatever your movement is, but I'll actually say that this Withings has changed my habits a little bit because if I see that I'm behind in my movement for the day I will put my earbuds in and take a phone call while I'm walking around, or if I need to drop something off at FedEx, it's maybe like a quarter of a mile from our house, if I'm working at home I'll walk down to FedEx and drop it off and walk back because I see that I'm already behind on my basic movement.

35:59: Again, all this is completely separate and apart from formal training, this is moving around in a day. How people do that, we're pretty agnostic about how people do that. We like the standing desk for the reason Kelly said, because it's a blocked behavior and just creates an automatic movement rich environment for people, but if that doesn't work for you, if getting up every 20 minutes and walking around for two to five minutes, that works great, that's another way to do it.

Dan - 36:21: In one of my previous shows I interviewed Professor Travis Saunders from the University of Prince Edward Island in Canada. Travis started something called the sedentary behavior research network, and one of the major objectives of that organization was to define what we really mean when we say sedentary behavior. Is it too little exercise? Or is it taking too much time sitting? Those things are really not the same thing, and yet in the literature, up until this point, they had been used interchangeably, and that can cause confusion. He went through the process to gain consensus and now sedentary behavior includes things like sitting at a desk, and TV watching, et cetera, and inactivity refers to too little exercise.

36:57: Personally, I went through a process where, when I started to stand more, at first I tried to, perhaps, stand too much and my productivity would drag in the afternoon. For me, while standing in the morning tends to be a good thing, I also realized that over the course of the day, listening to my body and doing both sitting and standing really makes the most sense. You have to manage your energy and it's really great to have options. Don't force it, self regulate, give yourself what you need.

Kelly - 37:21: I think that's vital for people to understand as they make this change in their lifestyle. The first thing we say is, "Hey, look, there's a lot of sitting you can do, and you can definitely sit with more skill." We talk a lot about that, sit on your sit bones, engage your legs, try to look over the chair, manage your positions, but if the first thing you do is just divide your world into optional sitting, non-optional sitting, what you're going to see is there's just a lot of junk sitting in there.

37:43: There's plenty of times when I need to sit in a meeting, where it's appropriate that I'm having coffee, and I can't stand, don't worry about it. [inaudible 00:37:49] the junk sitting. I think, also, you bring up a vital piece of this is that we think that standing still, is called [inaudible 00:37:55] yoga or standing meditation, and good luck managing about five minutes of that. You're going to burn out. What we want people to do is recognize that when you're in a moving environment then you have movement options, and you have more movement options than you do when you collapse.

38:10: The other thing that we say about a standing, moving environment is that it's not complete until you have a place to put your foot. As soon as you put your foot up on something, then you've adapted that Captain Morgan pose, you've taken a lot of [inaudible 00:38:22] back, and you've given yourself a chance to fidget and to be constantly in motion.

38:27: The last thing I'll say is that all of this rest is not about activity/non-activity as you say, it's about rising above that one and a half metabolic equivalence threshold for a centered behavior. Harvard defines it, centered lifestyles, less than six hours, trying to minimize centered behaviors, aggregation into less than six hours a day. Canada said kids should sit less than two hours a day, we're really saying, "Hey, try to keep down all of that sitting, and don't worry about it, but just try to keep it to four hours as a minimum." If you're in constant little motion then we can at least have the next conversation. What we're trying to do is layer on our Bulletproof coffee, and our sleep solutions, and our down regulation, and we're layering it on top of a foundation made of sand, and that's never going to work.

Dan - 39:10: What can people do if they want to support this cause of getting more standing desks in schools for kids? Where do they go?

Juliet - 39:16: Sure, we have a great website with tons of resources at standupkids.org. It's really easy to get on and donate there, we're actually presently in the midst of a big campaign to try to raise $50,000 throughout this holiday season, so our campaign ends on January 5th. Standupkids.org, it's a great resource for parents and teachers. We have a movement break curriculum for teachers, we've got some cool calculators, like a daily standing calculator, and some other interesting tools people can play with as well as tons of infographics that are printable information and so forth, and that's also the place folks can go to make a donation.

Dan - 39:52: That's great, so if you're a parent you can go there just to learn a little bit about how you can coach your own kid about how to stand, what's important. Not just a place to give but a place to learn.

Juliet - 40:02: Exactly.

Dan - 40:02: Right, great. Well thank you guys, and to everybody who is listening, I've recently joined StandUp Kids' board, but this is the first time that Kelly and Juliet and I have spoken, so it's nice to record it. Maybe the first time I've ever recorded an introductory conversation. I'm really excited.

Juliet - 40:15: Yeah, it's so nice to speak to you. Thank you so much for having us on and letting us talk about the ... We do a lot of work out there and we think this is the most important work we're doing.

Dan - 40:23: Agreed. Well everybody, think about how important this is and how much you can change lives. Go and contribute, and thank you guys so much for your time and for what you're doing, and I'm happy to be a part of it too. Thank you for including me.

Juliet - 40:33: Awesome, thank you so much Dan.