Get up and stand up for at least two hours daily during working hours

Office workers should be on their feet for a minimum of 2 hours daily during working hours, recommends the first ever UK guidance designed to curb the health risks of too much cumulative sitting time, and published online in the British Journal of Sports Medicine.

This daily quota should eventually be bumped up to 4 hours a day, breaking up prolonged periods of sitting with the use of sit-stand desks, standing based work, and regular walk-abouts, it says.

The guidance, which evaluates and distils the available evidence, was drawn up by a panel of international experts, at the behest of Public Health England and a UK community interest company (Active Working CIC).

It aims to make some core recommendations, amid the growing body of research linking prolonged periods spent seated?as opposed to being generally physically inactive?with a heightened risk of serious illness and premature death, and the burgeoning market of workplace products developed in response to the emerging evidence.

The authors point out that in the UK sedentary behaviour now accounts for 60% of people's waking hours and for 70% of those at high risk of a long term condition.

"For those working in offices, 65-75% of their working hours are spent sitting, of which more than 50% of this is accumulated in prolonged periods of sustained sitting," they write.

"The evidence is clearly emerging that a first 'behavioural' step could be simply to get people standing and moving more frequently as part of their working day," they say, adding that this is likely to be more achievable than targeted exercise.

Based on the current evidence they recommend:

• 2 hours daily of standing and light activity (light walking) during working hours, eventually progressing to a total of 4 hours for all office workers whose jobs are predominantly desk based
• Regularly breaking up seated based work with standing based work, with the use of adjustable sit-stand desks/work stations
• Avoidance of prolonged static standing, which may be as harmful as prolonged sitting
• Altering posture/light walking to alleviate possible musculoskeletal pain and fatigue as part of the adaptive process
• As well as encouraging staff to embrace other healthy behaviours, such as cutting down on drinking and smoking, eating a nutritious diet, and alleviating stress, employers should also warn their staff about the potential dangers of too much time spent sitting down either at work or at home

Some companies have already invested time and money creating a more active working environment for their staff, but those that haven't should evaluate how best to achieve the recommendations, they say.

This could include deciding when and how staff take breaks which involve standing and movement; and desk designs and technologies that allow employees to do their job more easily either at their desk or from other locations in the office while standing up, they suggest.

The authors acknowledge that much of the evidence they draw on for their recommendations is based on observational and retrospective studies, which make it difficult to prove direct cause and effect.

Nevertheless, they emphasise: "While longer term intervention studies are required, the level of consistent evidence accumulated to date, and the public health context of rising chronic diseases, suggest initial guidelines are justified."