# Stand Up for Your Health: A Randomized Study

> **NIH NIH R01** · MEDICAL COLLEGE OF WISCONSIN · 2024 · $551,977

## Abstract

Abstract: Sedentary behavior is becoming increasingly prevalent with the expansion of a ‘work from home’
culture, most recently driven by the COVID-19 pandemic. We now spend more time sitting than in all other
activities combined. This increased chair dependency, including a reduction in occupational energy expenditure
over the past 5 decades, has contributed to the epidemic of chronic disease, including metabolic syndrome,
cardiovascular disease, and type 2 diabetes mellitus (T2DM). Several studies, including a large meta-analysis
of 18 studies totaling 794,577 subjects, concluded that sedentary behavior mediates T2DM. The CDC predicts
that if current trends continue, as many as 1 in 3 U.S. adults could have diabetes by 2050. At present, 9% and
34% of U.S. adults have T2DM and prediabetes, respectively. Although we excluded diabetics in our pilot study,
11 of the 15 overweight or obese subjects were found to have some insulin resistance by HOMA-IR at baseline
(BMI positively correlates with the incidence of T2DM). In our pilot study of 15 subjects with sedentary office
jobs, 6 months of sit-stand desk use resulted in a 23% improvement in insulin resistance, most substantial in
those who decreased daily sitting by over 90 minutes/day. Additional improvements in vascular endothelial
function and triglyceride levels were seen without any change in exercise activity, step counts, or body weight.
These findings not only corroborate epidemiologic findings on this topic but suggest causality and warrant a
randomized control trial. This strategy of replacing sitting desks with a sit-stand desk has significant potential to
reduce cardiometabolic risk in the 70% of adults categorized as overweight or obese, the majority of whom have
insulin resistance. This intervention could have substantially strong impact, amplified by the COVID-19
pandemic, given nearly 80% of U.S. jobs are sedentary. We hypothesize that adult subjects at-risk for
diabetes will improve insulin sensitivity, metabolic and vascular (endothelial) health with a sit-stand desk
intervention at work (whether in the office or at home), in the context of a randomized, controlled trial.
We will randomize 198 sedentary office workers with a BMI≥25 at risk for T2DM in a 1:1:1 ratio of three groups:
(a) sit-stand desk intervention targeting 2 hours standing per day; (b) sit-stand desk intervention targeting 3 hours
standing per day; or (c) control arm over 6 months. Objective quantification of sitting and standing times will be
performed with sophisticated activity monitors and smartphone activity logs. We will ascertain if the sit-stand
desk improves insulin sensitivity and metabolic health and whether there is a dose-dependent relationship with
changes in sedentary time (Aim 1). We will determine if the intervention improves vascular endothelial function
locally (superficial femoral artery FMD) and/or systemically (assessing brachial artery FMD resilience) (Aim 2).
Sub-aims will assess changes in...

## Key facts

- **NIH application ID:** 10765735
- **Project number:** 5R01HL162888-02
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Jacquelyn P Kulinski
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $551,977
- **Award type:** 5
- **Project period:** 2023-02-01 → 2028-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10765735

## Citation

> US National Institutes of Health, RePORTER application 10765735, Stand Up for Your Health: A Randomized Study (5R01HL162888-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10765735. Licensed CC0.

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