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There are mountains of evidence that BMI correlates positively with the incidence of lower back pain. I have no history of LBP outside of the context of using a standing desk. Further, most of the purported benefit standing desks is to prolong lifespan, and there's even stronger evidence that low-BMI people live longer, so the suggestion that I should gain weight and sacrifice a clinically validated approach to living longer in favor of something as novel as a standing desk is just absurd.



"and there's even stronger evidence that low-BMI people live longer,"

Not true. If you go by the raw numbers, your BMI of 17.6 puts you at the same death risk as someone who has a BMI around 30 (which is borderline obese): http://ars.els-cdn.com/content/image/1-s2.0-S014067360960318...

Article: http://www.sciencedirect.com/science/article/pii/S0140673609...

Both higher than typical BMI and lower BMI are associated with higher mortality risk.

I don't think anyone knows which direction the causality goes ( and that is true for a lot of things, I'm think the direction of causality is unknown for a lot of these articles that say "standing is better" or "people who walk more live longer").


Per your article, "below the range 22.5-25 kg/m2, BMI was associated inversely with overall mortality, mainly because of strong inverse associations with respiratory disease and lung cancer" (italics mine) i.e. if your BMI is low, average mortality is comparatively high, but only because of smokers. (Study recruitment year looks to be 1979 when there were a lot more smokers).

Moreover, your study recruited people at age 46 (mean) and followed them through their death. Meaning, a whole lot of people got older, got sick, subsequently lost weight and died. Unless proper adjustments were made, the low BMI-high mortality connection is rather unproven.

For a similar example, see http://onlinelibrary.wiley.com/doi/10.3322/canjclin.55.5.268...:

The main concern regarding the newer CDC analysis is that it did not adequately account for weight loss from serious illnesses such as cancer and heart disease. Including such individuals in the analysis created the false appearance that being overweight protected against death during the follow up.

and

The newest CDC analysis also failed to account adequately for the effect of smoking on weight. Smokers tend to be a little lighter than nonsmokers, although the negative health impact of smoking far outweighs that of a few extra pounds. As a result, the Flegal study underestimated the risks from obesity and overestimated the risks of leanness.

Regardless, I don't think we are on different pages since you acknowledged that no one really knows which direction the causality goes.


I'm 5'9" 150#. I was diagnosed with scholiosis in jr. high, had lower back pain when sitting all through hs and college (back when i was 130#). I too tried the standing desk and it didn't help.

Here's what helped -- about 3 years ago I got into squats and dead-lifting. I got them up to 1.5x and 2x body weight, respectively. I didn't gain a whole lot of weight, but my core strength increased tremendously.

Maintaining good posture requires some (~10-30%) flexion of the core/abdominals at all times while sitting. Now, after learning proper form of squats and deadlifts, my body goes into proper sitting form without even thinking.

Back pain is completely gone. squats and dlifts -- highly recommended!

tldr-its not about weight, its about strength


This cannot be emphasized enough.

To anyone reading, you don't have to do more than the big three — squats, dead lift and bench press — to build a strong core and ameliorate most RSI issues.

Regular cardio fitness and 10-minute work breaks are good, but can only take you so far. Being stationed at a computer for extended periods of time requires having a proper muscular frame to support your bones.


Chins, man, chins.

Why do lats get no love?


Because we rarely ask our muscles to work that way. Deadlifts, especially, strengthen our bodies against the most commonly encountered stresses. While bench presses are commonly recommended, I think overhead presses and bent rows are more helpful at preventing injuries.


I'm suggesting it more for the overall balance, and I'm not advocating dropping any of the other lifts. I love me my deads, don't get me wrong.

I'll grant that the vertical pull isn't commonly encountered (swimmers excepted) unless you're climbing trees to escape lions/tigers/bears, and I do a fair bit of horizontal pulling exercises as well (open a door, lift something toward you, row a boat).

Focusing on pressing without balance pulling tends toward imbalance IMO/IME.


BMI is a misleading indicator in this case. It doesn't differentiate by body composition at all (e.g. fat vs muscle).

I doubt very much that adding muscle to an underweight person would decrease that person's life expectancy. Probably it would improve it (the health benefits of exercise are well known). Either way, it would improve his quality of life.


I don’t think this is true. Pretty much the only proven thing you can do if you want to live longer is calorie restriction. Supposedly this is because the fewer calories you consume the less exposure your body has to free radicals that are important in aging. The corollary of this is that building muscle, which requires eating a lot, is inferior to being a skinny rake for longevity alone. Then, if you eat barely anything, you would be better with only a small amount of exercise.

And, just to rule out any suspicion of bias, know that I have a job where I’m constantly lifting weight, I have my own strength exercise regime outside work, I drink protein shakes, and I eat quite a lot for my frame.


I wonder if calorie restriction works because it slows down your metabolism, and thus slows down cell division, and effectively makes it so you are just living more slowly/aging more slowly than other people. However, I would think you would also have less energy, and get less done. So effectively you would live longer as the calendar turns but you would not live any longer in terms of life experienced.

(this is all just pure speculation, I have never looked into any of the science regarding calorie restriction)


"The corollary of this is that building muscle, which requires eating a lot, is inferior to being a skinny rake for longevity alone."

Not true. Stronger people are less likely to die. Strength reduces your risk of death from all causes - and cancer in particular.

"[The inverse relationship between] muscular strength and death from all causes and cancer persisted after further adjustment for cardiorespiratory fitness; however, the association between muscular strength and death from cardiovascular disease was attenuated after further adjustment for cardiorespiratory fitness."

Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453303/


> Pretty much the only proven thing you can do if you want to live longer is calorie restriction.

This has not been proven for humans AFAIK.


I doubt that eating less and getting less exercise will really lead to longer life. It would be hard to measure such a thing, but my guess is that with less exercise and eating there would be a corresponding decline in happiness which alone could knock years off a person's life.


Calorie restriction is actually one of the fiew proven longevity tricks. In mice anyway.

http://en.wikipedia.org/wiki/Calorie_restriction

But I don't subscribe to the "live long an weak" mentality. I believe that your body is healthier and more capable when well nourished and physically strong. I'm 6'2" 190lbs and continually trying to gain muscle mass.


I stay fit by running and playing 5-a-side soccer but I am 5'9 weight 197lbs, I ran 10k in 50 minutes last weekend. BMI is a strange measure if I can be overweight without trying to put on muscle but be fitter than 95% of the population.


Calorie restriction is actually one of the fiew proven longevity tricks.

Nothing proven about it.

In mice anyway.

Not exactly. The calorie restricted mice do live longer unless they get an infection or some other unexpected source of stress, then they die at much grater rates. It is as if they have no reserves.

In humans calorie restriction is absolutely and utterly unproven.

Humans and mice are very different. They are tiny short lived animals, and we are large long lived animals. That is why a lot of the cancer cures you hear about in mice don't work in humans. Because often we already are born with them. There are known tumor suppressing genes, humans have more copies of them than mice, elephants have even more.

This is why it is not reasonable to assume that simple hacks like calorie restriction, which work in mice... sort of, will also work in humans.

A health diet and exercise on the other hand, have been proven to work in humans.


> I doubt that eating less and getting less exercise will really lead to longer life.

It does. Calorie Restriction is pretty much the only proven way to extend life and slow down the aging process.


Calorie Restriction is pretty much the only proven way to extend life and slow down the aging process.

The only source for this I've seen so far is the wikipedia page and according to it: There are ongoing studies on whether CR works in primates.

So unless you are a yeast or a fish, it is not proven.

Exercise and a healthy diet on the hand are proven.


I should have used the qualifier "alone".


No.

The one proven thing you can do to live longer is to not die.

Risk prevention / avoidance is a large part of this, but that includes a lot other than bodyweight. Seat belts, condoms, not smoking, little or no alcohol/drugs, pollution.

Several long term athlete studies show longevity, and quality of life benefits, to exercise (Stanford runners study, Scandinavian olympian study). And the specific mechanism of calorie restriction, telomere repair, is shown in both cardio and strength training.


As a 6'2" individual who tips the scales just shy of 145lbs on a good day, I am not you, but I'd strongly suggest you consider gaining some weight. If you are anything like myself, you (like myself) are so skinny as to be a health problem.

Among other things, gaining good weight (I used to fluctuate between 135-140) has clarified my mind, improved the strength of my heart, and a small host of other nice little upsides. I'm not even to my target weight yet, either.

Remember, just because someone with a BMI of 23 has better health prospects than a BMI of 27, doesn't mean a BMI of 3 is even better.


It has nothing to do with BMI - which is a terrible system of measurement by the way. I'm highly athletic and in great shape, and my BMI is 25. Which puts me right at the bottom of "overweight."

6' and 130 is very underweight - you don't have to look like a body builder, but your body does need some muscle to function properly. And 130 isn't enough.


Why are you getting so defensive? I'm 6'1" and 150 pounds and I am way too skinny for my own good. These people here aren't hating on you, they're telling you the truth — you would benefit from gaining some muscle. Muscles support your skeleton, that shouldn't be a suprise. 50 pushups won't help you when you've got back pain. Eat a burger and do some deadlifts.


6'1" and 150 lbs is not anywhere close to "way too skinny". It's well within the normal range of BMI. Sure you don't look like Schwarzenegger. But that's very different from being way too skinny.


I disagree. Here's why. I used to work out quite a bit and, with the help of P90X, I got up to 170-175 pounds of lean weight. I maintained it for a while, but adverse life events, a huge workload, and a crappy diet made me lost most of the weight (and a lot of the muscle mass) that I put on before.

Since my weight tumbled to 145 lbs, I noticed a huge difference in my physical well being, especially in sedentary positions. My posture worsened, my back constantly ached, and I started to suffer from RSI. I've been using the same chair all the while, a Herman Miller Mirra.

So, from my experience, weight and muscle mass was a primary determinant of my sedentary well being. Believe me, I was putting a lot less stress on my spine when I was doing 48 pullups in a workout, vs 8 now. I'm slowly working my way back up, and the back pain from sitting has lessened.


I don't know all of the personal details here -- but, if your muscles are underdeveloped your at risk for RSI issues. I'm taking a guess, at that height and weight your muscles are underdeveloped.

Since I switched to very basic body weight strength training nearly 2 years ago, problems I thought I would have until I died vanished. Nothing I ate or drank, no amount of aerobic exercises did anything to address those issues.

You should not be developing back pain from standing. Everything else should be getting sore. Back pain, that I've seen, generally occurs from people who either slouch forward at work, have major stress issues, or have some type of actual injury.


I can do 50 push-ups. I'm not an athlete but I'm in shape enough to be healthy. I'm by no means "underdeveloped". I appreciate your concern -- thanks.


Pushups do use core strength to maintain your posture, but are mostly about upper body. How much can you squat or deadlift?


Great, but how much can you squat or deadlift relative to your bodyweight? Your posterior chain, from your mid-back down to your ankles, is far more important to your long-term stability and comfort.

It's key to your complaint of discomfort standing up, and it's key to avoiding back or knee problems long-term.


I have read this article just yesterday: http://healthcorrelator.blogspot.com.au/2012/06/lowest-morta...

This is basically a reference point to support the opinion that was stated here: BMI is not the only thing that matters.

Take a look at the two numbers circled in red. The one on the left is the lowest-mortality BMI not adjusting for fat mass or fat-free mass: a reasonably high 27.4. The one on the right is the lowest-mortality BMI adjusting for fat mass and fat-free mass: a much lower 21.6.

I know this may sound confusing, but due to possible statistical distortions this does not mean that you should try to bring your BMI to 21.6 if you want to reduce your risk of dying. What this means is that fat mass and fat-free mass matter.


To put this in perspective, 6'0 and 130 is a BMI of 17.6 which is off the charts. He is well below the ideal lean BMI of 21.6.


Hmm... maybe you're used to an environment with a lot of overweight people.

Anything under 18.5 is considered "underweight", just as anything over 25 is considered "overweight". 17.6 is only off by .9 points. He's less off the charts than someone 6'0 and 195lbs (BMI of 26.4)


BMI is garbage because it doesn't take into account muscle, which is heavier than fat. I'd be willing to bet someone with a higher BMI that is muscular is going to be healthier than a lanky person who is actually pretty unfit.




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