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Am J Public Health. 2016 Oct;106(10):1849-54. doi: 10.2105/AJPH.2016.303323. Epub 2016 Aug 23.

Stand-Biased Versus Seated Classrooms and Childhood Obesity: A Randomized Experiment in Texas.

Author information

Monica L. Wendel is with the Department of Health Promotion and Behavioral Sciences, University of Louisville School of Public Health & Information Sciences, Louisville, KY. Mark E. Benden is with the Department of Environmental and Occupational Health, Texas A&M School of Public Health, College Station. Hongwei Zhao is with the Department of Epidemiology and Biostatistics, Texas A&M School of Public Health. Christina Jeffrey is with the Department of Educational Psychology, Texas A&M University.



To measure changes in body mass index (BMI) percentiles among third- and fourth-grade students in stand-biased classrooms and traditional seated classrooms in 3 Texas elementary schools.


Research staff recorded the height and weight of 380 students in 24 classrooms across the 3 schools at the beginning (2011-2012) and end (2012-2013) of the 2-year study.


After adjustment for grade, race/ethnicity, and gender, there was a statistically significant decrease in BMI percentile in the group that used stand-biased desks for 2 consecutive years relative to the group that used standard desks during both years. Mean BMI increased by 0.1 and 0.4 kilograms per meter squared in the treatment and control groups, respectively. The between-group difference in BMI percentile change was 5.24 (SE = 2.50; P = .037). No other covariates had a statistically significant impact on BMI percentile changes.


Changing a classroom to a stand-biased environment had a significant effect on students' BMI percentile, indicating the need to redesign traditional classroom environments.

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