If James Levine has his way, your next desk could be a treadmill.

If James Levine has his way, your next desk could be a treadmill.

An interview with James Levine, M.D.

On the fourth floor of the Mayo Clinic in Rochester, Minnesota, the staff are all on their feet. Researchers, lab technicians and physicians type on computers that are positioned at eye level over softly humming treadmills; they take meetings standing up or walking calmly at a zenlike one mile per hour; wear mobile phones on their belts; and regularly go home at the end of the day hundreds of calories lighter.

This is the office of the future, says innovator James Levine, and it may well save the nation from a future of chronic obesity. Levine, an endocrinologist who has built his data and hypotheses around the importance of the ordinary movements of daily life rather than deliberate exercise, had his "aha" moment when one of his studies revealed that lean people are on their feet 152 more minutes a day than obese people. The data quickly translated into an office makeover that encourages people in traditionally sedentary settings to get up and move throughout the workday.

With his keen sense of humor, British accent and unstoppable enthusiasm, Levine now travels the globe to persuade governments, corporations and individuals to turn offices, schools and other environments upside down, maximizing daily activity with creative solutions like treadmill desks and indoor walking tracks.

Q: You've said your research has convinced you that everyday movement may be more important to a person's health than deliberate exercise. How is this possible?

The key is the calories you burn throughout your day through normal activity, predominantly comprised of the walking you do and the mooching around that is life. You do it for many hours every single day, rendering it more important than something you do very intensively yet very infrequently.

Q: How can an office worker who uses his or her lunch break to go to the gym get as much exercise simply walking down the hallways?

What does it really mean when you spend an hour at lunchtime going to the gym? You get the keys, go down the elevator, get to the car, drive to the gym and about 20 minutes later check in, go down to the locker room, change and get on the exercise bike. With no warm up you pound away for 20 minutes, look down at the little readout, see 64 calories, and jump off the exercise bike now stressed-out rather than calmed. You jump into the shower, take another 5 minutes for your hair, jump back into the car, arrive at work, and you don't feel great. For all of that you achieve 20 minutes of real exercise. You do it three times a week and you're talking about burning cumulatively 192 calories.

Now, take a different scenario. Let's say every day you have two one-hour meetings and instead of having those meetings sitting down opposite your supervisor at a desk, you walk. That's two hours of very slow (1 mph) walking every day. Each of those walks will burn 100 calories-that's 200 calories per day. So already in one day of meetings, without rushing, without stretching or even changing your clothes, you've burned more calories than the person who went to the gym three times. It's the idea of lots of low-intensity movement being more powerful than short bursts of high intensity.

Q: That's sounds a bit unlikely for most office settings.

If every office had treadmill desks, it would be possible. It takes less than 10 minutes to get used to working this way, and of some 300 people who've tried treadmill desks, we have had no failures. We recommend that you spend 30 minutes out of the hour walking.

Q: Some would argue that it comes down to willpower rather than environment.

People make this horrendous mistake, all the time, of assuming heavy people are not intelligent. We have innate drives; some people's drives are to be active. For example, I just got off the plane in Washington, D.C., and I've got work to do, but for the last three hours, I've been walking around the city. I had the drive to do it. But others get off the plane and say, "Fantastic, I've got four hours with no interruptions and I can work now." They'll sit on their bottoms for four hours.

Similarly, when dessert comes around, some say, "I fancy I'm full," and pass on the offer while others wait for a second piece. I don't call those people lazy or gluttonous, they simply have a different biology.

Q: It's probably safe to assume that not every worker will convince her colleagues to walk at meetings. And there won't be treadmills on the sidelines of kids' soccer games for the parents, which is my fantasy. So what other steps can people take to increase their everyday movements?

I'll give you real examples from a study we did to discover whether it was feasible to have normal people stand and walk around for two and a half more hours a day when given the directive. All of them succeeded.

One woman moved the television to a room with her treadmill and never watched TV unless she was walking. Another lady created three 50-minute walking sessions she takes before work, in the evening, and at lunchtime after she eats her sandwich in five minutes. I'm not necessarily sure that I would do that, but people do what they want to do and that's the point.

At the government website www.small step.gov, by the way, one suggestion for improving health is to walk the sidelines at your child's soccer game.

Q: What could a single mom with toddlers do?

Well, we in fact worked with just such a woman. She had a 9-to-3 job and after work she collected her 4- and 2-year-olds, put them into a double stroller and walked the mall for an hour. Then, because the 4-year-old went to bed consistently at 7:30 but the 2-year-old bounced around until 9 p.m., she put on music and danced with the baby.

My personal theory is that people are incredibly smart and creative. You provide them with good information and they will come up with an answer.

Q: Are you still standing for this phone interview?

Of course, I'm walking around. Portable phones are great, but the extra-long cords you can get for $5 are also fabulous. I've been walking at a shopping pace (1 mph) for the last hour, and I've burned 100 calories. If I'd stood still I would have burned 10 calories. If I'd sat I would have burned 5.

What really inspires our patients, when we show them their numbers, is that at a shopping pace, you double your metabolic rate. At two miles per hour, you triple it. When you see yourself burning an extra 100 calories an hour, just by mooching around, why would you ever sit down?

Q: You've suggested that we must completely revolutionize the office environment to include treadmill desks and walking tracks for meetings. Has anyone accused you of being just a little bit wacky?

I've had scientists call me delusional, questioning how any researcher, based on data on relatively few people, could suggest that we need to completely uplift how we live. Science doesn't normally speak in such large brushstrokes. We're talking about societal change in a way that most of us can't even contemplate yet. Most colleagues are very receptive; there's a global recognition that this is really, really important information.

If you perform the work, look at the data and believe it, you can't help but respond and advocate for people. In fact, it's the dream of every scientist to influence how people think and behave.

Q: How has your research changed your own patterns?

I used to walk for an hour at lunchtime every single day. It didn't matter if I had a meeting, if it was minus-60 outside (as it often is in Minnesota). Now I don't because I spend my entire day on a treadmill. I have a pair of black running shoes in my office, and as soon as I get to work I put them on. I don't go home feeling like a sloth, or like I've been cheated of my walk.

Q: Until someone manufactures these treadmill desks, can people make their own?

For $50 of wood and screws I built a unit at home. It took two hours and I'm not a whiz.

The way you position the computer is crucial. If you position it at your hip so you have to stoop over it, you go home with back pain. Positioned at eye level, you don't get back pain, foot pain, you don't sweat, you don't have to change your clothes.

Q: You've said that "pervasive mechanization" may cost an individual 100-200 calories per day, a deficit that could potentially account for the entire obesity epidemic. But no one will go back to washing clothing by hand.

I'm not advocating that we regress. Humans go forward, we develop. Yet we never move. I see an office building across the street and I know in the middle of the day that they're all sitting in there. This lack of movement is pervasive, and the most pervasive thing of all is the computer and other screens, nothing but bland workspace. People go home, sit in front of the TV and Internet.

Q: You're not telling people "Leave your screen," just make the activity come to your screen?

Right, or associate the screen with the activity. In other words, make it a positive loop. The key thing is that it's got to be fun, dynamic and make us feel good about ourselves. That's why it's going to work, by the way. Put a computer or TV on top of the treadmill, and people will enjoy working and watching TV more while they're walking.

Q: What about the argument that to be active in this world you need a certain comfort in income?

You don't need money to walk to church rather than drive, or get off the bus a little bit earlier; you don't need money to take your boss for a walk-it's not money related. It's "Let's do it."

Q: Any concerns about future generations?

It's more than hard to stay healthy in our environment. It's pretty close to impossible. Sixty percent of us are overweight, and we're not even warmed up yet, because the kids coming behind this generation are heavier than we were as kids.

It is really necessary that we think completely differently about how we work, go to school and about how we spend our time at home. I am absolutely convinced that it is possible to do this. It has to happen-if it doesn't the consequences are catastrophic.

Q: At the end of the day, what do you hope to have contributed to public health?

An active, happy world. People think I'm about activity, health, controlling health-care costs and so on. But to me the real excitement is that this is a path for happiness. People who are active are happy, and that to me is the real sell.

Sources: Treadmills

For a quiet, reliable treadmill suited to office walking, Dr. Levine recommends a Pacemaster Bronze (very quiet) or True Classic:



Standup Desks

A number of companies make desks that can be adapted to use with a treadmill:




Further Information Details about the Mayo Clinic's Office of the Future, including images of their own facility.