Don't Just Sit There!
How bathroom posture affects your health.
http://www.slate.com/id/2264657?wpsrc=ob164794700&obref=obnetworkModern-day squat evangelists make money off the claim that a "more natural" posture wards off all sorts of health problems, from Crohn's disease to colon cancer. Inventor Jonathan Isbit runs a modest online business selling Nature's Platform—a homemade, $150 device that fits over toilets to make them more like holes in the ground.* (He also posted the Bockus quote above to the Wikipedia entry on defecation.) Other entrepreneurs peddle similar products, like the In-Lieu, the Lillipad, the Evaco toilet converter, and, for those who don't like explaining their squat platform to house guests, a $688 Japanese toilet that lets users switch among different squatting and sitting postures, from the "East Asian squat" to the "aft sit." (Confused? Watch the video.)
Before we dive into the data, let's review the mechanics of going to the bathroom. People can control their defecation, to some extent, by contracting or releasing the anal sphincter. But that muscle can't maintain continence on its own. The body also relies on a bend between the rectum—where feces builds up—and the anus—where feces comes out. When we're standing up, the extent of this bend, called the anorectal angle, is about 90 degrees, which puts upward pressure on the rectum and keeps feces inside. In a squatting posture, the bend straightens out, like a kink ringed out of a garden hose, and defecation becomes easier.
Proponents of squatting argue that conventional toilets produce an anorectal angle that's ill-suited for defecation. By squatting, they say, we can achieve "complete evacuation" of the colon, ridding our bowels of disease-causing toxins. But there's no reason to think that getting into a squat will make defecation more complete, nor that most people are sickened by their colons. If squatting does provide a health benefit, just as Michael Freilich stated in Time, it comes in the form of hemorrhoid prevention.
Of course, it's one thing to show that squatting streamlines defecation and reduces hemorrhoid risk. It's another to actually move your bowels while you squat. But how hard could it be? For most of human history—several hundred thousand years—we've squatted. Today, 1.2 billion people squat because they simply don't have a toilet, while many, many more in Asia, the Middle East, and parts of Europe use toilets designed specifically for squatting. And for 28 years—from his junior year at Yale in 1970 to the moment when he completed the first Nature's Platform prototype in 1998—Jonathan Isbit "perched," as he put it, squatting on the rim of toilet seats. So I decided to try it—each morning for a week, following a bowl of corn flakes and a cup of coffee.
Besides tipping over, there's little danger in squatting over a modern sit toilet. Both American Standard and Kohler say that floor-mounted toilets are designed to hold at least 1,000 pounds. (Still, neither company recommends perching.) The American Society for Engineers requires that wall-mounted toilets hold 500 pounds. But squatting on your toilet seat is not for everybody. Even when I was holding onto a towel rack, the situation felt precarious. A bedpan or a plastic container would have been easier, but I didn't have the former and the latter seemed gross. So I forged ahead, pushing through the week—or, as it turned out, not pushing: Bowel movements just seem to happen in a squat. My 10-minute routine dropped to a minute, two at the most, and within a few days my knees stopped complaining.
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