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Background: The appropriate limit to the amount of daily sedentary time (ST) required to minimize mortality is uncertain. This meta-analysis aimed to quantify the dose-response association between daily ST and all-cause mortality and to explore the cut-off point above which health is impaired in adults aged 18–64 years old. We also examined whether there are differences between studies using self-report ST and those with device-based ST. Methods: Prospective cohort studies providing effect estimates of daily ST (exposure) on all-cause mortality (outcome) were identified via MEDLINE, PubMed, Scopus, Web of Science, and Google Scholar databases until January 2018. Dose-response relationships between daily ST and all-cause mortality were examined using random-effects meta-regression models. Results: Based on the pooled data for more than 1 million participants from 19 studies, the results showed a log-linear dose-response association between daily ST and all-cause mortality. Overall, more time spent in sedentary behaviors is associated with increased mortality risks. However, the method of measuring ST moderated the association between daily ST and mortality risk (p < 0.05). The cut-off of daily ST in studies with self-report ST was 7 h/day in comparison with 9 h/day for those with device-based ST. Conclusions: Higher amounts of daily ST are log-linearly associated with increased risk of all-cause mortality in adults. On the basis of a limited number of studies using device-based measures, the findings suggest that it may be appropriate to encourage adults to engage in less sedentary behaviors, with fewer than 9 h a day being relevant for all-cause mortality.
A cut off of daily ST and mortality meta BMC Med
The appropriate limit to the amount of daily sedentary time (ST) required to minimize mortality is uncertain. This meta-analysis aimed to quantify the dose-response association between daily ST and all-cause mortality and to explore the cut-off point above which health is impaired in adults aged 18-64 years old. We also examined whether there are differences between studies using self-report ST and those with device-based ST. Methods: Prospective cohort studies providing effect estimates of daily ST (exposure) on all-cause mortality (outcome) were identified via MEDLINE, PubMed, Scopus, Web of Science, and Google Scholar databases until January 2018. Dose-response relationships between daily ST and all-cause mortality were examined using random-effects meta-regression models.
International Journal of Behavioral Nutrition and Physical Activity, 2020
BackgroundSedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers).ObjectiveThe primary objective of this systematic review was to compare self-report versus device measures of SB in adults.MethodsSix bibliographic databases were searched to identify all studies which included a comparable self-report and device measure of SB in adults. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses.ResultsThe review included 185 unique studies. A total of 123 studies comprising 173 comparisons and data from 55,199 participants were used to examine general criterion validity. The average mean difference was -105.19 minutes/day (95% CI: -127.21, -83.17); self-report underestimated sedentary time by ~1.74 hours/day compared to device measures. Self-reported time spent sedentary at work was ~40 minutes higher than when assessed by devices. Single item measures performed more poorly than multi-item questionnaires, EMAs and logs/diaries. On average, when compared to inclinometers, multi-item questionnaires, EMAs and logs/diaries were not significantly different, but had substantial amount of variability (up to 6 hours/day within individual studies) with approximately half over-reporting and half under-reporting. A total of 54 studies provided an assessment of reliability of a self-report measure, on average the reliability was good (ICC = 0.66).ConclusionsEvidence from this review suggests that single-item self-report measures generally underestimate sedentary time when compared to device measures. For accuracy, multi-item questionnaires, EMAs and logs/diaries with a shorter recall period should be encouraged above single item questions and longer recall periods if sedentary time is a primary outcome of study. Users should also be aware of the high degree of variability between and within tools. Studies should exert caution when comparing associations between different self-report and device measures with health outcomes.Systematic review registrationPROSPERO CRD42019118755
Sedentary Behaviors and Health Outcomes Among Adults
American Journal of Preventive Medicine, 2011
Context: Nowadays, people spend a substantial amount of time per day on sedentary behaviors and it is likely that the time spent sedentary will continue to rise. To date, there is no review of prospective studies that systematically examined the relationship between diverse sedentary behaviors and various health outcomes among adults.
Sedentary Behavior and Public Health: Integrating the Evidence and Identifying Potential Solutions
Annual Review of Public Health, 2020
In developed and developing countries, social, economic, and environmental transitions have led to physical inactivity and large amounts of time spent sitting. Research is now unraveling the adverse public health consequences of too much sitting. We describe improvements in device-based measurement that are providing new insights into sedentary behavior and health. We consider the implications of research linking evidence from epidemiology and behavioral science with mechanistic insights into the underlying biology of sitting time. Such evidence has led to new sedentary behavior guidelines and initiatives. We highlight ways that this emerging knowledge base can inform public health strategy: First, we consider epidemiologic and experimental evidence on the health consequences of sedentary behavior; second, we describe solutions-focused research from initiatives in workplaces and schools. To inform a broad public health strategy, researchers need to pursue evidence-informed collabora...
Replacing Sedentary Time: Meta-analysis of Objective-Assessment Studies
American Journal of Preventive Medicine, 2018
The aim was to summarize estimates of the potential benefits for cardiometabolic risk markers and all-cause mortality of replacing time spent in sedentary behaviors with light-intensity physical activity or with moderate to vigorous physical activity, from studies using device-based measurement. Evidence acquisition: Four databases covering the period up to December 2016 were searched and analyzed (February 2017). Data were extracted by two independent reviewers. For the metaanalyses, the estimated regression coefficients (b) and 95% CIs were analyzed for BMI, waist circumference, and high-density lipoprotein cholesterol. Pooled relative rate and 95% CIs were calculated for fasting glucose, fasting insulin, and homeostatic model assessment-insulin resistance values. Hazard ratios were extracted from studies of all-cause mortality risk. Evidence synthesis: Ten studies (with 17,390 participants) met the inclusion criteria. Reallocation of 30 minutes of sedentary time to light-intensity physical activity was associated with reductions in waist circumference, fasting insulin, and all-cause mortality risk; and with an increase in high-density lipoprotein cholesterol. Reallocating 30 minutes of sedentary time to moderate to vigorous physical activity was associated with reductions in BMI, waist circumference, fasting glucose, fasting insulin, and all-cause mortality (not pooled) and with an increase in high-density lipoprotein cholesterol. Conclusions: Replacing sedentary time with either light-intensity physical activity or moderate to vigorous physical activity may be beneficial, but when sedentary time is replaced with moderate to vigorous physical activity, the predicted impacts are stronger and apparent for a broader range of risk markers. These findings point to potential benefits of replacing sedentary time with light-intensity physical activity, which may benefit those less able to tolerate or accommodate higher-intensity activities, including many older adults.
Multicomponent intervention to reduce daily sedentary time: a randomised controlled trial
BMJ open, 2013
To test the efficacy of a multicomponent technology intervention for reducing daily sedentary time and improving cardiometabolic disease risk among sedentary, overweight university employees. Blinded, randomised controlled trial. A large south-eastern university in the USA. 49 middle-aged, primarily female, sedentary and overweight adults working in sedentary jobs enrolled in the study. A total of 40 participants completed the study. Participants were randomised to either: (1) an intervention group (N=23; 47.6+9.9 years; 94.1% female; 33.2+4.5 kg/m(2)); (2) or wait-list control group (N=17; 42.6+8.9 years; 86.9% female; 31.7+4.9 kg/m(2)). The intervention group received a theory-based, internet-delivered programme, a portable pedal machine at work and a pedometer for 12 weeks. The wait-list control group maintained their behaviours for 12 weeks. Primary (sedentary and physical activity behaviour measured objectively through StepWatch) and secondary (heart rate, blood pressure, heigh...