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Sitting time, physical activity, and risk of mortality in adults

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posted on 02.05.2019 by Emmanuel Stamatakis, Joanne Gale, Adrian Bauman, Ulf Ekelund, Mark Hamer, Ding Ding
© 2019 The Authors Background: It is unclear what level of moderate to vigorous intensity physical activity (MVPA) offsets the health risks of sitting. Objectives: The purpose of this study was to examine the joint and stratified associations of sitting and MVPA with all-cause and cardiovascular disease (CVD) mortality, and to estimate the theoretical effect of replacing sitting time with physical activity, standing, and sleep. Methods: A longitudinal analysis of the 45 and Up Study calculated the multivariable-adjusted hazard ratios (HRs) of sitting for each sitting-MVPA combination group and within MVPA strata. Isotemporal substitution modeling estimated the per-hour HR effects of replacing sitting. Results: A total of 8,689 deaths (1,644 due to CVD) occurred among 149,077 participants over an 8.9-year (median) follow-up. There was a statistically significant interaction between sitting and MVPA only for all-cause mortality. Sitting time was associated with both mortality outcomes in a nearly dose-response manner in the least active groups reporting <150 MVPA min/week. For example, among those reporting no MVPA, the all-cause mortality HR comparing the most sedentary (>8 h/day) to the least sedentary (<4 h/day) groups was 1.52 (95% confidence interval: 1.13 to 2.03). There was inconsistent and weak evidence for elevated CVD and all-cause mortality risks with more sitting among those meeting the lower (150 to 299 MVPA min/week) or upper (≥300 MVPA min/week) limits of the MVPA recommendation. Replacing sitting with walking and MVPA showed stronger associations among high sitters (>6 sitting h/day) where, for example, the per-hour CVD mortality HR for sitting replaced with vigorous activity was 0.36 (95% confidence interval: 0.17 to 0.74). Conclusions: Sitting is associated with all-cause and CVD mortality risk among the least physically active adults; moderate-to-vigorous physical activity doses equivalent to meeting the current recommendations attenuate or effectively eliminate such associations.

History

School

  • Sport, Exercise and Health Sciences

Published in

Journal of the American College of Cardiology

Volume

73

Issue

16

Pages

2062 - 2072

Citation

STAMATAKIS, E., ... et al., 2019. Sitting time, physical activity, and risk of mortality in adults. Journal of the American College of Cardiology, 73(16), pp. 2062 - 2072.

Publisher

© the authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Version

VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Acceptance date

02/02/2019

Publication date

2019-04-22

Copyright date

2019

Notes

This is an Open Access Article. It is published by Elsevier under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

ISSN

0735-1097

eISSN

1558-3597

Language

en

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