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Sitting Time, Physical Activity, and Risk of Mortality in Adults.

Abstract：

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.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Stamatakis E,Gale J,Bauman A,Ekelund U,Hamer M,Ding D

doi

10.1016/j.jacc.2019.02.031

subject

Has Abstract

pub_date

2019-04-30 00:00:00

pages

2062-2072

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(19)33789-1

journal_volume

pub_type

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Sitting Time, Physical Activity, and Risk of Mortality in Adults.