Sedentary behaviors and subsequent health outcomes in adults : A systematic review of longitudinal studies, 1996-2011
TL;DR: Findings indicate a consistent relationship of self-reported sedentary behavior with mortality and with weight gain from childhood to the adult years, however, findings were mixed for associations with disease incidence, weight gain during adulthood, and cardiometabolic risk.
About: This article is published in American Journal of Preventive Medicine.The article was published on 2011-08-01. It has received 1377 citations till now.
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TL;DR: It is hoped that the definitions resulting from this comprehensive, transparent, and broad-based participatory process will result in standardized terminology that is widely supported and adopted, thereby advancing future research, interventions, policies, and practices related to sedentary behaviors.
Abstract: Background: The prominence of sedentary behavior research in health science has grown rapidly. With this growth there is increasing urgency for clear, common and accepted terminology and definitions. Such standardization is difficult to achieve, especially across multi-disciplinary researchers, practitioners, and industries. The Sedentary Behavior Research Network (SBRN) undertook a Terminology Consensus Project to address this need. Method: First, a literature review was completed to identify key terms in sedentary behavior research. These key terms were then reviewed and modified by a Steering Committee formed by SBRN. Next, SBRN members were invited to contribute to this project and interested participants reviewed and provided feedback on the proposed list of terms and draft definitions through an online survey. Finally, a conceptual model and consensus definitions (including caveats and examples for all age groups and functional abilities) were finalized based on the feedback received from the 87 SBRN member participants who responded to the original invitation and survey. Results: Consensus definitions for the terms physical inactivity, stationary behavior, sedentary behavior, standing, screen time, non-screen-based sedentary time, sitting, reclining, lying, sedentary behavior pattern, as well as how the terms bouts, breaks, and interruptions should be used in this context are provided. Conclusion: It is hoped that the definitions resulting from this comprehensive, transparent, and broad-based participatory process will result in standardized terminology that is widely supported and adopted, thereby advancing future research, interventions, policies, and practices related to sedentary behaviors.
2,025 citations
TL;DR: This work proposes that journal editors adopt a consistent definition of the term sedentary and require that all manuscripts published within their journal adhere to this common terminology, and suggests that authors use the term “inactive” to describe those who are performing insufficient amounts of MVPA.
Abstract: There has recently been an increase in research related to the health impact of sedentary behaviour (e.g., sitting) (Tremblay et al. 2010). Numerous studies suggest that those who engage in high amounts of sedentary behaviour can be at increased risk of morbidity and mortality regardless of their level of moderateto vigorous-intensity physical activity (MVPA) (Dunstan et al. 2010; Grøntved and Hu 2011; Katzmarzyk et al. 2009; Thorp et al. 2011; Wijndaele et al. 2011). Further, it has been noted that there is often little association between sedentary behaviour and MVPA (Biddle et al. 2004; Ekelund et al. 2006) and that it is possible for an individual to accumulate large amounts of both MVPA and sedentary behaviour in the course of a day (Healy et al. 2008; Katzmarzyk et al. 2009; Owen et al. 2010; Tremblay et al. 2010; Wong and Leatherdale 2008). Taken together, these findings suggest that too much sitting and too little MVPA represent separate and distinct risk factors for chronic, noncommunicable diseases (e.g., cardiovascular disease, diabetes, cancer). While research into the biology and health impact of sedentary behaviour represents an exciting new field of study, current inconsistencies in terminology are confusing for students, researchers, policymakers, and the general public. In short, the term “sedentary” currently has two separate and contradictory operational definitions. In this emerging field of research, sedentary behaviours are typically defined by both low energy expenditure (e.g., resting metabolic rate, typically ≤1.5 metabolic equivalents (METs)) and a sitting or reclining posture (Owen et al. 2010; Pate et al. 2008; Tremblay et al. 2010). In this context, a person may be described as sedentary if they engage in a large amount of sedentary behaviour. In contrast, in the sport and exercise literature the term sedentary is frequently used to describe the absence of some threshold of MVPA (Church et al. 2009; Melanson et al. 2009; Mullen et al. 2011; Sims et al. 2012; Smith et al. 2010). Thus, it is common for researchers in this field to describe a participant as sedentary because they are not meeting physical activity guidelines. Hence, many exercise studies include a “sedentary control group” or refer to their participants as coming from a “sedentary population” because of their lack of physical activity without actually measuring or assessing their level of sedentary behaviour. It is not difficult to see how these conflicting definitions of the term sedentary can easily lead to confusion. When reading the title or abstract of an article, it is often difficult to ascertain which definition of sedentary the authors have employed. If an article focuses on the health impact of a “sedentary lifestyle”, are they concerned with excessive sitting–lying down, the lack of physical activity, or both? Further, it is surprisingly common for articles within a given academic journal to oscillate between one definition and the other. To prevent further confusion, we propose that journal editors adopt a consistent definition of the term sedentary and require that all manuscripts published within their journal adhere to this common terminology. We suggest that journals formally define sedentary behaviour as any waking behaviour characterized by an energy expenditure ≤1.5 METs while in a sitting or reclining posture. In contrast, we suggest that authors use the term “inactive” to describe those who are performing insufficient amounts of MVPA (i.e., not meeting specified physical activity guidelines). The formal adoption of the above definitions by journal editors and reviewers would greatly improve the clarity of research and discussion related to these important health behaviours and help researchers searching for studies specific to sedentary behaviour or physical inactivity. We hope the research community will support these definitions and we look forward to further improvements in our understanding of the health impacts of sedentary behaviour and physical activity.
1,653 citations
Cites background from "Sedentary behaviors and subsequent ..."
...…who engage in high amounts of sedentary behaviour can be at increased risk of morbidity and mortality regardless of their level of moderate- to vigorous-intensity physical activity (MVPA) (Dunstan et al. 2010; Grøntved and Hu 2011; Katzmarzyk et al. 2009; Thorp et al. 2011; Wijndaele et al. 2011)....
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TL;DR: Recommendations for community action to accompany the 4 recommendations for individual choices to reduce cancer risk recognize that a supportive social and physical environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors.
Abstract: The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and, ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published approximately every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and they reflect the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines focus on recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or creates barriers to healthy behaviors. Therefore, this committee presents recommendations for community action to accompany the 4 recommendations for individual choices to reduce cancer risk. These recommendations for community action recognize that a supportive social and physical environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the 2010 Dietary Guidelines for Americans and the 2008 Physical Activity Guidelines for Americans. CA Cancer J Clin 2012. © 2012 American Cancer Society.
1,299 citations
TL;DR: The incidence of stroke is likely to continue to escalate because of an expanding population of elderly Americans; a growing epidemic of diabetes, obesity, and physical inactivity among the general population; and a greater prevalence of heart failure patients.
Abstract: Purpose—This scientific statement provides an overview of the evidence on physical activity and exercise recommendations for stroke survivors. Evidence suggests that stroke survivors experience phy...
1,130 citations
TL;DR: The final recommendations recognize that obesity is a complex, adiposity-based chronic disease, where management targets both weight-related complications and adiposity to improve overall health and quality of life.
978 citations
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TL;DR: An updated version of the Compendium of Physical Activities, a coding scheme that classifies specific physical activity (PA) by rate of energy expenditure, is provided to enhance the comparability of results across studies using self-reports of PA.
Abstract: We provide an updated version of the Compendium of Physical Activities, a coding scheme that classifies specific physical activity (PA) by rate of energy expenditure. It was developed to enhance the comparability of results across studies using self-reports of PA. The Compendium coding scheme links a five-digit code that describes physical activities by major headings (e.g., occupation, transportation, etc.) and specific activities within each major heading with its intensity, defined as the ratio of work metabolic rate to a standard resting metabolic rate (MET). Energy expenditure in MET-minutes, MET-hours, kcal, or kcal per kilogram body weight can be estimated for specific activities by type or MET intensity. Additions to the Compendium were obtained from studies describing daily PA patterns of adults and studies measuring the energy cost of specific physical activities in field settings. The updated version includes two new major headings of volunteer and religious activities, extends the number of specific activities from 477 to 605, and provides updated MET intensity levels for selected activities.
7,872 citations
TL;DR: Gaining a better understanding of the relationship between obesity and cancer can provide new insight into mechanisms of cancer pathogenesis.
Abstract: The prevalence of obesity is rapidly increasing globally. Epidemiological studies have associated obesity with a range of cancer types, although the mechanisms by which obesity induces or promotes tumorigenesis vary by cancer site. These include insulin resistance and resultant chronic hyperinsulinaemia, increased bioavailability of steroid hormones and localized inflammation. Gaining a better understanding of the relationship between obesity and cancer can provide new insight into mechanisms of cancer pathogenesis.
3,281 citations
TL;DR: The authors evaluate participants from the 2003-2004 National Health and Nutrition Examination Survey aged >/=6 years who wore an activity monitor for up to 7 days to provide the first objective measure of the amount of time spent in sedentary behavior in the US population.
Abstract: Sedentary behaviors are linked to adverse health outcomes, but the total amount of time spent in these behaviors in the United States has not been objectively quantified. The authors evaluated participants from the 2003-2004 National Health and Nutrition Examination Survey aged >/=6 years who wore an activity monitor for up to 7 days. Among 6,329 participants with at least one 10-hour day of monitor wear, the average monitor-wearing time was 13.9 hours/day (standard deviation, 1.9). Overall, participants spent 54.9% of their monitored time, or 7.7 hours/day, in sedentary behaviors. The most sedentary groups in the United States were older adolescents and adults aged >/=60 years, and they spent about 60% of their waking time in sedentary pursuits. Females were more sedentary than males before age 30 years, but this pattern was reversed after age 60 years. Mexican-American adults were significantly less sedentary than other US adults, and White and Black females were similarly sedentary after age 12 years. These data provide the first objective measure of the amount of time spent in sedentary behavior in the US population and indicate that Americans spend the majority of their time in behaviors that expend very little energy.
2,380 citations
TL;DR: Sitting time, TV time, and time sitting in automobiles increase premature mortality risk, and breaking up sedentary time is beneficial.
Abstract: Even when adults meet physical activity guidelines, sitting for prolonged periods can compromise metabolic health Television (TV) time and objective measurement studies show deleterious associations, and breaking up sedentary time is beneficial Sitting time, TV time, and time sitting in automobiles increase premature mortality risk Further evidence from prospective studies, intervention trials, and population-based behavioral studies is required
2,054 citations
TL;DR: Independent of exercise levels, sedentary behaviors, especially TV watching, were associated with significantly elevated risk of obesity and type 2 diabetes, whereas even light to moderate activity was associated with substantially lower risk.
Abstract: ContextCurrent public health campaigns to reduce obesity and type 2 diabetes
have largely focused on increasing exercise, but have paid little attention
to the reduction of sedentary behaviors.ObjectiveTo examine the relationship between various sedentary behaviors, especially
prolonged television (TV) watching, and risk of obesity and type 2 diabetes
in women.Design, Setting, and ParticipantsProspective cohort study conducted from 1992 to 1998 among women from
11 states in the Nurses' Health Study. The obesity analysis included 50 277
women who had a body mass index (BMI) of less than 30 and were free from diagnosed
cardiovascular disease, diabetes, or cancer and completed questions on physical
activity and sedentary behaviors at baseline. The diabetes analysis included
68 497 women who at baseline were free from diagnosed diabetes mellitus,
cardiovascular disease, or cancer.Main Outcome MeasuresOnset of obesity and type 2 diabetes mellitus.ResultsDuring 6 years of follow-up, 3757 (7.5%) of 50 277 women who had
a BMI of less than 30 in 1992 became obese (BMI ≥30). Overall, we documented
1515 new cases of type 2 diabetes. Time spent watching TV was positively associated
with risk of obesity and type 2 diabetes. In the multivariate analyses adjusting
for age, smoking, exercise levels, dietary factors, and other covariates,
each 2-h/d increment in TV watching was associated with a 23% (95% confidence
interval [CI], 17%-30%) increase in obesity and a 14% (95% CI, 5%-23%) increase
in risk of diabetes; each 2-h/d increment in sitting at work was associated
with a 5% (95% CI, 0%-10%) increase in obesity and a 7% (95% CI, 0%-16%) increase
in diabetes. In contrast, standing or walking around at home (2 h/d) was associated
with a 9% (95% CI, 6%-12%) reduction in obesity and a 12% (95% CI, 7%-16%)
reduction in diabetes. Each 1 hour per day of brisk walking was associated
with a 24% (95% CI, 19%-29%) reduction in obesity and a 34% (95% CI, 27%-41%)
reduction in diabetes. We estimated that in our cohort, 30% (95% CI, 24%-36%)
of new cases of obesity and 43% (95% CI, 32%-52%) of new cases of diabetes
could be prevented by adopting a relatively active lifestyle (<10 h/wk
of TV watching and ≥30 min/d of brisk walking).ConclusionsIndependent of exercise levels, sedentary behaviors, especially TV watching,
were associated with significantly elevated risk of obesity and type 2 diabetes,
whereas even light to moderate activity was associated with substantially
lower risk. This study emphasizes the importance of reducing prolonged TV
watching and other sedentary behaviors for preventing obesity and diabetes.
1,647 citations