Too Much Sitting and Cardio-Metabolic Risk: An Update of Epidemiological Evidence
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PHYSICAL ACTIVITY (D WARBURTON, SECTION EDITOR)
Too Much Sitting and Cardio-Metabolic Risk: An Update of Epidemiological Evidence Adrian E. Bauman & Josephine Y. Chau & Ding Ding & Jason Bennie
Published online: 29 May 2013 # Springer Science+Business Media New York 2013
Abstract Sedentary behavior, as distinct from a lack of moderate-to-vigorous physical activity, is an emerging health risk behavior for the development of chronic diseases. Examples of sedentary behavior include sitting, watching television, using a computer, and driving a car. In this article, we define sedentary behavior; outline key concepts related to the physiology of sedentary behavior, review the recent evidence on the effects of prolonged sedentary behavior (or sitting) on the risk of cardio-metabolic disease and all cause mortality, and discuss the implications for current clinical practice. We found that most large scale studies on sedentary behavior were published in the last 5 years. There is moderately consistent evidence for an association between total sitting time and all-cause mortality, even when adjusted for or stratified by leisure time physical activity. Overall, we identified a compelling case for sitting reduction to be included in clinical preventive advice as a key component of ‘active living,’ where adults and children are encouraged to ‘move more and sit less’ across different settings and locations throughout the day. Keywords Sedentary behavior . Cardiovascular disease . Diabetes . Epidemiology
Introduction: Definition and Prevalence of Sedentary Behavior
moderate-to-vigorous physical activity for good health [2]. Recently, increasing attention has been given to sedentary behavior, which appears to be associated with adverse health outcomes independent of moderate-to-vigorous physical activity [3•, 4, 5, 6•]. Sedentary behaviors are defined as any waking behavior characterized by an energy expenditure ≤1.5 METs while in a sitting or reclining posture [7, 8•]. Common examples of sedentary behaviors include:, sitting at work, driving a car, and watching television, and as such are a ubiquitous part of modern day living. Studies that have objectively assessed population movement patterns (via accelerometry) have shown that adults in developed countries spend typically 55 % to 70 % of their waking time in sedentary behaviors (about 8.8–11.2 h/d assuming 8 h/d of sleep) [9–12]. In a multinational study, over 20 % of respondents from half of the 20 participating countries self-reported overall sitting time of 9 or more hours per day [13]. Population time use surveys have found that adults are sedentary for 7.6 h/d in their nonworking time, and that the majority of leisure time is sedentary, mostly spent in screen time (watching TV and using computers) [14, 15]. The prevalence of people with sedentary occupations has also increased steadily over the last 50 years [16]. The aims of this paper are first, to present the key concepts related to the physiology of prolonged sitting; second, to review the recent evidence on the ef
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