Wilmot EG, Edwardson CL, Achana FA, et al. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis

Department of Cardiovascular Sciences, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
Diabetologia (Impact Factor: 6.67). 08/2012; 55(11):2895-905. DOI: 10.1007/s00125-012-2677-z
Source: PubMed


Sedentary (sitting) behaviours are ubiquitous in modern society. We conducted a systematic review and meta-analysis to examine the association of sedentary time with diabetes, cardiovascular disease and cardiovascular and all-cause mortality.
Medline, Embase and the Cochrane Library databases were searched for terms related to sedentary time and health outcomes. Cross-sectional and prospective studies were included. RR/HR and 95% CIs were extracted by two independent reviewers. Data were adjusted for baseline event rate and pooled using a random-effects model. Bayesian predictive effects and intervals were calculated to indicate the variance in outcomes that would be expected if new studies were conducted in the future.
Eighteen studies (16 prospective, two cross-sectional) were included, with 794,577 participants. Fifteen of these studies were moderate to high quality. The greatest sedentary time compared with the lowest was associated with a 112% increase in the RR of diabetes (RR 2.12; 95% credible interval [CrI] 1.61, 2.78), a 147% increase in the RR of cardiovascular events (RR 2.47; 95% CI 1.44, 4.24), a 90% increase in the risk of cardiovascular mortality (HR 1.90; 95% CrI 1.36, 2.66) and a 49% increase in the risk of all-cause mortality (HR 1.49; 95% CrI 1.14, 2.03). The predictive effects and intervals were only significant for diabetes.
Sedentary time is associated with an increased risk of diabetes, cardiovascular disease and cardiovascular and all-cause mortality; the strength of the association is most consistent for diabetes.

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    • "A large epidemiological study (N = 222,497) showed that prolonged sitting is a risk factor for all-cause mortality, independent of physical activity, and is responsible for 7% of premature deaths (van der Ploeg, Chey, Korda, Banks, & Bauman, 2012). Reviews on epidemiological studies have suggested that sedentary behavior (i.e., overall sedentary behavior, including occupational and leisure time) is a major independent lifestyle risk factor for the development of obesity, cardiovascular disease, diabetes, and cancer (Proper, Singh, van Mechelen, & Chinapaw, 2011; Thorp, Owen, Neuhaus, & Dunstan, 2011; van Uffelen et al., 2010; Wilmot et al., 2012). "
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    ABSTRACT: Office workers spend a large part of their workday sitting down. Too much sitting seems bad for people's health and puts them at risk for premature death. Workstation alternatives that allow desk work to be done while standing, walking, biking, or stepping reduce the total time spent sitting without affecting work performance much. Moreover, these alternatives seem acceptable to users. Future research is needed to determine long-term effects and whether results apply to different working populations. Ergonomists play an important role in developing recommendations for the setup and use of alternative workstations and in improving their feasibility.
    Ergonomics in Design The Quarterly of Human Factors Applications 07/2015; 23(3):4-8. DOI:10.1177/1064804615585410
    • "Sedentary behaviors are characterized by a sitting or lying posture and low energy expenditure (Sedentary Behaviour Research Network, 2012). In older adults, sedentary time is related to obesity, cardiovascular disease, diabetes, and mortality even after adjustment moderate-to-vigorous physical activity (Leon-Munoz et al., 2013; Proper, Singh, van Mechelen, & Chinapaw, 2011; Wilmot et al., 2012). Overweight and obese older adults have low levels of physical activity, high sedentary time, and often have multiple chronic conditions (Evenson, "
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    ABSTRACT: Overweight and obese older adults have high sedentary time. We tested the feasibility and preliminary effects of a sedentary time reduction intervention among adults over age 60 with a body mass index over 27 kg/m(2) using a nonrandomized one-arm design. Participants (N = 25, mean age = 71.4, mean body mass index = 34) completed an 8-week theory-based intervention targeting reduced total sitting time and increased sit-to-stand transitions. An inclinometer (activPAL™) measured the primary outcomes, change in total sitting time and sit-to-stand transitions. Secondary outcomes included physical activity (ActiGraph GT3X+ accelerometer), self-reported sedentary behaviors, physical function (Short Physical Performance Battery), depressive symptoms (8-item Patient Health Questionnaire), quality of life (PROMIS), and study satisfaction. Paired t tests examined pre-post test changes in sitting time, sit-to-stand transitions, and secondary outcomes. Inclinometer measured sitting time decreased by 27 min/day (p < .05) and sit-to-stand transitions increased by 2 per day (p > .05), while standing time increased by 25 min/day (p < .05). Accelerometer measured sedentary time, light-intensity, and moderate-to-vigorous physical activity improved (all p values ≤ .05). Self-reported sitting time, gait speed, and depressive symptoms also improved (all p values < .05). Effect sizes were small. Study satisfaction was high. Reducing sitting time is feasible, and the intervention shows preliminary evidence of effectiveness among older adults with overweight and obesity. Randomized trials of sedentary behavior reduction in overweight and obese older adults, most of whom have multiple chronic conditions, may be promising. © 2015 Society for Public Health Education.
    Health Education & Behavior 03/2015; 42(5). DOI:10.1177/1090198115577378 · 2.23 Impact Factor
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    • "It is well-recognized that increasing physical activity plays an important role in lowering diabetes risk, while a sedentary lifestyle (e.g., prolonged TV watching) increases diabetes risk [2]. We agree with Dr. Kawada that physical inactivity and sedentary behavior are important risk factors for the development of type 2 diabetes, and we thank him for drawing attention to this field. "

    Journal of Psychosomatic Research 01/2015; 78(4). DOI:10.1016/j.jpsychores.2015.01.004 · 2.74 Impact Factor
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