Dataset Information

Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults: A National Cohort Study.

ABSTRACT:

Background

Excessive sedentary time is ubiquitous in Western societies. Previous studies have relied on self-reporting to evaluate the total volume of sedentary time as a prognostic risk factor for mortality and have not examined whether the manner in which sedentary time is accrued (in short or long bouts) carries prognostic relevance.

Objective

To examine the association between objectively measured sedentary behavior (its total volume and accrual in prolonged, uninterrupted bouts) and all-cause mortality.

Design

Prospective cohort study.

Setting

Contiguous United States.

Participants

7985 black and white adults aged 45 years or older.

Measurements

Sedentary time was measured using a hip-mounted accelerometer. Prolonged, uninterrupted sedentariness was expressed as mean sedentary bout length. Hazard ratios (HRs) were calculated comparing quartiles 2 through 4 to quartile 1 for each exposure (quartile cut points: 689.7, 746.5, and 799.4 min/d for total sedentary time; 7.7, 9.6, and 12.4 min/bout for sedentary bout duration) in models that included moderate to vigorous physical activity.

Results

Over a median follow-up of 4.0 years, 340 participants died. In multivariable-adjusted models, greater total sedentary time (HR, 1.22 [95% CI, 0.74 to 2.02]; HR, 1.61 [CI, 0.99 to 2.63]; and HR, 2.63 [CI, 1.60 to 4.30]; P for trend < 0.001) and longer sedentary bout duration (HR, 1.03 [CI, 0.67 to 1.60]; HR, 1.22 [CI, 0.80 to 1.85]; and HR, 1.96 [CI, 1.31 to 2.93]; P for trend < 0.001) were both associated with a higher risk for all-cause mortality. Evaluation of their joint association showed that participants classified as high for both sedentary characteristics (high sedentary time [≥12.5 h/d] and high bout duration [≥10 min/bout]) had the greatest risk for death.

Limitation

Participants may not be representative of the general U.S. population.

Conclusion

Both the total volume of sedentary time and its accrual in prolonged, uninterrupted bouts are associated with all-cause mortality, suggesting that physical activity guidelines should target reducing and interrupting sedentary time to reduce risk for death.

Primary funding source

National Institutes of Health.

SUBMITTER: Diaz KM

PROVIDER: S-EPMC5961729 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults: A National Cohort Study.

Diaz Keith M KM Howard Virginia J VJ Hutto Brent B Colabianchi Natalie N Vena John E JE Safford Monika M MM Blair Steven N SN Hooker Steven P SP

Annals of internal medicine 20170912 7

<h4>Background</h4>Excessive sedentary time is ubiquitous in Western societies. Previous studies have relied on self-reporting to evaluate the total volume of sedentary time as a prognostic risk factor for mortality and have not examined whether the manner in which sedentary time is accrued (in short or long bouts) carries prognostic relevance.<h4>Objective</h4>To examine the association between objectively measured sedentary behavior (its total volume and accrual in prolonged, uninterrupted bou ...[more]

PMID: 28892811

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Project description:ImportanceSedentary behavior is associated with several health outcomes, including diabetes, cardiovascular disease, and all-cause mortality. Less is known about the association between objectively measured sedentary behavior and cancer mortality, as well as the association with physical activity.ObjectiveTo examine the association between accelerometer-measured sedentary behavior (total volume and accrual in prolonged, uninterrupted bouts) and cancer mortality.Design, setting, and participantsA prospective cohort study conducted in the contiguous US included 8002 black and white adults aged 45 years or older enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. The present analysis was performed from April 18, 2019, to April 21, 2020.ExposuresSedentary time, light-intensity physical activity (LIPA), and moderate- to vigorous-intensity physical activity (MVPA) were measured using a hip-mounted accelerometer worn for 7 consecutive days.Main outcomes and measuresCancer mortality.ResultsOf the 8002 study participants, 3668 were men (45.8%); mean (SD) age was 69.8 (8.5) years. Over a mean (SD) follow-up of 5.3 (1.5) years, 268 participants (3.3%) died of cancer. In multivariable-adjusted models, including MVPA, greater total sedentary time was associated with a greater risk of cancer mortality (tertile 2 vs tertile 1: hazard ratio [HR], 1.45; 95% CI, 1.00-2.11; tertile 3 vs tertile 1: HR, 1.52; 95% CI, 1.01-2.27). Longer sedentary bout duration was not significantly associated with greater cancer mortality risk: after adjustment for MVPA (tertile 2 vs tertile 1: HR, 1.26; 95% CI, 0.90-1.78; tertile 3 vs tertile 1: HR, 1.36; 95% CI, 0.96-1.93). Replacing 30 minutes of sedentary time with LIPA was significantly associated with an 8% (per 30 minutes: HR, 0.92; 95% CI, 0.86-0.97) lower risk of cancer mortality; MVPA was significantly associated with a 31% (per 30 minutes: HR, 0.69; 95% CI, 0.48-0.97) lower risk of cancer mortality.Conclusions and relevanceIn this cohort study, greater sedentary time, as measured with accelerometry, appeared to be independently associated with cancer mortality risk. Replacing sedentary time with either LIPA or MVPA may be associated with a lower risk of cancer mortality. These findings suggest that the total volume of sedentary behavior is a potential cancer mortality risk factor and support the public health message that adults should sit less and move more to promote longevity.

Project description:PurposeThe purposes of this study were to examine patterns of objectively measured sedentary behavior in a national cohort of US middle-age and older adults and to determine factors that influence prolonged sedentary behavior.MethodsWe studied 8096 participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a population-based study of black and white adults 45 yr or older. Seven-day accelerometry was conducted. Prolonged sedentary behavior was defined as accumulating 50% or more of total sedentary time in bouts of 30 min or greater.ResultsThe number of sedentary bouts greater than or equal to 20, 30, 60, and 90 min were 8.8 ± 2.3, 5.5 ± 1.9, 1.9 ± 1.1, and 0.8 ± 0.7 bouts per day, respectively. Sedentary bouts greater than or equal to 20, 30, 60, and 90 min accounted for 60.0% ± 13.9%, 48.0% ± 15.5%, 26.0% ± 15.4%, and 14.2% ± 12.9% of total sedentary time, respectively. Several factors were associated with prolonged sedentary behavior in multivariate-adjusted models (odds ratio [95% confidence interval]): older age (65-74 yr: 1.99 [1.55-2.57]; 75 yr or older: 4.68 [3.61-6.07] vs 45-54 yr), male sex (1.41 [1.28-1.56] vs female), residence in nonstroke belt/buckle region of the United States (stroke belt: 0.87 [0.77-0.98]; stroke buckle: 0.86 [0.77-0.95] vs non-belt/buckle), body mass index (BMI) (overweight: 1.33 [1.18-1.51]; obese: 2.15 [1.89-2.44] vs normal weight), winter (1.18 [1.03-1.35] vs summer), and low amounts of moderate-to-vigorous physical activity (MVPA) [0 min·wk: 2.00 [1.66-2.40] vs ≥150 min·wk).ConclusionsIn this sample of US middle-age and older adults, a large proportion of total sedentary time was accumulated in prolonged, uninterrupted bouts of sedentary behavior as almost one-half was accumulated in sedentary bouts greater than or equal to 30 min. Several sociodemographic (age, sex, and BMI), behavioral (MVPA), environmental (region), and seasonal factors are associated with patterns of prolonged sedentary behavior.

Project description:Introduction:Sedentary behavior (SB) is highly prevalent among older adults, with more than 25% engaging in 6 hours or more of SB daily. SB has been associated with several cardiometabolic biomarkers in younger adults; however, there is a paucity of research in older populations. This study examined associations between patterns of SB and cardiometabolic biomarkers in community-dwelling adults aged 55 years and older. Methods:Data were drawn from a convenience sample of 54 community-dwelling individuals (12 males, 42 females; mean age?=?72.6?±?6.8 years, range?=?56-89 years). Cardiometabolic biomarkers assessed included systolic (SBP) and diastolic blood pressure (DBP), body mass index, waist circumference, and fasting blood glucose and cholesterol parameters. SB was assessed via accelerometry over a 7-day period, and measures included daily time in SB, number and length of sedentary bouts, the number and length of breaks between sedentary bouts, moderate-to-vigorous physical activity (MVPA), and light physical activity (LPA). Associations between the SB measures and each cardiometabolic risk factor were examined using separate stepwise multiple regression models, controlling for sex, MVPA, and accelerometer wear time. Isotemporal substitution models were used to examine the change in cardiometabolic outcomes when SB is replaced by an equal duration of either LPA or MVPA. Results:Adjusted regression analyses showed that daily sedentary time was positively associated with DBP (??=?0.052, ?R 2?=?0.112, p = 0.022) and inversely associated with HDL cholesterol (??=?-0.111, ?R 2?=?0.121, p = 0.039). Sedentary bout length was also associated with DBP and HDL cholesterol (??=?0.575, ?R 2?=?0.152, p?=?0.007; ??=?-1.529, ?R 2?=?0.196, p = 0.007, respectively). Replacement of 10 minutes of SB a day with LPA was associated with improved DBP and HDL cholesterol (p ? 0.05). No other significant associations (p ? 0.05) were found. Conclusion:Sitting for prolonged periods of time without interruption is unfavorably associated with DBP and HDL cholesterol. Prospective studies should identify causal relationships and observe specific changes in cardiometabolic profiles in older populations.

Dataset Information

Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults: A National Cohort Study.

Background

Objective

Design

Setting

Participants

Measurements

Results

Limitation

Conclusion

Primary funding source

Publications

Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults: A National Cohort Study.

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