A Primer on Repeated Sitting Exposure and the Cardiovascular System: Considerations for Study Design, Analysis, Interpretation, and Translation

Abstract

Sedentary behavior, particularly sitting, is ubiquitous in many contemporary societies. This is a major societal concern considering the evidence for a strong association between sitting behavior and cardiovascular disease morbidity and mortality. Unsurprisingly, leading public health agencies have begun to advocate “reduction” in sitting behavior. Though, the guidelines are typically vague and non-specific. The lack of specific guidelines for prolonged sitting is attributable to the absence of available evidence to facilitate guideline development. To inform policy, well-designed randomized controlled trials are required to test the efficacy of specific and translatable sitting reduction strategies. To guide the design of randomized controlled trials, this review postulates that several gaps in the literature first need to be filled. Following a general discussion of the importance of sitting behavior to contemporary societies, each of the following are discussed: (i) acute sitting exposure and systems physiology; (ii) recommendations for a systems physiology toolbox; (iii) study design considerations for acute sitting exposure; and (iv) translation of sitting-focused research.

Leg Fidgeting Improves Executive Function following Prolonged Sitting with a Typical Western Meal: A Randomized, Controlled Cross-Over Trial

“…In accordance with procedures recommended by Stoner, Barone Gibbs, et al [22], following the 20 min supine rest, a Doppler ultrasound (Terrason T3300, Burlington, MA, USA) fitted with a linear array probe (15-4 mHz) was used to collect 3 × 10 s videos of the common carotid artery (CCA) on the left side of the body. After this, the participant was manually moved into a seated position using an electronic three-way tilt table (Plinth 2000, Plinth Medical, Suffolk, UK).…”

Sedentary behavior and cardiovascular disease risk: An evolutionary perspective

“…The primary driver for the deleterious cardiovascular effects of SB is thought to be venous pooling within the lower limbs as a consequence of reduced muscle activity and therefore reduced action of the muscle pump. (Stoner et al, 2021) The subsequent venous pooling is hypothesised to reduce venous return and, in…”

Sedentary Behavior Reduction: A Stepwise Approach to Increasing Physical Activity and Reducing Cardiovascular Disease Risk in Endometrial Cancer Survivors

“…Intention-Behavior Gap The failure to translate a goal intention into an actualized behavior. [15] tivity leads to lower extremity venous blood pooling and reduced blood transit time in venous circulation, which subsequently decreases venous return inversely with stroke volume [25,34]. Reduced stroke volume decreases shear stress which promotes oxidative stress, endothelial dysfunction, and acutely increases arterial stiffness [35][36][37][38][39].…”

“…A working hypothesis is that SB contributes to CVD risk via repeated exposure to acute sitting-induced increases in arterial stiffness likely driven by hemodynamic changes with metabolic, autonomic, and hormonal factors [25]. During acute prolonged sitting, a lack of muscle pump ac-Table 1.…”