Replacing Sedentary Time with Physical Activity in Relation to Mortality

Schmid, Daniela; Ricci, Cristian; Baumeister, Sebastian E.; Leitzmann, Michael F.

doi:10.1249/mss.0000000000000913

Cited by 88 publications

(91 citation statements)

References 37 publications

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“…These results are in accordance with recent work reporting on changes in metabolic risk outcomes and mortality risk when replacing time in higher intensity PA with lower intensity activities [28, 29, 30]. For example, Hamer et al [28] reported similar changes on BMI and blood lipid levels when hypothetically replacing a 10-minute period of MVPA with either LPA or sedentary time in a sample of older men and women.…”

Section: Discussionsupporting

confidence: 90%

Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women

2017

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IntroductionWhether amount of time spent in sedentary activities influences on clustered metabolic risk in elderly, and to what extent such an influence is independent of physical activity behavior, remain unclear. Therefore, the aim of the study was to examine cross-sectional associations of objectively assessed physical activity and sedentary behavior on metabolic risk outcomes in a sample of elderly community-dwelling women.MethodsMetabolic risk outcomes including waist circumference, systolic and diastolic blood pressures, fasting levels of plasma glucose, HDL-cholesterol and triglycerides were assessed in 120 community-dwelling older women (65–70 yrs). Accelerometers were used to retrieve daily sedentary time, breaks in sedentary time, daily time in light (LPA) and moderate-to-vigorous physical activity (MVPA), and total amount of accelerometer counts. Multivariate regression models were used to examine influence of physical activity and sedentary behavior on metabolic risk outcomes including a clustered metabolic risk score.ResultsWhen based on isotemporal substitution modeling, replacement of a 10-min time block of MVPA with a corresponding time block of either LPA or sedentary activities was associated with an increase in clustered metabolic risk score (β = 0.06 to 0.08, p < 0.05), and an increase in waist circumference (β = 1.78 to 2.19 p < 0.01). All associations indicated between sedentary time and metabolic risk outcomes were lost once variation in total accelerometer counts was adjusted for.ConclusionsDetrimental influence of a sedentary lifestyle on metabolic health is likely explained by variations in amounts of physical activity rather than amount of sedentary time per se. Given our findings, increased amounts of physical activity with an emphasis on increased time in MVPA should be recommended in order to promote a favorable metabolic health profile in older women.

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Section: Discussionsupporting

confidence: 90%

Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women

2017

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“…34 Multiple studies have shown that sedentary behaviours are associated with mortality in middle-aged and older adults. 20,21,35,36 Wijndaele and colleagues 35 showed that time spent watching television was associated with all-cause mortality in a populationbased cohort (the European Prospective Investigation into Cancer and Nutrition study) of about 13 000 people (62 ± 9 yr), even after stratification by age, sex, education, body mass index and energy expenditure for total physical activity. Similarly, Matthews and colleagues 36 showed that time spent watching television was associated with all-cause mortality in 240 819 adults (50-71 yr) from the Diet and Health Study of the National Institutes of Health and the American Association of Retired Persons, even after stratification by age, sex, education, race, body mass index, smoking, chronic conditions and diet quality.…”

Section: Discussionmentioning

confidence: 99%

Association between sedentary time and mortality across levels of frailty

Theou

Blodgett

Godin

et al. 2017

CMAJ

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Sedentary behaviours are increasingly recognized as conferring health risks, independent of physical activity. The health benefits of physical activity are well established, and meeting minimum guidelines for physical activity is associated with reduced risk of many chronic conditions, functional decline, development of psychologic disorders and mortality. [1][2][3][4][5][6][7][8][9] However, even among people who engage in periods of purposeful exercise, sedentary behaviours can increase the risk of adverse outcomes, such as metabolic risk factors, functional limitations, and all-cause and cardiovascular disease mortality. [10][11][12][13][14][15][16] Even so, a recent meta-analysis showed that engaging in moderate physical activity, such as exercise, for at least 1 hour/day could eliminate the detrimental effects of prolonged sitting. 17Although most of the research on sedentary behaviours has focused on children and younger adults, middle-aged and older adults are the most sedentary group. A study using data from the Canadian Health Measures Survey showed that Canadians over the age of 40 are highly sedentary, spending about 9.5-10 of their waking hours in sedentary behaviours (age 40-59 yr, 9.5 h for men and 9.8 h for women; age 60-79 yr, 9.9 h for men, 10 h for women). 18Only 14.6% of the Canadian population aged 40-59 years and 13.1% of those aged 60-79 years met the recommended 2.5 hours/ week of moderate-to-vigorous physical activity. 18 Another study using data from the US National Health and Nutrition Examination Survey (NHANES) showed that participants over the age of 50 years spent on average 8.5 of their waking hours in sedentary behaviours. 19 Only 7.1% of the population met the recommended 2.5 hours/week of moderate-to-vigorous physical activity. 19Reducing sedentary behaviours could improve health outcomes in middle-aged and older adults. Replacing 30 minutes of sedentary time with an equal amount of light activity or moderate-to-vigorous activity was associated with 14% and 50% reductions in risk of mortality, respectively. 20,21 Even so, studies have shown a strong relation between sedentary behaviours and frailty, independent of moderate-to-vigorous activity.

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“…34 This finding is important because light activity may be the only intensity of physical activity available to people with knee OA who find higher intensity activities to be difficult due to pain. Importantly, this protective effect was significant to reduce the development of slow gait speed, which is a known risk factor for death, 18 persistent lower extremity limitation, and hospitalization in older adults.…”

Section: Discussionmentioning

confidence: 99%

Potential Functional Benefit From Light Intensity Physical Activity in Knee Osteoarthritis

White

Lee

Song

et al. 2017

American Journal of Preventive Medicine

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Introduction Knee pain may preclude participation in higher intensity physical activity in people with knee osteoarthritis and benefits of light activity are unclear. The effect of replacing sedentary time with light intensity activity on incident functional limitation 2 years later was investigated. Methods Included were people with or at high risk of knee osteoarthritis without baseline functional limitation using data from the Osteoarthritis Initiative collected between August 2008 and July 2010. Data was analyzed between May 2016 and August 2016 for time in sedentary, light, and moderate to vigorous physical activity from accelerometer monitoring. Incident functional limitation was defined as (1) slow gait speed <1.0 meters/sec during a 20-meter walk, (2) Western Ontario and McMasters University Osteoarthritis Index physical function >28, or (3) Short Form 12 Physical Component scale <40. Results Inclusion criteria was met by 1,873 people (mean age=65.0 [SD=9.0] years, mean BMI=28.4 [SD=4.7] kg/m2). Replacing 60 minutes/day of sedentary time with 60 minutes/day of light activity was associated with a 17% reduced risk for incident slow gait speed 2 years later (Hazard Ratio=0.83, 95% CI=0.70, 0.99) after adjustment. Approximately 5 minutes/day of moderate to vigorous physical activity would be necessary to receive the equivalent benefit of 60 minutes/day of light activity. Effects in secondary patient-reported outcomes did not reach statistical significance. Conclusions Replacing sedentary time with light activity may reduce the risk of performance-based functional limitation. As expected, moderate to vigorous physical activity rather than light provided stronger risk reduction. When moderate to vigorous physical activity is not an option, pursuing light activity may be a beneficial alternative to being sedentary.

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Replacing Sedentary Time with Physical Activity in Relation to Mortality

Abstract: Replacing sedentary time with an equal amount of physical activity may protect against preterm mortality. Replacement of light physical activity with moderate to vigorous activity is also associated with protection from premature mortality.

Cited by 88 publications

References 37 publications

Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women

Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women

Association between sedentary time and mortality across levels of frailty

Potential Functional Benefit From Light Intensity Physical Activity in Knee Osteoarthritis

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