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      Association of Sedentary Time with Mortality Independent of Moderate to Vigorous Physical Activity

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          Abstract

          Background

          Sedentary behavior has emerged as a novel health risk factor independent of moderate to vigorous physical activity (MVPA). Previous studies have shown self-reported sedentary time to be associated with mortality; however, no studies have investigated the effect of objectively measured sedentary time on mortality independent of MVPA. The objective our study was to examine the association between objectively measured sedentary time and all-cause mortality.

          Methods

          7-day accelerometry data of 1906 participants aged 50 and over from the U.S. nationally representative National Health and Nutrition Examination Survey (NHANES) 2003–2004 were analyzed. All-cause mortality was assessed from the date of examination through December 31, 2006.

          Results

          Over an average follow-up of 2.8 years, there were 145 deaths reported. In a model adjusted for sociodemographic factors, lifestyle factors, multiple morbidities, mobility limitation, and MVPA, participants in third quartile (hazard ratio (HR):4.05; 95%CI:1.55–10.60) and fourth quartile (HR:5.94; 95%CI: 2.49–14.15) of having higher percent sedentary time had a significantly increased risk of death compared to those in the lowest quartile.

          Conclusions

          Our study suggests that sedentary behavior is a risk factor for mortality independent of MVPA. Further investigation, including studies with longer follow-up, is needed to address the health consequences of sedentary behavior.

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          Most cited references8

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          Breaks in sedentary time: beneficial associations with metabolic risk.

          Total sedentary (absence of whole-body movement) time is associated with obesity, abnormal glucose metabolism, and the metabolic syndrome. In addition to the effects of total sedentary time, the manner in which it is accumulated may also be important. We examined the association of breaks in objectively measured sedentary time with biological markers of metabolic risk. Participants (n = 168, mean age 53.4 years) for this cross-sectional study were recruited from the 2004-2005 Australian Diabetes, Obesity and Lifestyle study. Sedentary time was measured by an accelerometer (counts/minute(-1) or = 100) was considered a break. Fasting plasma glucose, 2-h plasma glucose, serum triglycerides, HDL cholesterol, weight, height, waist circumference, and resting blood pressure were measured. MatLab was used to derive the breaks variable; SPSS was used for the statistical analysis. Independent of total sedentary time and moderate-to-vigorous intensity activity time, increased breaks in sedentary time were beneficially associated with waist circumference (standardized beta = -0.16, 95% CI -0.31 to -0.02, P = 0.026), BMI (beta = -0.19, -0.35 to -0.02, P = 0.026), triglycerides (beta = -0.18, -0.34 to -0.02, P = 0.029), and 2-h plasma glucose (beta = -0.18, -0.34 to -0.02, P = 0.025). This study provides evidence of the importance of avoiding prolonged uninterrupted periods of sedentary (primarily sitting) time. These findings suggest new public health recommendations regarding breaking up sedentary time that are complementary to those for physical activity.
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            Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab).

            We examined the associations of objectively measured sedentary time and physical activity with continuous indexes of metabolic risk in Australian adults without known diabetes. An accelerometer was used to derive the percentage of monitoring time spent sedentary and in light-intensity and moderate-to-vigorous-intensity activity, as well as mean activity intensity, in 169 Australian Diabetes, Obesity and Lifestyle Study (AusDiab) participants (mean age 53.4 years). Associations with waist circumference, triglycerides, HDL cholesterol, resting blood pressure, fasting plasma glucose, and a clustered metabolic risk score were examined. Independent of time spent in moderate-to-vigorous-intensity activity, there were significant associations of sedentary time, light-intensity time, and mean activity intensity with waist circumference and clustered metabolic risk. Independent of waist circumference, moderate-to-vigorous-intensity activity time was significantly beneficially associated with triglycerides. These findings highlight the importance of decreasing sedentary time, as well as increasing time spent in physical activity, for metabolic health.
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              Assessment of physical activity by self-report: status, limitations, and future directions.

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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2012
                13 June 2012
                : 7
                : 6
                : e37696
                Affiliations
                [1 ]National Institute on Aging, Intramural Research Program, Laboratory of Epidemiology, Demography, and Biometry, Bethesda, Maryland, United States of America
                [2 ]Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
                [3 ]Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
                [4 ]Division of Cancer Epidemiology and Genetics Nutritional Epidemiology, National Cancer Institute, Rockville, Maryland, United States of America
                [5 ]Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, United States of America
                [6 ]National Institute of Diabetes and Digestive and Kidney Diseases, Diabetes, Endocrinology, and Obesity Branch, Bethesda, Maryland, United States of America
                University of Granada, Spain
                Author notes

                Conceived and designed the experiments: AK PC TBH KVP. Analyzed the data: AK KVP. Wrote the paper: AK. Contributed to writing the manuscript: PC TBH KVP. Interpreted the data and reviewed drafts of the paper: PC TBH KVP CEM DB DRV KYC RJB. Processed the data: RJB.

                Article
                PONE-D-11-12369
                10.1371/journal.pone.0037696
                3374810
                22719846
                03e040a3-695f-4631-a6f9-c97fd0a4dc97
                This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
                History
                : 29 June 2011
                : 25 April 2012
                Page count
                Pages: 7
                Categories
                Research Article
                Biology
                Population Biology
                Epidemiology
                Life Course Epidemiology
                Medicine
                Epidemiology
                Lifecourse Epidemiology
                Geriatrics
                Non-Clinical Medicine
                Health Care Policy
                Quality of Life
                Health Informatics
                Public Health
                Sports and Exercise Medicine
                Social and Behavioral Sciences
                Sociology
                Demography
                Life Expectancy
                Social Research
                Social Welfare

                Uncategorized
                Uncategorized

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