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Abstract
To provide an overview of relationships between sedentary behavior and mortality as
well as incidence of several non-communicable diseases and weight status reported
in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (2018
PAGAC Scientific Report), and to update the evidence from recent studies. Evidence
related to sedentary behavior in the 2018 PAGAC Scientific Report was summarized and
a systematic review was undertaken to identify original studies published between
January 2017 and February 2018. The 2018 PAGAC Scientific Report concluded there was
strong evidence that high amounts of sedentary behavior increase the risk for all-cause
and cardiovascular disease (CVD) mortality and incident CVD and type 2 diabetes. Moderate
evidence indicated sedentary behavior is associated with incident endometrial, colon
and lung cancer. Limited evidence suggested sedentary behavior is associated with
cancer mortality and weight status. There was strong evidence that the hazardous effects
of sedentary behavior are more pronounced in physically inactive people. Evidence
was insufficient to determine if bout length or breaks in sedentary behavior are associated
with health outcomes. The new literature search yielded seven new studies for all-cause
mortality, two for CVD mortality, two for cancer mortality, four for type 2 diabetes,
one for weight status, and four for cancer; no new studies were identified for CVD
incidence. Results of the new studies supported the conclusions in the 2018 PAGAC
Scientific Report. The results of the updated search add further evidence on the association
between sedentary behavior and health. Further research is required on how sex, age,
race/ethnicity, socioeconomic status, and weight status may modify associations between
sedentary behavior and health outcomes.
Moderate-to-vigorous-intensity physical activity is recommended to maintain and improve health, but the mortality benefits of light activity and risk for sedentary time remain uncertain.
Prior studies suggest that higher sedentary time is associated with a greater risk for cardiovascular disease (CVD). However, the quantitative, dose-response association between sedentary time and CVD risk is not known.