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Reviews20 January 2015

Sedentary Time and Its Association With Risk for Disease Incidence, Mortality, and Hospitalization in Adults

A Systematic Review and Meta-analysis
Author, Article, and Disclosure Information
https://doi.org/10.7326/M14-1651

Abstract

This article has been corrected. The original version (PDF) is appended to this article as a Supplement.

Background:

The magnitude, consistency, and manner of association between sedentary time and outcomes independent of physical activity remain unclear.

Purpose:

To quantify the association between sedentary time and hospitalizations, all-cause mortality, cardiovascular disease, diabetes, and cancer in adults independent of physical activity.

Data Sources:

English-language studies in MEDLINE, PubMed, EMBASE, CINAHL, Cochrane Library, Web of Knowledge, and Google Scholar databases were searched through August 2014 with hand-searching of in-text citations and no publication date limitations.

Study Selection:

Studies assessing sedentary behavior in adults, adjusted for physical activity and correlated to at least 1 outcome.

Data Extraction:

Two independent reviewers performed data abstraction and quality assessment, and a third reviewer resolved inconsistencies.

Data Synthesis:

Forty-seven articles met our eligibility criteria. Meta-analyses were performed on outcomes for cardiovascular disease and diabetes (14 studies), cancer (14 studies), and all-cause mortality (13 studies). Prospective cohort designs were used in all but 3 studies; sedentary times were quantified using self-report in all but 1 study. Significant hazard ratio (HR) associations were found with all-cause mortality (HR, 1.220 [95% CI, 1.090 to 1.410]), cardiovascular disease mortality (HR, 1.150 [CI, 1.107 to 1.195]), cardiovascular disease incidence (HR, 1.143 [CI, 1.002 to 1.729]), cancer mortality (HR, 1.130 [CI, 1.053 to 1.213]), cancer incidence (HR, 1.130 [CI, 1.053 to 1.213]), and type 2 diabetes incidence (HR, 1.910 [CI, 1.642 to 2.222]). Hazard ratios associated with sedentary time and outcomes were generally more pronounced at lower levels of physical activity than at higher levels.

Limitation:

There was marked heterogeneity in research designs and the assessment of sedentary time and physical activity.

Conclusion:

Prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity.

Primary Funding Source:

None.

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