Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis.

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, 1.240 [95% CI, 1.090 to 1.410]), cardiovascular disease mortality (HR, 1.179 [CI, 1.106 to 1.257]), cardiovascular disease incidence (HR, 1.143 [CI, 1.002 to 1.729]), cancer mortality (HR, 1.173 [CI, 1.108 to 1.242]), 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.