Theme: The science of sedentary behavior
Sedentary Behaviors and Subsequent Health Outcomes in Adults: A Systematic Review of Longitudinal Studies, 1996–2011

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Context

To systematically review and provide an informative synthesis of findings from longitudinal studies published since 1996 reporting on relationships between self-reported sedentary behavior and device-based measures of sedentary time with health-related outcomes in adults.

Evidence acquisition

Studies published between 1996 and January 2011 were identified by examining existing literature reviews and by systematic searches in Web of Science, MEDLINE, PubMed, and PsycINFO. English-written articles were selected according to study design, targeted behavior, and health outcome.

Evidence synthesis

Forty-eight articles met the inclusion criteria; of these, 46 incorporated self-reported measures including total sitting time; TV viewing time only; TV viewing time and other screen-time behaviors; and TV viewing time plus other sedentary behaviors. Findings indicate a consistent relationship of self-reported sedentary behavior with mortality and with weight gain from childhood to the adult years. However, findings were mixed for associations with disease incidence, weight gain during adulthood, and cardiometabolic risk. Of the three studies that used device-based measures of sedentary time, one showed that markers of obesity predicted sedentary time, whereas inconclusive findings have been observed for markers of insulin resistance.

Conclusions

There is a growing body of evidence that sedentary behavior may be a distinct risk factor, independent of physical activity, for multiple adverse health outcomes in adults. Prospective studies using device-based measures are required to provide a clearer understanding of the impact of sedentary time on health outcomes.

Section snippets

Context

Today's environment is distinctively different from that of the past century. Information and communication technology and labor-saving devices are now ubiquitous across many settings,1 substantially reducing demands for physical activity and, consequently, energy expenditure.2 For adults, the most obvious changes evident are in the amount of time that is spent sitting and in sedentary behaviors.

The term sedentary behavior (from the Latin word sedere, “to sit”) describes a distinct class of

Description of Search and Selection Process

Three search strategies were applied to identify relevant literature for this review. In June 2010, four existing literature reviews on the association of sedentary behavior and health outcomes initially were screened for any publications that matched the current inclusion criteria.4, 5, 8, 9 A systematic literature search was then conducted in Web of Science, MEDLINE, PubMed, and PsycINFO using three blocks of terms to identify additional papers not reported in the reviews. The first search

Evidence Synthesis

Of the 48 studies identified, 43 used a self-reported measure of either total sitting time (n=9); TV viewing time only (n=12); TV viewing time and other screen-time behaviors (n=14); or TV viewing time plus other sedentary behaviors (n=8). Two studies used both a self-reported measure of total sitting time and TV viewing time and other screen-time behaviors; two used a device (heart rate or accelerometry) measure of sedentary time; and one used both a device measure of sedentary time and a

Discussion

This paper builds on previous reviews of sedentary behavior, specifically focusing on prospective studies conducted in adults from 1996 to January 2011. There is now an emerging body of evidence to indicate that sedentary behavior may be a distinct risk factor for multiple health outcomes, including mortality. Further, the adverse relationships observed with sedentary behavior in many of these longitudinal studies have been shown to persist even when physical activity has been accounted for

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