ReviewThe relationship between sedentary behaviour and physical activity in adults: A systematic review
Introduction
Over the past few decades, the way in which we live our daily lives has changed dramatically. Technological advances, societal influences and environmental attributes have significantly influenced the way we spend our leisure, work and travel time, and how we live our lives at home and in our communities, resulting in substantial proportions of the day spent in sedentary pursuits, or sitting. For example, estimates from objective monitoring in the US show that adults spend 7–9 h of their working day sedentary (Matthews et al., 2008). Sedentary behaviour has been defined as “any waking behaviour characterised by an energy expenditure ≤ 1.5 METs whilst in a sitting or reclining posture” (Sedentary Behaviour Research Network, 2012, p. 540). This definition includes activities such as sitting, lying down, watching television, reading, screen-based entertainment and driving a vehicle (Pate et al., 2008). A growing body of epidemiological evidence has linked sedentary behaviour to health risks including an increased risk of type 2 diabetes (Proper et al., 2011, Van Uffelen et al., 2010, Wilmot et al., 2012), metabolic syndrome (Edwardson et al., 2012), cancer (Lynch, 2010, Schmid and Leitzmann, 2014), and all-cause and CVD mortality (Proper et al., 2011, Van Uffelen et al., 2010, Wilmot et al., 2012, Chau et al., 2013). These associations have been shown to be at least partially independent of levels of moderate-to-vigorous physical activity (MVPA), suggesting that sedentary behaviours have the potential to influence risk of disease, independent of physical activity levels typically recommended for good health.
Traditionally it was believed that only MVPA was beneficial to health, however recent studies employing objective monitoring have shown that time spent in light physical activity may also have health benefits (Healy et al., 2007, Healy et al., 2008, Dunstan et al., 2012, Carson et al., 2013). For example, Healy et al. (2007) observed that, after adjustment for confounders, objectively measured light intensity physical activity was beneficially associated with blood glucose levels in a sample of adults. The temporal patterning of behaviours suggests that MVPA and some single sedentary behaviours (e.g. TV viewing and/or computer use) may compete for time at certain periods during the day, but over 24 h there appears to be time for both behaviours to co-exist (Biddle et al., 2009). However, in contrast, population level studies have shown that sedentary behaviour is strongly and inversely associated with time spent in light physical activity, such as standing and light ambulation (Healy et al., 2008). Therefore, on a population level, sedentary time appears not to displace MVPA but, instead, may displace levels of light-intensity physical activity. Given that light physical activity will include standing and light ambulation, and these are the kinds of behaviours likely to be undertaken when not sitting, it is logical to expect a relationship between sedentary behaviour and light activity. For example, a recent study examining hourly patterns of sedentary behaviour and light intensity physical activity showed that the two behaviours displayed an inverse pattern throughout waking hours (Clemes et al., 2014).
These arguments may assist researchers in better understanding the nature of the displacement hypothesis — a notion suggesting that time in sedentary behaviour is displacing physical activity (Mutz et al., 1993). A recent meta-analysis conducted in children and adolescents has shown a small but significant inverse association between sedentary time and physical activity (Pearson et al., 2014), however associations between sedentary behaviour and all intensities of physical activity have received limited attention in adults. Understanding the presence of any association between sedentary behaviour and physical activity will provide insight into how certain behaviours may displace others and could aid in the development of effective interventions to reduce sedentary behaviour in adults. It is opportune, therefore, to review whether sedentary behaviours are associated with physical activity in adults. Therefore the aim of this study was to systematically review the literature to determine the nature and strength of the relationship between sedentary behaviour and different types and intensities of physical activity.
Section snippets
Search strategy
Potential studies were located from computerized (PubMed, Science Direct, Cochrane Library and Web of Knowledge) and manual searches of personal files and review articles. Search strategies were built around four groups of key words: sedentary behaviour (e.g. sitting, lying, seated, TV viewing, computers), physical activity (e.g. exercise, light physical activity, MVPA, walking, sports, cycling, active travel, active transport), sample type (e.g. healthy adults, young adults, middle age adults)
Results
The literature searches yielded 17,499 titles of potentially relevant articles, 26 of which met the inclusion criteria and were included in this review (see Fig. 1). The included studies are summarised in Table 1. Twenty studies examined associations between sedentary behaviour and physical activity cross-sectionally, and 6 examined associations prospectively. (For ease of reading and space, references for studies in the results are numbered as in Table 1).
Discussion
The purpose of this systematic review was to appraise and summarise the literature on associations between sedentary behaviour and physical activity in adults. The associations between these behaviours were evaluated across five domains of sedentary behaviour and nine domains of physical activity. The most commonly reported method of assessing sedentary behaviour and physical activity in the included studies was via self-report. The majority of these studies reported small to medium inverse
Conclusions
Given the high volumes of time adults reportedly spend in sedentary behaviour, along with the detrimental effects of sedentary behaviour on health (Wilmot et al., 2012), interventions are urgently needed to re-address the balance between sedentary behaviour and physical activity. Findings of this review suggest weak to moderate inverse associations between sedentary behaviour and physical activity, with stronger evidence from objective monitoring studies reporting larger associations between
Conflict of interest statement
The authors declare that there are no conflicts of interest
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