Patterns of sedentary behavior and mortality in U.S. middle-aged and older adults a national cohort study

Keith M. Diaz, Virginia J. Howard, Brent Hutto, Natalie Colabianchi, John E. Vena, Monika M. Safford, Steven N. Blair, Steven P. Hooker

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    Abstract

    Background: Excessive sedentary time is ubiquitous in Western societies. Previous studies have relied on self-reporting to evaluate the total volume of sedentary time as a prognostic risk factor for mortality and have not examined whether the manner in which sedentary time is accrued (in short or long bouts) carries prognostic relevance. Objective: To examine the association between objectively measured sedentary behavior (its total volume and accrual in prolonged, uninterrupted bouts) and all-cause mortality. Design: Prospective cohort study. Setting: Contiguous United States. Participants: 7985 black and white adults aged 45 years or older. Measurements: Sedentary time was measured using a hipmounted accelerometer. Prolonged, uninterrupted sedentariness was expressed as mean sedentary bout length. Hazard ratios (HRs) were calculated comparing quartiles 2 through 4 to quartile 1 for each exposure (quartile cut points: 689.7, 746.5, and 799.4 min/d for total sedentary time; 7.7, 9.6, and 12.4 min/ bout for sedentary bout duration) in models that included moderate to vigorous physical activity. Results: Over a median follow-up of 4.0 years, 340 participants died. In multivariable-adjusted models, greater total sedentary time (HR, 1.22 [95% CI, 0.74 to 2.02]; HR, 1.61 [CI, 0.99 to 2.63]; and HR, 2.63 [CI, 1.60 to 4.30]; P for trend < 0.001) and longer sedentary bout duration (HR, 1.03 [CI, 0.67 to 1.60]; HR, 1.22 [CI, 0.80 to 1.85]; and HR, 1.96 [CI, 1.31 to 2.93]; P for trend < 0.001) were both associated with a higher risk for all-cause mortality. Evaluation of their joint association showed that participants classified as high for both sedentary characteristics (high sedentary time [≥12.5 h/d] and high bout duration [≥10 min/bout]) had the greatest risk for death. Limitation: Participants may not be representative of the general U.S. population. Conclusion: Both the total volume of sedentary time and its accrual in prolonged, uninterrupted bouts are associated with all-cause mortality, suggesting that physical activity guidelines should target reducing and interrupting sedentary time to reduce risk for death. Primary Funding Source: National Institutes of Health.

    Original languageEnglish (US)
    Pages (from-to)465-475
    Number of pages11
    JournalAnnals of Internal Medicine
    Volume167
    Issue number7
    DOIs
    StatePublished - Oct 3 2017

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    Cohort Studies
    Mortality
    National Institutes of Health (U.S.)
    Prospective Studies
    Guidelines
    Population

    ASJC Scopus subject areas

    • Internal Medicine

    Cite this

    Diaz, K. M., Howard, V. J., Hutto, B., Colabianchi, N., Vena, J. E., Safford, M. M., ... Hooker, S. P. (2017). Patterns of sedentary behavior and mortality in U.S. middle-aged and older adults a national cohort study. Annals of Internal Medicine, 167(7), 465-475. https://doi.org/10.7326/M17-0212

    Patterns of sedentary behavior and mortality in U.S. middle-aged and older adults a national cohort study. / Diaz, Keith M.; Howard, Virginia J.; Hutto, Brent; Colabianchi, Natalie; Vena, John E.; Safford, Monika M.; Blair, Steven N.; Hooker, Steven P.

    In: Annals of Internal Medicine, Vol. 167, No. 7, 03.10.2017, p. 465-475.

    Research output: Contribution to journalArticle

    Diaz, KM, Howard, VJ, Hutto, B, Colabianchi, N, Vena, JE, Safford, MM, Blair, SN & Hooker, SP 2017, 'Patterns of sedentary behavior and mortality in U.S. middle-aged and older adults a national cohort study', Annals of Internal Medicine, vol. 167, no. 7, pp. 465-475. https://doi.org/10.7326/M17-0212
    Diaz, Keith M. ; Howard, Virginia J. ; Hutto, Brent ; Colabianchi, Natalie ; Vena, John E. ; Safford, Monika M. ; Blair, Steven N. ; Hooker, Steven P. / Patterns of sedentary behavior and mortality in U.S. middle-aged and older adults a national cohort study. In: Annals of Internal Medicine. 2017 ; Vol. 167, No. 7. pp. 465-475.
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    abstract = "Background: Excessive sedentary time is ubiquitous in Western societies. Previous studies have relied on self-reporting to evaluate the total volume of sedentary time as a prognostic risk factor for mortality and have not examined whether the manner in which sedentary time is accrued (in short or long bouts) carries prognostic relevance. Objective: To examine the association between objectively measured sedentary behavior (its total volume and accrual in prolonged, uninterrupted bouts) and all-cause mortality. Design: Prospective cohort study. Setting: Contiguous United States. Participants: 7985 black and white adults aged 45 years or older. Measurements: Sedentary time was measured using a hipmounted accelerometer. Prolonged, uninterrupted sedentariness was expressed as mean sedentary bout length. Hazard ratios (HRs) were calculated comparing quartiles 2 through 4 to quartile 1 for each exposure (quartile cut points: 689.7, 746.5, and 799.4 min/d for total sedentary time; 7.7, 9.6, and 12.4 min/ bout for sedentary bout duration) in models that included moderate to vigorous physical activity. Results: Over a median follow-up of 4.0 years, 340 participants died. In multivariable-adjusted models, greater total sedentary time (HR, 1.22 [95{\%} CI, 0.74 to 2.02]; HR, 1.61 [CI, 0.99 to 2.63]; and HR, 2.63 [CI, 1.60 to 4.30]; P for trend < 0.001) and longer sedentary bout duration (HR, 1.03 [CI, 0.67 to 1.60]; HR, 1.22 [CI, 0.80 to 1.85]; and HR, 1.96 [CI, 1.31 to 2.93]; P for trend < 0.001) were both associated with a higher risk for all-cause mortality. Evaluation of their joint association showed that participants classified as high for both sedentary characteristics (high sedentary time [≥12.5 h/d] and high bout duration [≥10 min/bout]) had the greatest risk for death. Limitation: Participants may not be representative of the general U.S. population. Conclusion: Both the total volume of sedentary time and its accrual in prolonged, uninterrupted bouts are associated with all-cause mortality, suggesting that physical activity guidelines should target reducing and interrupting sedentary time to reduce risk for death. Primary Funding Source: National Institutes of Health.",
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    AU - Diaz, Keith M.

    AU - Howard, Virginia J.

    AU - Hutto, Brent

    AU - Colabianchi, Natalie

    AU - Vena, John E.

    AU - Safford, Monika M.

    AU - Blair, Steven N.

    AU - Hooker, Steven P.

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    N2 - Background: Excessive sedentary time is ubiquitous in Western societies. Previous studies have relied on self-reporting to evaluate the total volume of sedentary time as a prognostic risk factor for mortality and have not examined whether the manner in which sedentary time is accrued (in short or long bouts) carries prognostic relevance. Objective: To examine the association between objectively measured sedentary behavior (its total volume and accrual in prolonged, uninterrupted bouts) and all-cause mortality. Design: Prospective cohort study. Setting: Contiguous United States. Participants: 7985 black and white adults aged 45 years or older. Measurements: Sedentary time was measured using a hipmounted accelerometer. Prolonged, uninterrupted sedentariness was expressed as mean sedentary bout length. Hazard ratios (HRs) were calculated comparing quartiles 2 through 4 to quartile 1 for each exposure (quartile cut points: 689.7, 746.5, and 799.4 min/d for total sedentary time; 7.7, 9.6, and 12.4 min/ bout for sedentary bout duration) in models that included moderate to vigorous physical activity. Results: Over a median follow-up of 4.0 years, 340 participants died. In multivariable-adjusted models, greater total sedentary time (HR, 1.22 [95% CI, 0.74 to 2.02]; HR, 1.61 [CI, 0.99 to 2.63]; and HR, 2.63 [CI, 1.60 to 4.30]; P for trend < 0.001) and longer sedentary bout duration (HR, 1.03 [CI, 0.67 to 1.60]; HR, 1.22 [CI, 0.80 to 1.85]; and HR, 1.96 [CI, 1.31 to 2.93]; P for trend < 0.001) were both associated with a higher risk for all-cause mortality. Evaluation of their joint association showed that participants classified as high for both sedentary characteristics (high sedentary time [≥12.5 h/d] and high bout duration [≥10 min/bout]) had the greatest risk for death. Limitation: Participants may not be representative of the general U.S. population. Conclusion: Both the total volume of sedentary time and its accrual in prolonged, uninterrupted bouts are associated with all-cause mortality, suggesting that physical activity guidelines should target reducing and interrupting sedentary time to reduce risk for death. Primary Funding Source: National Institutes of Health.

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