Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis
Tóm tắt
Sedentary (sitting) behaviours are ubiquitous in modern society. We conducted a systematic review and meta-analysis to examine the association of sedentary time with diabetes, cardiovascular disease and cardiovascular and all-cause mortality. Medline, Embase and the Cochrane Library databases were searched for terms related to sedentary time and health outcomes. Cross-sectional and prospective studies were included. RR/HR and 95% CIs were extracted by two independent reviewers. Data were adjusted for baseline event rate and pooled using a random-effects model. Bayesian predictive effects and intervals were calculated to indicate the variance in outcomes that would be expected if new studies were conducted in the future. Eighteen studies (16 prospective, two cross-sectional) were included, with 794,577 participants. Fifteen of these studies were moderate to high quality. The greatest sedentary time compared with the lowest was associated with a 112% increase in the RR of diabetes (RR 2.12; 95% credible interval [CrI] 1.61, 2.78), a 147% increase in the RR of cardiovascular events (RR 2.47; 95% CI 1.44, 4.24), a 90% increase in the risk of cardiovascular mortality (HR 1.90; 95% CrI 1.36, 2.66) and a 49% increase in the risk of all-cause mortality (HR 1.49; 95% CrI 1.14, 2.03). The predictive effects and intervals were only significant for diabetes. Sedentary time is associated with an increased risk of diabetes, cardiovascular disease and cardiovascular and all-cause mortality; the strength of the association is most consistent for diabetes.
Tài liệu tham khảo
Morris JN, Heady JA, Raffle PA, Roberts CG, Parks JW (1953) Coronary heart-disease and physical activity of work. Lancet 265:1111–1120
Healy GN, Matthews CE, Dunstan DW, Winkler EAH, Owen N (2011) Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06. Eur Heart J 32:590–597
Pate RR, O'Neill JR, Lobelo F (2008) The evolving definition of "sedentary". Exerc Sport Sci Rev 36:173–178
Sedentary Behaviour Research Network (2012) Letter to the Editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab 37:540–542
van Uffelen JGZ, Wong J, Chau JY et al (2010) Occupational sitting and health risks: a systematic review. Am J Prev Med 39:379–388
Proper KI, Singh AS, van Mechelen W, Chinapaw MJM (2011) Sedentary behaviors and health outcomes among adults: a systematic review of prospective studies. Am J Prev Med 40:174–182
Grøntved A, Hu FB (2011) Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis. JAMA 305:2448–2455
Sugiyama T, Healy GN, Dunstan DW, Salmon J, Owen N (2008) Is television viewing time a marker of a broader pattern of sedentary behavior? Ann Behav Med 35:245–250
Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 283:2008–2012
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsch PC, Vandenbroucke JP (2008) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349
Zhang J, Yu KF (1998) What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 280:1960–1961
Arends LR, Hoes AW, Lubsen J, Grobbee DE, Stijnen T (2000) Baseline risk as predictor of treatment benefit: three clinical meta-re-analyses. Stat Med 19:3497–3518
Sharp SJ, Thompson SG (2000) Analysing the relationship between treatment effect and underlying risk in meta-analysis: comparison and development of approaches. Stat Med 19:3251–3274
Ades AE, Lu G, Higgins JPT (2005) The interpretation of random-effects meta-analysis in decision models. Med Decis Making 25:646–654
Higgins JPT, Thompson SG, Spiegelhalter DJ (2009) A re-evaluation of random-effects meta-analysis. J R Stat Soc Ser A Stat Soc 172:137–159
Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L (2008) Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol 61:991–996
Sterne JAC, Sutton AJ, Ioannidis JPA et al (2011) Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 343:d4002–d4002
Duval S, Tweedie R (2000) Trim and fill: a simple funnel-plot based method of testing and adjusting for publication bias in meta-analysis. Biometrics 56:455–463
Spiegelhalter D, Thomas A, Lunn D (2007) WinBUGS User Manual Version 1.4 January 2003. Upgraded to Version 1.4.3. 2007
Stamatakis E, Hamer M, Lawlor DA (2009) Physical activity, mortality, and cardiovascular disease: is domestic physical activity beneficial? The Scottish Health Survey—1995, 1998, and 2003. Am J Epidemiol 169:1191–1200
Dunstan DW, Salmon J, Owen N et al (2004) Physical activity and television viewing in relation to risk of undiagnosed abnormal glucose metabolism in adults. Diabetes Care 27:2603–2609
Hu FB, Leitzmann MF, Stampfer MJ, Colditz GA, Willett WC, Rimm EB (2001) Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men. Arch Intern Med 161:1542–1548
Hu FB, Li TY, Colditz GA, Willett WC, Manson JE (2003) Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 289:1785–1791
Ford ES, Schulze MB, Kroger J, Pischon T, Bergmann MM, Boeing H (2010) Television watching and incident diabetes: findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. J Diabetes 2:23–27
Krishnan S, Rosenberg L, Palmer JR (2009) Physical activity and television watching in relation to risk of type 2 diabetes: the Black Women's Health Study. Am J Epidemiol 169:428–434
Tonstad S, Butler T, Yan R, Fraser GE (2009) Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 32:791–796
Stamatakis E, Hamer M, Dunstan DW (2011) Screen-based entertainment time, all-cause mortality, and cardiovascular events: population-based study with ongoing mortality and hospital events follow-up. J Am Coll Cardiol 57:292–299
Matthews CE, George SM, Moore SC et al (2012) Amount of time spent in sedentary behaviors and cause-specific mortality in US adults. Am J Clin Nutr 95:437–445
Hawkes AL, Lynch BM, Owen N, Aitken JF (2011) Lifestyle factors associated concurrently and prospectively with co-morbid cardiovascular disease in a population-based cohort of colorectal cancer survivors. Eur J Cancer 47:267–276
Wijndaele K, Brage S, Besson H et al (2011) Television viewing and incident cardiovascular disease: prospective associations and mediation analysis in the EPIC Norfolk Study. PLoS One 6:e20058
Manson JE, Greenland P, LaCroix AZ et al (2002) Walking compared with vigorous exercise for the prevention of cardiovascular events in women. N Engl J Med 347:716–725
Dunstan DW, Barr EL, Healy GN et al (2010) Television viewing time and mortality: the Australian Diabetes, Obesity And Lifestyle Study (AusDiab). Circulation 121:384–391
Katzmarzyk PT, Church TS, Craig CL, Bouchard C (2009) Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc 41:998–1005
Patel AV, Bernstein L, Deka A et al (2010) Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epid 172:419–429
Warren TY, Barry V, Hooker S, Sui X, Church T, Blair S (2010) Sedentary behaviors increase risk of cardiovascular disease mortality in men. Med Sci Sports Exerc 42:879–885
Wijndaele K, Brage S, Besson H et al (2011) Television viewing time independently predicts all-cause and cardiovascular mortality: the EPIC Norfolk Study. Int J Epidemiol 40:150–159
Weller I, Corey P (1998) The impact of excluding non-leisure energy expenditure on the relation between physical activity and mortality in women. Epidemiology 9:632–635
Inoue M, Yamamoto S, Kurahashi N et al (2008) Daily total physical activity level and total cancer risk in men and women: results from a large-scale population-based cohort study in Japan. Am J Epidemiol 168:391–403
Marshall SJ, Biddle SJH, Sallis JF, McKenzie TL, Conway TL (2002) Clustering of sedentary behaviours and physical activity among youth: a cross-national study. Pediatr Exerc Sci 14:401–417
Biddle SJH, Marshall SJ, Gorely T, Cameron N (2009) Temporal and environmental patterns of sedentary and active behaviors during adolescents’ leisure time. Int J Behav Med 16:278–286
Healy GN, Wijndaele K, Dunstan DW et al (2008) Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care 31:369–371
Hamilton MT, Healy GN, Dunstan DW, Zderic TW, Owen N (2008) Too little exercise and too much sitting: inactivity physiology and the need for new recommendations on sedentary behavior. Curr Cardiovasc Risk Rep 2:292–298
Bey L, Hamilton MT (2003) Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity. J Physiol 551:673–682
Seider MJ, Nicholson WF, Booth FW (1982) Insulin resistance for glucose metabolism in disused soleus muscle of mice. Am J Physiol 242:E12–E18
Hamburg NM, McMackin CJ, Huang AL et al (2007) Physical inactivity rapidly induces insulin resistance and microvascular dysfunction in healthy volunteers. Arterioscler Thromb Vasc Biol 27:2650–2656
Alibegovic AC, Sonne MP, Højbjerre L et al (2010) The T-allele of TCF7L2 rs7903146 associates with a reduced compensation of insulin secretion for insulin resistance induced by 9 days of bed rest. Diabetes 59:836–843
Stephens BR, Granados K, Zderic TW, Hamilton MT, Braun B (2011) Effects of 1 day of inactivity on insulin action in healthy men and women: interaction with energy intake. Metabolism 60:941–949
Dunstan DW, Kingwell BA, Larsen R et al (2012) Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care 35:976–983
Clark BK, Sugiyama T, Healy GN, Salmon J, Dunstan DW, Owen N (2009) Validity and reliability of measures of television viewing time and other non-occupational sedentary behaviour of adults: a review. Obes Rev 10:7–16
Biddle SJH, O’Connell S, Braithwaite RE (2011) Sedentary behaviour interventions in young people: a meta-analysis. Br J Sports Med 45:937–942
Wilmot EG, Davies MJ, Edwardson CL et al (2011) Rationale and study design for a randomised controlled trial to reduce sedentary time in adults at risk of type 2 diabetes mellitus: project stand (sedentary time and diabetes). BMC Publ Health 11:908
Gardiner PA, Eakin EG, Healy GN, Owen N (2011) Feasibility of reducing older adults' sedentary time. Am J Prev Med 41:174–177