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Sedentary Behavior, Physical Activity, and All-Cause Mortality: Dose-Response and Intensity Weighted Time-Use Meta-analysis.

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机构: [1]Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China [2]Department of Population Medicine, College of Medicine, Qatar University, Doha, Qatar [3]Research School of Population Health, ANU College of Health and Medicine, Australian National University, Acton, Australia [4]Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China [5]Steno Diabetes Center Copenhagen, Gentofte, Denmark [6]Centre for Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Frederiksberg, Denmark [7]Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark [8]Division of Nutritional Sciences, Cornell University, Ithaca, NY [9]Fred Hutchinson Cancer Research Center, Seattle, WA [10]Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain [11]Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia [12]Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia [13]Swinburne University of Technology, Hawthorn, Victoria, Australia [14]Central Clinical School, Medicine, Monash University, Melbourne, Victoria, Australia
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关键词: Sedentary time physical activity all-cause mortality dose-response meta-analysis intensity-weighted time-use epidemiology

摘要:
Previous studies have placed those with excessive sedentary behavior at increased risk of all-cause mortality. There is evidence of interdependency of sedentary behavior with physical activity, and its elucidation will have implications for guidelines and practice. This study investigated if sedentary behavior-related mortality risk can be offset by moderate- to vigorous-intensity physical activity (MVPA) considered in a time-use fashion. PubMed was searched (from its inception till May 2018) for studies or meta-analyses that used data harmonized for MVPA. Of the 17 data-custodians located, 7 provided data on sitting time or TV viewing time, or both. A dose-response meta-analysis modeling log relative risks of all-cause mortality against uncompensated sedentary behavior metabolic equivalent hours (USMh) was run using the robust error meta-regression method. (Registration: CRD42017062439) SETTING: Individual subject data held by data custodians on this topic. General adults. Sedentary time, MVPA. Five harmonized cohorts of sitting time (258,688 participants) and 4 of TV viewing time (156,593 participants) demonstrated that sedentary behavior was significantly associated with mortality, but this risk was attenuated with increasing energy expenditure through MVPA modeled in a time-use fashion. The average increment in mortality per USMh spent on sitting was 1% [relative risk (RR) 1.01, 95% confidence interval (CI) 1.00, 1.02; P = .01] and that per USMh spent on TV viewing was 7% (RR 1.07, 95% CI 1.04, 1.10; P < .001). The thresholds for risk started at 7 USMh for sitting and 3 USMh for TV viewing. Our findings suggest that overall daily sitting time energy expenditure of 7 MET-hours (or TV viewing of 3 MET-hours) in excess of that expended on MVPA is independently related to all-cause mortality. These findings support the view that sitting is strongly influenced by consideration of concurrent MVPA in its impact on adverse health consequences and that the USMh is a more practical metric of sedentary behavior. Copyright © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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大类 | 2 区 医学
小类 | 2 区 老年医学
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 老年医学
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第一作者机构: [1]Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
通讯作者:
通讯机构: [2]Department of Population Medicine, College of Medicine, Qatar University, Doha, Qatar [*1]Department of Population Medicine, College of Medicine, Qatar University, Al Jamiaa Street, P.O. Box 2713, Doha, Qatar
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