All-cause mortality effects of replacing sedentary time with physical activity and sleeping using an isotemporal substitution model: a prospective study of 201,129 mid-aged and older adults

International Journal of Behavioral Nutrition and Physical Activity

Adrian Bauman³  Mark Hamer¹  Josephine Chau³  David Berrigan⁴  Ding Ding²  Kris Rogers³  Emmanuel Stamatakis⁵ 

[1] National Centre for Sport & Exercise Medicine, Loughborough University, Loughborough, UK;Graduate School of Public Health, San Diego State University, San Diego, CA, USA;Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, Australia;National Cancer Institute, Behavioral Research Program, Division of Cancer Control and Population Sciences, Bethesda, MD, USA;UCL-PARG (Physical Activity Research Group), Department of Epidemiology and Public Health, University College London, London, UK

关键词: Population cohort;    Public health;    Sleeping;    Epidemiology;    Mortality;    Screen time;    Sitting;    Prevention;    Isotemporal substitution;    Longitudinal;    Mortality;    Sedentary behaviour;    Physical activity;   

Others  :  1231250
DOI  :  10.1186/s12966-015-0280-7

 received in 2015-04-20, accepted in 2015-09-12,  发布年份 2015

【 摘 要 】

Background

Sedentary behaviour, sleeping, and physical activity are thought to be independently associated with health outcomes but it is unclear whether these associations are due to the direct physiological effects of each behaviour or because, across a finite 24-hour day, engagement in one behavior requires displacement of another. The aim of this study was to examine the replacement effects of sedentary behaviour (total sitting, television/computer screen time combined), sleeping, standing, walking, and moderate-to-vigorous physical activity on all-cause mortality using isotemporal substitution modelling.

Methods

Longitudinal analysis (4.22 ± 0 · 9 years follow-up/849,369 person-years) of 201,129 participants of the 45 and Up study aged ≥45 years from New South Wales, Australia.

Results

Seven thousand four hundred and sixty deaths occurred over follow-up. There were beneficial associations for replacing total sitting time with standing (per-hour HR: 95 % CI: 0.95, 0.94–0.96), walking (0.86, 0.81–0.90), moderate-to-vigorous physical activity (0.88, 0.85–0.90), and sleeping in those sleeping ≤ 7 h/day (0.94, 0.90–0.98). Similar associations were noted for replacing screen time. Replacing one hour of walking or moderate-to-vigorous physical activity with any other activity class was associated with an increased mortality risk by 7–18 %. Excluding deaths in the first 24 months of the follow up and restricting analyses to those who were healthy at baseline did not materially change the above observations.

Conclusion

Although replacing sedentary behaviour with walking and moderate-to-vigorous physical activity are associated with the lowest mortality risk, replacements with equal amounts of standing and sleeping (in low sleepers only) are also linked to substantial mortality risk reductions.

【 授权许可】

   
2015 Stamatakis et al.

【 参考文献 】

• [1]Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–29.
• [2]Network SBR. Standardized use of the terms “sedentary” and “sedentary behaviours. Appl  Physiol  Nutr  Metab. 2012;37:540–2.
• [3]Chau JY, Grunseit AC, Chey T, Stamatakis E, Brown WJ, Matthews CE, et al. Daily Sitting Time and All-Cause Mortality: A Meta-Analysis. PLoS ONE. 2013;8(11), e80000.
• [4]van der Ploeg HP, Chey T, Korda RJ, Banks E, Bauman A. Sitting Time and All-Cause Mortality Risk in 222 497 Australian Adults. Arch Intern Med. 2012; 172(6):494-500.
• [5]Grøntved A, Hu FB. Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality. JAMA. 2011; 305(23):2448-2455.
• [6]Stamatakis E, Hamer M, Dunstan DW. Screen-Based Entertainment Time, All-Cause Mortality, and Cardiovascular EventsPopulation-Based Study With Ongoing Mortality and Hospital Events Follow-Up. J Am Coll Cardiol. 2011;57(3):292–9.
• [7]Cappuccio F, D’Elia L, Strazzullo P, Miller M. Sleep Duration and All-Cause Mortality: A Systematic Review and Meta-Analysis of Prospective Studies. Sleep. 2010; 33(5):585-592.
• [8]Moore SC, Patel AV, Matthews CE, Berrington de Gonzalez A, Park Y, Katki HA, et al. Leisure Time Physical Activity of Moderate to Vigorous Intensity and Mortality: A Large Pooled Cohort Analysis. PLoS Med. 2012;9(11), e1001335.
• [9]Magee CA, Holliday EG, Attia J, Kritharides L, Banks E. Investigation of the relationship between sleep duration, all-cause mortality, and preexisting disease. Sleep Med. 2013;14(7):591–6.
• [10]Mekary RA, Lucas M, Pan A, Okereke OI, Willett WC, Hu FB, et al. Isotemporal Substitution Analysis for Physical Activity, Television Watching, and Risk of Depression. Am J Epidemiol. 2013;178(3):474–83.
• [11]Hamer M, Stamatakis E, Steptoe A. Effects of substituting sedentary time with physical activity on metabolic risk. Med Sci Sports Exerc. 2014 Mar 28 [ePub]
• [12]Buman M, Winkler E, Kurka J, Hekler E, Baldwin C, Owen N, et al. Reallocating Time to Sleep, Sedentary Behaviors, or Active Behaviors: Associations With Cardiovascular Disease Risk Biomarkers, NHANES. Am J Epidemiol 2014. 2005;179(3):323–34.
• [13]Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International Physical Activity Questionnaire: 12-Country Reliability and Validity. Med Sci Sports Exe. 2003;35(8):1381–95.
• [14]Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International Physical Activity Questionnaire: 12-Country Reliability and Validity. Med Sci Sports Exe. 2003;35(8):1381–95.
• [15]Timperio A, Salmon J, Rosenberg M, Bull FC. Do Logbooks Influence Recall of Physical Activity in Validation Studies? Med Sci Sports Exe. 2004;36(7):1181–6.
• [16]Brown WJ, Burton NW, Marshall AL, Miller YD. Reliability and validity of a modified self-administered version of the Active Australia physical activity survey in a sample of mid-age women. Aust N Z J Public Health. 2008;32(6):535–41.
• [17]Reeves M, Marshall A, Owen N, Winkler E, Eakin E. Measuring physical activity change in broad-reach intervention trials. J Phys Act Health. 2010;7(2):194–202.
• [18]Ng SP, Korda R, Clements M, Latz I, Bauman A, Bambrick H, et al. Validity of self-reported height and weight and derived body mass index in middle-aged and elderly individuals in Australia. Aust N Z J Public Health. 2011;35(6):557–63.
• [19]Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Med. 2002;32(6):959–76.
• [20]Little R, Rubin D. Statistical Analysis with Missing Data. 2nd ed. John Wiley & Sons, New York; 2002.
• [21]Chief Medical Officers UK. Physical Activity, Health Improvement and Protection. Start Active, Stay Active. A report on physical activity for health from the four home counties. Department of Health, London; 2011.
• [22]Marshall SJ, Ramirez E. Reducing Sedentary Behavior: A New Paradigm in Physical Activity Promotion. Am J Lifestyle Med. 2011;5(6):518–30.
• [23]Alkhajah TA, Reeves MM, Eakin EG, Winkler EAH, Owen N, Healy GN. Sit–Stand Workstations: A Pilot Intervention to Reduce Office Sitting Time. Am J Prev Med. 2012;43(3):298–303.
• [24]Katzmarzyk PT. Standing and Mortality in a Prospective Cohort of Canadian Adults. Med Sci Sports Exe. 2014;46(5):940–6.
• [25]Bey L, Hamilton MT. Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity. J Physiol. 2003; 551:673-682.
• [26]Thorp AA, Kingwell BA, Sethi P, Hammond L, Owen N, Dunstan DW. Alternating Bouts of Sitting and Standing Attenuates Postprandial Glucose Responses. Med Sci Sports Exerc. 2014; 46:2053-2061.
• [27]Bailey DP, Locke CD. Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not. J  Sci  Med  Sport. 2014.
• [28]Miyashita M, Park JH, Takahashi M, Suzuki K, Stensel D, Nakamura Y. Postprandial lipaemia: effects of sitting, standing and walking in healthy normolipidaemic humans. Int J Sports Med. 2013;34(1):21–7.
• [29]Buckley JP, Mellor DD, Morris M, Joseph F. Standing-based office work shows encouraging signs of attenuating post-prandial glycaemic excursion. J Occup Env Med. 2013;71:109–11.
• [30]Dunstan DW, Kingwell BA, Larsen R, Healy GN, Cerin E, Hamilton MT, et al. Breaking Up Prolonged Sitting Reduces Postprandial Glucose and Insulin Responses. Diabetes Care. 2012;35(5):976–83.
• [31]Basner M, Fomberstein K, Razavi F, Banks S, William J, Roger R, et al. American time use survey: Sleep time and its relationship to waking activities. Sleep. 2007;30:1085–95.
• [32]Jurakic D, Andrijasevic M, Pedisic Z. Assessment of workplace characteristics and physical activity preferences as integral part of physical activity promotion strategies for middle-aged employees. Sociologija i Prostor. 2010; 48:113-131.
• [33]Davis MG, Fox KR, Hillsdon M, Sharp DJ, Coulson JC, Thomson JL. Objectively Measured Physical Activity in a Diverse Sample of Older Urban UK Adults. Med Sci Sports Exe. 2011;43(4):647–54. 610.1249/MSS.1240b1013e3181f36196.
• [34]Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol. 2008;167(7):875–81.
• [35]Mealing NM, Banks E, Jorm LR, Steel DG, Clements MS, Rogers KD. Investigation of relative risk estimates from studies of the same population with contrasting response rates and designs. BMC Med Res Methodol. 2010;10:26.