Independent and joint effects of sedentary time and cardiorespiratory fitness on all-cause mortality: the Cooper Center Longitudinal Study

• Published in: BMJ open Vol. 5; no. 10; p. e008956
• Main Authors: Shuval, Kerem, Finley, Carrie E, Barlow, Carolyn E, Nguyen, Binh T, Njike, Valentine Y, Pettee Gabriel, Kelley
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.01.2015; BMJ Publishing Group
• Subjects: Adult; Alcohol; Automobile Driving; Blood pressure; Body Mass Index; Cardiovascular disease; Cardiovascular System; Chronic illnesses; Diabetes; Disease prevention; Epidemiology; Exercise; Exercise Test; Family medical history; Female; Fitness equipment; Gender; Health care; Health risk assessment; Health Status; Humans; Longitudinal Studies; Male; Mens health; Metabolic syndrome; Middle Aged; Mortality; Physical Fitness; Preventive medicine; Proportional Hazards Models; Prospective Studies; Public Health; Risk Factors; Sedentary Behavior; Television; Womens health; United States > US; PUBLIC HEALTH; PREVENTIVE MEDICINE; EPIDEMIOLOGY
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2015-008956

ObjectivesTo examine the independent and joint effects of sedentary time and cardiorespiratory fitness (fitness) on all-cause mortality.Design, setting, participantsA prospective study of 3141 Cooper Center Longitudinal Study participants. Participants provided information on television (TV) viewing and car time in 1982 and completed a maximal exercise test during a 1-year time frame; they were then followed until mortality or through 2010. TV viewing, car time, total sedentary time and fitness were the primary exposures and all-cause mortality was the outcome. The relationship between the exposures and outcome was examined utilising Cox proportional hazard models.ResultsA total of 581 deaths occurred over a median follow-up period of 28.7 years (SD=4.4). At baseline, participants’ mean age was 45.0 years (SD=9.6), 86.5% were men and their mean body mass index was 24.6 (SD=3.0). Multivariable analyses revealed a significant linear relationship between increased fitness and lower mortality risk, even while adjusting for total sedentary time and covariates (p=0.02). The effects of total sedentary time on increased mortality risk did not quite reach statistical significance once fitness and covariates were adjusted for (p=0.05). When examining this relationship categorically, in comparison to the reference category (≤10 h/week), being sedentary for ≥23 h weekly increased mortality risk by 29% without controlling for fitness (HR=1.29, 95% CI 1.03 to 1.63); however, once fitness and covariates were taken into account this relationship did not reach statistical significance (HR=1.20, 95% CI 0.95 to 1.51). Moreover, spending >10 h in the car weekly significantly increased mortality risk by 27% in the fully adjusted model. The association between TV viewing and mortality was not significant.ConclusionsThe relationship between total sedentary time and higher mortality risk is less pronounced when fitness is taken into account. Increased car time, but not TV viewing, is significantly related to higher mortality risk, even when taking fitness into account, in this cohort.