Replacement of sedentary behavior with various physical activities and the risk of all-cause and cause-specific mortality

• Published in: BMC medicine Vol. 22; no. 1; pp. 385 - 14
• Main Authors: Chang, Qinyu, Zhu, Yiqun, Liu, Zhichen, Cheng, Jun, Liang, Huaying, Lin, Fengyu, Li, Dianwu, Peng, Juan, Pan, Pinhua, Zhang, Yan
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.09.2024; BioMed Central; BMC
• Subjects: Adult; Aged; Biobanks; Cancer; Cardiovascular diseases; Cardiovascular Diseases - mortality; Cardiovascular Diseases - prevention & control; Cause of Death; China; Digestive system diseases; Exercise; Exercise - physiology; Female; Health aspects; Heart diseases; Humans; Luminous intensity; Male; Methods; Middle Aged; Mortality; Neoplasms - mortality; NHANES; Physical activity; Population; Predation; Prevention; Proportional Hazards Models; Prospective Studies; Questionnaires; Regression analysis; Regression models; Respiratory diseases; Respiratory Tract Diseases - mortality; Risk; Risk Factors; Risk taking; Sedentary Behavior; Socioeconomic factors; Statistical analysis; Substitutes; UK Biobank; United Kingdom - epidemiology; United Kingdom; China; United Kingdom > UK; United States > US; Sedentary behavior; NHANES; Physical activity; UK Biobank; Mortality
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-024-03599-2

Sedentary behavior (SB) has emerged as a significant health concern that deserves attention. This study aimed to examine the associations between prolonged sedentary behavior and the risk of all-cause and cause-specific mortality as well as to explore desirable alternatives to sitting in terms of physical activity (PA). Two prospective cohort investigations were conducted using the UK Biobank and NHANES datasets, with a total of 490,659 and 33,534 participants, respectively. Cox proportional hazards regression models were used to estimate the associations between SB and the risk of all-cause and cause-specific mortality due to cancer, cardiovascular disease (CVD), respiratory diseases, and digestive diseases. In addition, we employed isotemporal substitution models to examine the protective effect of replacing sitting with various forms of PA. During the average follow-up times of 13.5 and 6.7 years, 36,109 and 3057 deaths were documented in the UK Biobank and NHANES, respectively. Both cohorts demonstrated that, compared with individuals sitting less than 5 h per day, individuals with longer periods of sitting had higher risks of all-cause and cause-specific mortality due to cancer, CVD, and respiratory diseases but not digestive diseases. Moreover, replacing SB per day with PA, even substituting 30 min of walking for pleasure, reduced the risk of all-cause mortality by 3.5% (hazard ratio [HR] 0.965, 95% confidence interval [CI] 0.954-0.977), whereas cause-specific mortality from cancer, CVD, and respiratory diseases was reduced by 1.6% (HR 0.984, 95% CI 0.968-1.000), 4.4% (HR 0.956, 95% CI 0.930-0.982), and 15.5% (HR 0.845, 95% CI 0.795-0.899), respectively. Furthermore, the protective effects of substitution became more pronounced as the intensity of exercise increased or the alternative duration was extended to 1 h. SB was significantly correlated with substantially increased risks of all-cause mortality and cause-specific mortality from cancer, CVD, and respiratory diseases. However, substituting sitting with various forms of PA, even for short periods involving relatively light and relaxing physical activity, effectively reduced the risk of both overall and cause-specific mortality.