Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis
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PURPOSE: To estimate the strength and shape of the dose-response relationship between sedentary behaviour and all-cause, cardiovascular disease (CVD) and cancer mortality, and incident type 2 diabetes (T2D), adjusted for physical activity (PA). Data Sources: Pubmed, Web of Knowledge, Medline, Embase, Cochrane Library and Google Scholar (through September-2016); reference lists. Study Selection: Prospective studies reporting associations between total daily sedentary time or TV viewing time, and ≥ one outcome of interest. Data Extraction: Two independent reviewers extracted data, study quality was assessed; corresponding authors were approached where needed. Data Synthesis: Thirty-four studies (1,331,468 unique participants; good study quality) covering 8 exposure-outcome combinations were included. For total sedentary behaviour, the PA-adjusted relationship was non-linear for all-cause mortality (RR per 1 h/day: were 1.01 (1.00-1.01) ≤ 8 h/day; 1.04 (1.03-1.05) > 8 h/day of exposure), and for CVD mortality (1.01 (0.99-1.02) ≤ 6 h/day; 1.04 (1.03-1.04) > 6 h/day). The association was linear (1.01 (1.00-1.01)) with T2D and non-significant with cancer mortality. Stronger PA-adjusted associations were found for TV viewing (h/day); non-linear for all-cause mortality (1.03 (1.01-1.04) ≤ 3.5 h/day; 1.06 (1.05-1.08) > 3.5 h/day) and for CVD mortality (1.02 (0.99-1.04) ≤ 4 h/day; 1.08 (1.05-1.12) > 4 h/day). Associations with cancer mortality (1.03 (1.02-1.04)) and T2D were linear (1.09 (1.07-1.12)). CONCLUSIONS: Independent of PA, total sitting and TV viewing time are associated with greater risk for several major chronic disease outcomes. For all-cause and CVD mortality, a threshold of 6-8 h/day of total sitting and 3-4 h/day of TV viewing was identified, above which the risk is increased.
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Thresholds of 6-8 hours per day for total sitting and 3-4 hours per day for TV viewing have been identified above which all-cause and cardiovascular disease mortality risk is increased.
“a threshold of 6-8 and 3-4 h/ day has been identified for total sitting and TV viewing, respectively, above which the risk of all-cause and CVD mortality is increased.14”
From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [14]
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- Authors
- Patterson, R., McNamara, E., Tainio, M., de Sá, T. H., Smith, A. D., Sharp, S. J., Edwards, P., Woodcock, J., Brage, S., & Wijndaele, K.
- Affiliations
- Imperial College London (GB)
- University of Cambridge (GB)
- University College London (GB)
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Patterson, Richard
- ORCID
- Venue
- European Journal of Epidemiology
- Published
- 2018-03-28
- Volume
- 33
- Issue
- 9
- Pages
- 811-829
- ISSN
- 0393-2990 (ISSN-L)
- 1573-7284
- PMC
- PMC6133005
- OpenAlex
- W2794463825
- Cited by
- 1,423
- References
- 99
- Citations by year
- 2026: 118 · 2025: 188 · 2024: 247 · 2023: 202 · 2022: 206 · 2021: 169 · 2020: 184 · 2019: 88 · 2018: 21
- FWCI
- 15.20
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Epidemiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- British Heart Foundation (FS/12/58/29709)
- Medical Research Council (MC_UU_12015/3, MC_UU_12015/1)
- Cancer Research UK
- Economic and Social Research Council
- National Institute for Health Research
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Keywords
- sedentary behavior, sitting time, television viewing, all-cause mortality, cardiovascular mortality, cancer mortality, type 2 diabetes, dose-response relationship, physical activity, nonlinear relationship, threshold effects, chronic disease risk
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Humans, Male, Neoplasms, Television, Time Factors, Exercise, Sedentary Behavior
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