Cited by 340Physical Activity and HealthContext-Aware Activity Recognition SystemsHealth disparities and outcomes

The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index; none of the 9 sources its claims cite is checked for support yet.

Association of Sedentary Time with Mortality Independent of Moderate to Vigorous Physical Activity

Open access

Abstract

BACKGROUND: Sedentary behavior has emerged as a novel health risk factor independent of moderate to vigorous physical activity (MVPA). Previous studies have shown self-reported sedentary time to be associated with mortality; however, no studies have investigated the effect of objectively measured sedentary time on mortality independent of MVPA. The objective our study was to examine the association between objectively measured sedentary time and all-cause mortality. METHODS: 7-day accelerometry data of 1906 participants aged 50 and over from the U.S. nationally representative National Health and Nutrition Examination Survey (NHANES) 2003-2004 were analyzed. All-cause mortality was assessed from the date of examination through December 31, 2006. RESULTS: Over an average follow-up of 2.8 years, there were 145 deaths reported. In a model adjusted for sociodemographic factors, lifestyle factors, multiple morbidities, mobility limitation, and MVPA, participants in third quartile (hazard ratio (HR):4.05; 95%CI:1.55-10.60) and fourth quartile (HR:5.94; 95%CI: 2.49-14.15) of having higher percent sedentary time had a significantly increased risk of death compared to those in the lowest quartile. CONCLUSIONS: Our study suggests that sedentary behavior is a risk factor for mortality independent of MVPA. Further investigation, including studies with longer follow-up, is needed to address the health consequences of sedentary behavior.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In a nationally representative sample of US adults aged 50 and older, objectively measured sedentary time was associated with higher all-cause mortality after adjustment that included moderate to vigorous physical activity (MVPA). The association persisted in sensitivity analyses, but follow-up was short.

Key findings

  • Over an average 2.8 years of follow-up, 145 deaths occurred among 1,906 participants. In the fully adjusted model, the highest quartile of sedentary hours had an HR of 3.26 (95% CI: 1.59–6.69) for mortality compared with the lowest quartile.
  • For percent sedentary time, fully adjusted mortality HRs were 4.05 (95% CI: 1.55–10.60) in the third quartile and 5.94 (95% CI: 2.49–14.15) in the fourth quartile compared with the lowest quartile.
  • MVPA was also associated with mortality: the lowest quartile of MVPA had an HR of 5.60 (95% CI: 2.25–13.96) compared with the highest quartile in a model adjusted for sociodemographic factors, lifestyle factors, morbidities, and mobility limitation.
  • Sensitivity analyses excluding participants with mobility limitation, diabetes/coronary heart disease/congestive heart failure/stroke, cancer, or the first year of follow-up showed that positive associations between sedentary time and mortality remained; results were similar when selecting participants with 4 or more valid accelerometry days.

Methods

  • The study analyzed 2003–2004 NHANES accelerometry data from 1,941 participants aged 50 and older with at least 1 valid day of accelerometry data (≥10 hours wear time); 35 participants with missing mortality or covariate data were excluded, leaving 1,906 for analysis.
  • Sedentary time was measured with a uniaxial ActiGraph AM-7164 accelerometer and defined as counts per minute below 100; percent sedentary time was total sedentary time divided by total wear time; MVPA was defined as counts per minute ≥2020. Mortality was assessed through December 31, 2006 via linkage to the National Death Index.
  • Cox proportional hazard models estimated hazard ratios by gender-specific quartiles of sedentary time, with progressive adjustment for sociodemographic factors, lifestyle factors, morbidities, mobility limitation, and MVPA; interactions with gender and age were not statistically significant (all p>0.10), and analyses accounted for the complex survey design and sample weights.

Limitations

  • The paper states that accelerometers are not sensitive to all activities, such as standing still, upper body movements, and biking; the MVPA cutpoint based primarily on younger adults may underestimate MVPA in older adults, potentially leading to residual confounding; and the sedentary cutpoint’s accuracy may vary by age, though small cutpoint variations were judged unlikely to affect quartile classification.
  • The paper states that the short follow-up may increase the risk of reverse causation, that unknown or unmeasured factors may account for some associations, and that longer follow-up and larger studies are needed.
  • Evident from the text: the observational design cannot establish causality, and the sample is restricted to US adults aged 50 and older with only 2.8 years average follow-up and 145 deaths, limiting precision and generalizability.

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Integrity signals

Registry

Crossref · 10.1371/journal.pone.0037696

Cites

20 of 20 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 9 cited sources checked · 0 supported · 0 flagged

Show all 14 claims

  • The quote only partly states this claim. 2
  • Probably not a substantial claim. 11
  • It may state two separate claims as one. 6
14 of 14
  • The paper relies on this without support.

    No studies have investigated the effect of objectively measured sedentary behavior on mortality and whether this association is independent of MVPA.

    “however, no studies have investigated the effect of objectively measured sedentary time on mortality independent of MVPA.”
    “To our knowledge no studies have investigated the effect of objectively measured sedentary behavior on mortality and whether this association is independent of MVPA.”
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Claims other papers make about this one

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting sample sizes for the four-valid-day analysis

    Minor

    The Results give 1,701 participants, while Table 4 gives 1,711. The quartile counts in Table 4 also sum to 1,711.

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Metadata

Authors
Koster, A., Caserotti, P., Patel, K. V., Matthews, C. E., Berrigan, D., Van Domelen, D. R., Brychta, R. J., Chen, K. Y., & Harris, T. B.
Affiliations
  • National Institutes of Health (US)
  • University of Southern Denmark (DK)
  • National Institute on Aging (US)
  • National Cancer Institute (US)
Corresponding author
Koster, Annemarie
Venue
PLoS ONE
Published
2012-06-13
Volume
7
Issue
6
Pages
e37696
ISSN
1932-6203 (ISSN-L)
OpenAlex
W1978604479
Cited by
340
References
20
Citations by year
2026: 6 · 2025: 4 · 2024: 14 · 2023: 18 · 2022: 14 · 2021: 29 · 2020: 23 · 2019: 29 · 2018: 26 · 2017: 32 · 2016: 45 · 2015: 37 · 2014: 35 · 2013: 25 · 2012: 3
FWCI
21.45
Type
journal article
Language
en
Open access
Locations
  • PLoS ONE (publishedVersion, public-domain)
  • PubMed Central (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
  • Research Publications (Maastricht University) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
  • Social Sciences › Health › Health disparities and outcomes
Keywords
sedentary behavior, all-cause mortality, moderate-to-vigorous physical activity, accelerometry, older adults, mortality risk factors, physical inactivity
MeSH terms
Aged, Female, Humans, Male, Middle Aged, Mortality, Motor Activity, Sedentary Behavior

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