Amount of time spent in sedentary behaviors and cause-specific mortality in US adults
Open accessAbstract
Background Sedentary behaviors predominate modern life, yet we do not fully understand the adverse effects of these behaviors on mortality after considering the benefits of moderate-vigorous physical activity (MVPA).Objective We tested the hypotheses that higher amounts of overall sitting time and television viewing are positively associated with mortality and described the independent and combined effects of these sedentary behaviors and MVPA on mortality.Design In the NIH-AARP Diet and Health Study, we examined 240,819 adults (aged 50-71 y) who did not report any cancer, cardiovascular disease, or respiratory disease at baseline. Mortality was ascertained over 8.5 y.Results Sedentary behaviors were positively associated with mortality after adjustment for age, sex, education, smoking, diet, race, and MVPA. Participants who reported the most television viewing (≥7 h compared with <1 h/d) were at greater risk of all-cause (HR: 1.61; 95% CI: 1.47, 1.76), cardiovascular (HR: 1.85; 95% CI: 1.56, 2.20), and cancer (HR: 1.22; 95% CI: 1.06, 1.40) mortality after adjustment for MVPA. Overall sitting was associated with all-cause mortality. Even among adults reporting high levels of MVPA (>7 h/wk), high amounts of television viewing (≥7 h/d) remained associated with increased risk of all-cause (HR: 1.47; 95% CI: 1.20, 1.79) and cardiovascular (HR: 2.00; 95% CI: 1.33, 3.00) mortality compared with those reporting the least television viewing (<1 h/d).Conclusions Time spent in sedentary behaviors was positively associated with mortality, and participation in high levels of MVPA did not fully mitigate health risks associated with prolonged time watching television. Adults should be encouraged to reduce time spent in sedentary behaviors, when possible, and to participate in MVPA at recommended levels. The NIH-AARP Diet and Health Study was registered at clinicaltrials.gov as NCT00340015.
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Fifty-six percent of older adults report watching over 2 h of TV per day.
“Fifty six percent of the older population report watching over 2 h of TV per day, 54.2% report over 3 h and 15.1% report over 4 h.”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [33]
The meta-prevalence of sitting was obtained for a total population of 372,550 compiled from seven surveys covering six countries (Australia, Canada, Norway, Spain, UK and USA).
“These results were obtained for a total population of 372,550 compiled from seven surveys covering six countries (Australia, Canada, Norway, Spain, UK and USA) [3,17,18,24,25,27,33].”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [33]
54.2% of older adults report watching over 3 h of TV per day.
“Fifty six percent of the older population report watching over 2 h of TV per day, 54.2% report over 3 h and 15.1% report over 4 h.”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [33]
15.1% of older adults report watching over 4 h of TV per day.
“Fifty six percent of the older population report watching over 2 h of TV per day, 54.2% report over 3 h and 15.1% report over 4 h.”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [33]
There is an association between sitting time and negative health outcomes, such as increased risk of cardiovascular disease and all causes of mortality.
“There has been shown to be an association between sitting time and negative health outcomes, such as increased risk of cardiovascular disease and all causes of mortality [14,24,27,33].”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [33]
Matthews et al. noted a stronger association with mortality and TV viewing than with reports of "overall sitting".
“In addition, Matthews et al. [33] notes a stronger association with mortality and TV viewing than of reports of “overall sitting”.”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [33]
Five of the six studies also presented data for models without adjustment for physical activity, which allowed examination of associations between daily total sitting time and mortality risk with and without adjustment for physical activity.
“Five of the six studies also presented data for models without adjustment for physical activity[10,11,30,32,33], which allowed us to examine associations between daily total sitting time and mortality risk, with and without adjustment for physical activity.”
From Daily Sitting Time and All-Cause Mortality: A Meta-Analysis (2013) · cites this paper as [11]
A growing body of literature suggests high sitting time is associated with higher risk of adverse health outcomes, including cardiovascular disease, type 2 diabetes, cancer and mortality, even after adjustment for moderate-to-vigorous physical activity.
“A growing body of literature suggests high sitting time is associated with higher risk of adverse health outcomes, including cardiovascular disease, type 2 diabetes, cancer and mortality, even after adjustment for moderate-to-vigorous physical activity[8-13].”
From Daily Sitting Time and All-Cause Mortality: A Meta-Analysis (2013) · cites this paper as [11]
Five studies assessed daily total sitting time by self-report, and one study used objective measurement of daily sedentary time.
“Five studies assessed daily total sitting time by self-report[10,11,32-34]. One study used objective measurement of daily sedentary time[30].”
From Daily Sitting Time and All-Cause Mortality: A Meta-Analysis (2013) · cites this paper as [11]
Individual study PAFs ranged from 1.9% (largest self-report study) to 58% (Koster et al. objective measure study).
“Individual study PAFs ranged from 1.9% for the largest study with self-report data [11] to 58% for the smaller objective measure study by Koster and colleagues[30].”
From Daily Sitting Time and All-Cause Mortality: A Meta-Analysis (2013) · cites this paper as [11]
Two studies excluded participants with poor self-rated health or pre-existing chronic illness.
“Two studies also excluded participants with poor self-rated health at baseline or pre-existing chronic illness from their analyses[11,32].”
From Daily Sitting Time and All-Cause Mortality: A Meta-Analysis (2013) · cites this paper as [11]
In several studies, associations between sedentary behaviour and increased risks persisted even among persons active enough to meet physical activity recommendations.
“In several studies, investigators reported on the persistence of these associations even among persons active enough to meet physical activity recommendations.[13-20]”
From Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges (2014) · cites this paper as [18]
In a study of almost one-quarter million US older adults free from cardiovascular disease and cancer, more TV viewing was associated with higher all-cause mortality rates, regardless of physical activity level.
“For example, in a recent study of almost one-quarter million US older adults (50-71 years) free from cardiovascular disease and cancer, more time spent on TV viewing was associated with higher all-cause mortality rates, regardless of physical activity level.”
From Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges (2014) · cites this paper as [18]
Among persons reporting more than 7 hours per week of moderate-to-vigorous intensity activity, the risk of dying during follow-up was 50% higher among those declaring 7 or more hours of TV viewing a day compared with less than 1 hour a day.
“Among persons reporting >7 hours a week of moderate-to-vigorous intensity activity, the risk of dying during follow-up was 50% higher among those declaring 7 or more hours of TV viewing a day, compared to <1 hour a day.[18]”
From Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges (2014) · cites this paper as [18]
Both physical inactivity and sedentary behavior are independently associated with increased mortality from any cause and cardiovascular disease in the general population.
“Both physical inactivity and sedentary behavior are independently associated with increased mortality from any cause and cardiovascular disease (CVD) in the general population (1,2)”
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Surveillance of Youth Physical Activity and Sedentary Behavior with Wrist Accelerometry
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- Authors
- Matthews, C. E., George, S. M., Moore, S. C., Bowles, H. R., Blair, A., Park, Y., Troiano, R. P., Hollenbeck, A., & Schatzkin, A.
- Affiliations
- National Institutes of Health (US)
- AARP (US)
- ORCID
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2012-02
- Volume
- 95
- Issue
- 2
- Pages
- 437-445
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3260070
- OpenAlex
- W2130278098
- Cited by
- 655
- References
- 36
- Citations by year
- 2026: 15 · 2025: 22 · 2024: 25 · 2023: 32 · 2022: 21 · 2021: 50 · 2020: 34 · 2019: 55 · 2018: 57 · 2017: 77 · 2016: 66 · 2015: 74 · 2014: 57 · 2013: 52 · 2012: 16
- FWCI
- 42.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Social Psychology › Ergonomics and Musculoskeletal Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- sedentary behavior, sitting time, television viewing, moderate-to-vigorous physical activity, all-cause mortality, cardiovascular mortality, cancer mortality, cause-specific mortality, older adults, NIH-AARP Diet and Health Study
- MeSH terms
- Aged, Cardiovascular Diseases, Cause of Death, Female, Humans, Male, Middle Aged, Mortality, Neoplasms, Surveys and Questionnaires, Television, United States, Cohort Studies, Exercise, Sedentary Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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