Abstract
In developed and developing countries, social, economic, and environmental transitions have led to physical inactivity and large amounts of time spent sitting. Research is now unraveling the adverse public health consequences of too much sitting. We describe improvements in device-based measurement that are providing new insights into sedentary behavior and health. We consider the implications of research linking evidence from epidemiology and behavioral science with mechanistic insights into the underlying biology of sitting time. Such evidence has led to new sedentary behavior guidelines and initiatives. We highlight ways that this emerging knowledge base can inform public health strategy: First, we consider epidemiologic and experimental evidence on the health consequences of sedentary behavior; second, we describe solutions-focused research from initiatives in workplaces and schools. To inform a broad public health strategy, researchers need to pursue evidence-informed collaborations with occupational health, education, and other sectors.
Highlights
Insufficient physical activity is a global public health concern, affecting millions of people in developed and developing countries [58]
Whereas the latter refers to performing insufficient amounts of moderate-to-vigorous physical activity, sedentary behavior is defined by the Sedentary Behavior Research Network as “any waking behavior characterized by an energy expenditure ≤1.5 metabolic equivalents (METs), while in a sitting, reclining or lying posture” [122]
Biracial sample of middle-aged and older US adults using accelerometer measures, Diaz and colleagues [41, 42] were the first to report that both total sedentary time and prolonged uninterrupted sedentary bouts were associated with increased risk for all-cause mortality, after controlling for the role of physical activity
Summary
Insufficient physical activity is a global public health concern, affecting millions of people in developed and developing countries [58]. The emergence of explicit concerns about sedentary behavior and health can be traced back to studies pioneered by Leonard Epstein [47], who examined experimentally how overweight and obese children’s choices to take part in physically active or sedentary behaviors could be influenced Taking these insights into a public health research and translational framework [38], the time that adults spend sitting may be understood to be a class of behaviors that can coexist with, and potentially compete with, physical activity, with distinct health consequences and environmental and social determinants [98, 100]. A foundation in public health research on sedentary behavior and health has rapidly developed [94] Those findings are influencing recommendations for chronic disease management and informing broader preventive health guidelines and policies [95]. We emphasize the interplay of evidence from observational and experimental studies as well as the development and testing of scalable interventions to reduce sitting in workplaces and schools
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