Journal of Behavioral Medicine

, Volume 42, Issue 3, pp 502–510 | Cite as

Physical activity, sitting, and risk factors of cardiovascular disease: a cross-sectional analysis of the CARRS study

  • Jingkai WeiEmail author
  • Ranjit Mohan Anjana
  • Shifalika Goenka
  • Felipe Lobelo
  • Roopa Shivashankar
  • Muhammad Masood Kadir
  • Nikhil Tandon
  • Viswanathan Mohan
  • K. M. Venkat Narayan
  • Dorairaj Prabhakaran
  • Mohammed K. Ali


We aimed to estimate the associations between substituting 30-min/day of walking or moderate-to-vigorous physical activity (MVPA) for 30 min/day of sitting and cardiovascular risk factors in a South Asian population free of cardiovascular disease. We collected information regarding sitting and physical activity from a representative sample of 6991 participants aged 20 years and above from New Delhi, India and Karachi, Pakistan enrolled in 2010–2011 in the Center for cArdio-metabolic Risk Reduction in South Asia study using the International Physical Activity Questionnaire (short form). We conducted isotemporal substitution analyses using multivariable linear regression models to examine the cross-sectional associations between substituting MVPA and walking for sitting with cardiovascular risk factors. Substituting 30 min/day of MVPA for 30 min/day of sitting was associated with 0.08 mmHg lower diastolic blood pressure (β = −0.08 [− 0.15, − 0.0003]) and 0.13 mg/dl higher high-density lipoprotein cholesterol (β = 0.13 [0.04, 0.22]). Substituting 30 min/day of walking for 30 min/day of sitting was associated with 0.08 kg/m2 lower body mass index (β = −0.08 [− 0.15, − 0.02]), and 0.25 cm lower waist circumference (β = −0.25 [− 0.39, − 0.11]). In conclusion, substituting time engaged in more-active pursuits for time engaged in less-active pursuits was associated with modest but favorable cardiovascular risk factor improvements among South Asians.


Physical activity Sitting Cardiovascular risk factor Isotemporal substitution models South Asia 



The authors thank all CARRS participants and staff for the providing information for this study.


This project was funded in part by the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Department of Health and Human Services, under Contract No. HHSN268200900026C, and the United Health Group, Minneapolis, MN, US.

Compliance with ethical standards

Conflict of interest

Jingkai Wei, Ranjit Mohan Anjana, Shifalika Goenka, Felipe Lobelo, Roopa Shivashankar, Muhammad Masood Kadir, Nikhil Tandon, Viswanathan Mohan, K. M. Venkat Narayan, Dorairaj Prabhakaran and Mohammed K. Ali declares that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all patients for being included in the study.

Supplementary material

10865_2018_9989_MOESM1_ESM.docx (21 kb)
Supplementary material 1 (DOCX 20 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jingkai Wei
    • 1
    Email author
  • Ranjit Mohan Anjana
    • 2
  • Shifalika Goenka
    • 3
  • Felipe Lobelo
    • 4
  • Roopa Shivashankar
    • 5
  • Muhammad Masood Kadir
    • 6
  • Nikhil Tandon
    • 7
  • Viswanathan Mohan
    • 2
  • K. M. Venkat Narayan
    • 4
  • Dorairaj Prabhakaran
    • 3
    • 5
  • Mohammed K. Ali
    • 4
  1. 1.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Madras Diabetes Research FoundationChennaiIndia
  3. 3.Public Health Foundation of IndiaNew DelhiIndia
  4. 4.Emory Global Diabetes Research Center, Hubert Department of Global HealthEmory UniversityAtlantaUSA
  5. 5.Centre for Chronic Disease ControlNew DelhiIndia
  6. 6.Aga Khan UniversityKarachiPakistan
  7. 7.All India Institute of Medical SciencesNew DelhiIndia

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