Skip to main content

Prolonged Sitting and the Risk of Cardiovascular Disease and Mortality

Current Cardiovascular Risk Reports volume 5, pages 350–357 (2011)Cite this article

Abstract

Prolonged sitting behaviors are a distinct subset of sedentary behaviors. They include television viewing, computer and video use, sitting in automobiles, and workplace sitting. I reviewed scientific literature from 2005 to 2010 to assess the effects of prolonged sitting on cardiovascular disease mortality and risk factors. I conclude that prolonged sitting is positively associated with cardiovascular disease risk factors and increases in mortality risk, independent of physical activity. The weakness of the current literature is an over-reliance on self-reports of prolonged sitting. Also, a better understanding is needed of the unique biomarkers and metabolic alterations related to prolonged sitting, as well as whether sitting displaces light-intensity physical activity. Overall, the findings support previous recommendations to consider guidelines and strategies to reduce and interrupt prolonged sitting.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Xu J, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final data for 2007. National Vital Statistics Reports. 2010;58:1–136.

    Google Scholar 

  2. Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation. 2010;121:586–613.

    Article  PubMed  Google Scholar 

  3. • Dunstan DW, Barr EL, Healy GN, et al. Television viewing time and mortality: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Circulation 2010;121:384–91. In this study, television viewing time was associated with increased CVD mortality.

  4. Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32:S498–504.

    Article  PubMed  CAS  Google Scholar 

  5. •• Tremblay MS, Colley RC, Saunders TJ, et al. Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab 2010;35:725–40. This article introduces the term “sedentary physiology” and presents relevant definitions, measurement procedures, major health outcomes, and future directions.

  6. Matthews CE, Chen KY, Freedson PS, et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol. 2008;167:875–81.

    Article  PubMed  Google Scholar 

  7. Healy GN, Dunstan DW, Salmon J, et al. Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose. Diabetes Care. 2007;30:1384–9.

    Article  PubMed  CAS  Google Scholar 

  8. Lollgen H, Bockenhoff A, Knapp G. Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. Int J Sports Med. 2009;30:213–24.

    Article  PubMed  CAS  Google Scholar 

  9. Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes. 2007;56:2655–67.

    Article  PubMed  CAS  Google Scholar 

  10. Zwart SR, Hargens AR, Lee SMC, et al. Lower body negative pressure treadmill exercise as a countermeasure for bed rest-induced bone loss in female identical twins. Bone. 2007;40:529–37.

    Article  PubMed  Google Scholar 

  11. •• Hamilton M, Healy G, Dunstan D, et al. Too little exercise and too much sitting: inactivity physiology and the need for new recommendations on sedentary behavior. Curr Cardiovasc Risk Rep 2008;2:292–98. This article is one of the first reviews of the literature on the health effects of sedentary behavior. It concludes that too much sedentary behavior is hazardous to your health, and it describes underlying mechanisms for this association.

  12. •• Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev 2010;38:105–13. This comprehensive review presents 11 research questions to advance the science of sedentary behavior.

  13. Owen N, Sparling PB, Healy GN, et al. Sedentary behavior: emerging evidence for a new health risk. Mayo Clin Proc. 2010;85:1138–41.

    Article  PubMed  Google Scholar 

  14. van Uffelen JG, Wong J, Chau JY, et al. Occupational sitting and health risks: a systematic review. Am J Prev Med. 2010;39:379–88.

    Article  PubMed  Google Scholar 

  15. •• Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc 2009;41:998–1005. In this study of 17,013 adults, a dose-response association was found between sitting time and CVD mortality, independent of leisure time physical activity.

  16. Patel AV, Bernstein L, Deka A, et al. Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epidemiol. 2010;172:419–29.

    Article  PubMed  Google Scholar 

  17. •• Warren TY, Barry V, Hooker SP, et al. Sedentary behaviors increase risk of cardiovascular disease mortality in men. Med Sci Sports Exerc 2010;42:879–85. In men, time spent riding in a car and watching television were positively associated with CVD mortality. High levels of physical activity were associated with lower rates of CVD mortality, even with high levels of prolonged sitting.

  18. Ekelund U, Brage S, Griffin SJ, Wareham NJ. Objectively measured moderate- and vigorous-intensity physical activity but not sedentary time predicts insulin resistance in high-risk individuals. Diabetes Care. 2009;32:1081–6.

    Article  PubMed  Google Scholar 

  19. •• Healy GN, Dunstan DW, Salmon J, et al. Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care 2008;31:661–66. The findings of this study indicate that interrupting periods of prolonged sitting (ie, breaks in prolonged sitting) reduces metabolic risk.

  20. Aadahl M, Kjaer M, Jorgensen T. Influence of time spent on TV viewing and vigorous intensity physical activity on cardiovascular biomarkers: the Inter 99 study. Eur J Cardiovasc Prev Rehabil. 2007;14:660–5.

    Article  PubMed  Google Scholar 

  21. Bertrais S, Beyeme-Ondoua JP, Czernichow S, et al. Sedentary behaviors, physical activity, and metabolic syndrome in middle-aged French subjects. Obes Res. 2005;13:936–44.

    Article  PubMed  Google Scholar 

  22. • Dunstan DW, Salmon J, Owen N, et al. Associations of TV viewing and physical activity with the metabolic syndrome in Australian adults. Diabetologia 2005;48:2254–61. In a population-based, cross-sectional study of 6241 adults, increased television viewing time was associated with an increased prevalence of the metabolic syndrome.

  23. Ford ES, Kohl III HW, Mokdad AH, Ajani UA. Sedentary behavior, physical activity, and the metabolic syndrome among U.S. adults. Obes Res. 2005;13:608–14.

    Article  PubMed  Google Scholar 

  24. Gao X, Nelson ME, Tucker KL. Television viewing is associated with prevalence of metabolic syndrome in Hispanic elders. Diabetes Care. 2007;30:694–700.

    Article  PubMed  Google Scholar 

  25. Hardy LL, Denney-Wilson E, Thrift AP, et al. Screen time and metabolic risk factors among adolescents. Arch Pediatr Adolesc Med. 2010;164:643–9.

    Article  PubMed  Google Scholar 

  26. Sisson SB, Camhi SM, Church TS, et al. Leisure time sedentary behavior, occupational/domestic physical activity, and metabolic syndrome in U.S. men and women. Metab Syndr Relat Disord. 2009;7:529–36.

    Article  PubMed  Google Scholar 

  27. Wijndaele K, Duvigneaud N, Matton L, et al. Sedentary behaviour, physical activity and a continuous metabolic syndrome risk score in adults. Eur J Clin Nutr. 2009;63:421–9.

    Article  PubMed  CAS  Google Scholar 

  28. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112:2735–52.

    Article  PubMed  Google Scholar 

  29. Churilla JR, Fitzhugh EC, Thompson DL. The metabolic syndrome: how definition impacts the prevalence and risk in U.S. adults: 1999–2004 NHANES. Metab Syndr Relat Disord. 2007;5:331–41.

    Article  PubMed  Google Scholar 

  30. Grundy SM, Brewer Jr HB, Cleeman JI, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109:433–8.

    Article  PubMed  Google Scholar 

  31. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006;23:469–80.

    Article  PubMed  CAS  Google Scholar 

  32. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15:539–53.

    Article  PubMed  CAS  Google Scholar 

  33. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001;285:2486–97.

    Google Scholar 

  34. National Cholesterol Education Program (U.S.). Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults.: Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (adult treatment panel III): final report. [Washington, D.C.]: The Program; 2002.

  35. •• Zagol BW, Krasuski RA. Effect of motorized scooters on quality of life and cardiovascular risk. Am J Cardiol 2010;105:672–6. This study investigated the possible adverse effects of regular motorized scooter use. The authors concluded that physicians should carefully weigh the risks before approving motorized scooter use. The health concerns include long-term increases in cardiovascular risk.

  36. • Beunza JJ, Martinez-Gonzalez MA, Ebrahim S, et al. Sedentary behaviors and the risk of incident hypertension: the SUN Cohort. Am J Hypertens 2007;20:1156–62. In this study of adults, interactive sedentary behaviors (driving and computer use) were independent risk factors for incident hypertension, whereas non-interactive sedentary behaviors (television viewing and sleeping) were not associated with incident hypertension.

  37. Pardee PE, Norman GJ, Lustig RH, et al. Television viewing and hypertension in obese children. Am J Prev Med. 2007;33:439–43.

    Article  PubMed  Google Scholar 

  38. • Schneider M, Dunton GF, Cooper DM. Media use and obesity in adolescent females. Obesity 2007;15:2328–35. In this study of female adolescents, interactive media use (Internet surfing and video games) was associated with body fat percentage and body mass index, whereas non-interactive media use (watching television or a movie, reading/homework) was not.

  39. Shields M, Tremblay MS. Sedentary behaviour and obesity. Health Rep. 2008;19:19–30.

    PubMed  Google Scholar 

  40. American Academy of Pediatrics CoPE. Children, adolescents, and television. Pediatrics. 2001;107:423–6.

    Article  Google Scholar 

  41. Healthy People 2020: physical activity. Available at http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicid=33. Accessed January 2011.

  42. Bridging the gap: connecting environment, economy, and community. Walking school bus. Available at http://www.bridgingthegap.org/egap.php?id=256. Accessed January 2011.

  43. The walking school bus: combining safety, fun and the walk to school. Available at http://www.saferoutesinfo.org/guide/walking_school_bus/index.cfm. Accessed January 2011.

  44. Lubans DR, Boreham CA, Kelly P, Foster CE. The relationship between active travel to school and health-related fitness in children and adolescents: a systematic review. Int J Beh Nutr Phy Act. 2011; http://www.ijbnpa.org/content/8/1/5.

  45. Active living research brief: designing for active transportation. Available at www.activelivingresearch.org. Accessed January 2011.

  46. Wang Y, Tuomilehto J, Jousilahti P, et al. Occupational, commuting, and leisure-time physical activity in relation to heart failure among Finnish men and women. J Am Coll Cardiol. 2010;56:1140–8.

    Article  PubMed  Google Scholar 

  47. Yancey AK. Instant recess: building a fit nation 10 minutes at a time. Berkeley: University of California Press; 2010.

    Google Scholar 

  48. Yancey AK, McCarthy WJ, Taylor WC, et al. The Los Angeles Lift Off: a sociocultural environmental change intervention to integrate physical activity into the workplace. Prev Med. 2004;38:848–56.

    Article  PubMed  Google Scholar 

  49. Research reflections. Leeds Metropolitan University 2006 (January 22). Available at www.leedsmet.ac.uk/the_news/research_reflections/. Accessed January 2011.

  50. Active voice: walking at the desk—workplace innovation fosters better health. Available at http://www.multibriefs.com/briefs/acsm/active8-3.htm. Accessed December 2010.

  51. Taylor WC. Transforming work breaks to promote health. Am J Prev Med. 2005;29:461–5.

    Article  PubMed  Google Scholar 

  52. Taylor WC. Booster breaks: an easy-to-implement workplace policy designed to improve employee health, increase productivity, and lower health care costs. J Workplace Behav Health. 2011;26:70–84.

    Article  Google Scholar 

  53. Taylor WC, Pepkin KL. Booster Breaks: improving employee health one break at a time. Houston: Karrick Press; 2010.

    Google Scholar 

  54. •• Taylor WC, Shegog R, Chen V, et al. The Booster Break program: description and feasibility test of a worksite physical activity daily practice. Work 2010;37:433–43. This study demonstrated that the Booster Break program is feasible in a worksite setting. After 117 sessions conducted over a 6-month period, Booster Break participants had reductions in cardiovascular risk factors, specifically high-density lipoprotein levels and weight.

  55. Lombard WR, Goebel M. The effects of Booster Breaks during a sedentary night shift on physiological, psychomotor, psycho-physiological, and cognitive performance over a 3 night shift habituation phase. In Proceedings of the 11th Conference of the Ergonomics Society of South Africa (CD-ROM), 4th-6th November 2009 in Port Elizabeth. Edited by A. Thatcher, S. Zschernack, A. Todd and S. Davies. 60–2.

  56. Weight-control information network, an information service of the National Institute of Diabetes and Digestive and Kidney Diseases. Available at http://win.niddk.nih.gov/publications/better_health.htm. Accessed April 2011.

Download references

Acknowledgments

This article was supported in part by a National Institutes of Health grant, number R03NR10291. The author gratefully acknowledges Helena M. VonVille, MLS, MPH, an expert health sciences librarian, who conducted a comprehensive literature search for this review, and Karen L. Pepkin, MA, who provided substantive guidance on revisions and assisted in preparation of the manuscript. Also, the author is indebted to Stephen Palmer, PhD, ELS, for a critical and comprehensive review of an earlier draft of the paper and thorough editorial assistance.

Disclosure

The author reports no potential conflict of interest relevant to this article.

Author information

Authors and Affiliations

  1. Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin Street, Suite 2670, Houston, TX, 77030, USA

    Wendell C. Taylor

Authors
  1. Wendell C. Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wendell C. Taylor.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Taylor, W.C. Prolonged Sitting and the Risk of Cardiovascular Disease and Mortality. Curr Cardiovasc Risk Rep 5, 350–357 (2011). https://doi.org/10.1007/s12170-011-0174-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12170-011-0174-4

Keywords

  • Breaks in sedentary time
  • Metabolic health
  • Coronary heart disease
  • Cardiovascular disease
  • Metabolic syndrome
  • Sedentary behavior
  • Physical inactivity
  • Television viewing
  • Computer use
  • Occupational sitting
  • Screen time
  • Booster breaks
  • Obesity and overweight
  • Diabetes mellitus
  • Blood pressure
  • Office treadmill
  • Active transport
  • Exercise
  • Lifestyle
  • Mortality
  • Obesity
  • Risk factors
  • Sedentary lifestyle
  • Sitting in automobiles