Purpose of Review
The aim of this paper is to assess the association between sedentary behaviours, including screen time, and risk of obesity in adults. A review of 10 systematic reviews was undertaken.
Available evidence is generally not supportive of associations between sedentary behaviour and obesity in adults. Most studies that found significant associations indicated mostly small effect sizes. Somewhat more consistent associations were shown for screen time (mainly TV viewing), among older adults, and for pre-adult sedentary behaviour to increase the risk of obesity in adulthood. Some evidence also exists for breaks in sedentary time to be associated with a more favourable BMI, and for use of a car to be associated with greater risk of obesity.
There is limited evidence for an association between sedentary behaviour in adulthood and obesity and any association that exists does not seem to be causal. Future research is required investigating potentially positive effects for frequent breaks from sitting, less car use, and an uncoupling of TV viewing and dietary intake.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Ng SW, Popkin BM. Time use and physical activity: a shift away from movement across the globe. Obes Rev. 2012;13(8):659–80. doi:10.1111/j.1467-789X.2011.00982.x.
Network SBR. Letter to the Editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Me. 2012;37:540–2. doi:10.1139/H2012-024.
Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol. 2008;167:875–81. doi:10.1093/aje/kwm390.
Healy GN, Matthews CE, Dunstan DW, Winkler EA, Owen N. Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06. Eur Heart J. 2011;32(5):590–7. doi:10.1093/eurheartj/ehq451.
• Henson J, Davies MJ, Bodicoat DH, Edwardson CL, Gill JMR, Stensel DJ, et al. Breaking up prolonged sitting with standing or walking attenuates the postprandial metabolic response in postmenopausal women: a randomized acute study. Diabetes Care. 2016;39(1):130–8. doi:10.2337/dc15-1240. Found that breaking up prolonged sitting with 5-min bouts of standing or walking reduced postprandial glucose, insulin, and nonesterified fatty acids in women at high risk of type 2 diabetes.
•• Biddle SJH, Bennie J, Bauman A, Chau J, Dunstan D, Owen N, et al. Too much sitting and all-cause mortality: is there a causal link? BMC Public Health. 2016;16(1):635. doi:10.1186/s12889-016-3307-3. A review of reviews and primary studies showing some evidence for sedentary behaviour being causally associated with all-cause mortality.
Wilmot EG, Edwardson CL, Achana FA, Davies MJ, Gorely T, Gray LJ, et al. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012;55(11):2895–905. doi:10.1007/s00125-012-2677-z.
•• Rezende LFM, Rodrigues Lopes M, Rey-López JP, Matsudo VKR, Luiz OC. Sedentary behavior and health outcomes: an overview of systematic reviews. PLoS One. 2014;9(8):e105620. doi:10.1371/journal.pone.0105620. Systematic synthesis of sedentary behaviour and health outcomes.
Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007;7(1):10. doi:10.1186/1471-2288-7-10.
van Uffelen JGZ, Wong J, Chau JY, van der Ploeg HP, Riphagen I, Gilson ND, et al. Occupational sitting and health risks: a systematic review. Am J Prev Med. 2010;39(4):379–88. doi:10.1016/j.amepre.2010.05.024.
Proper KI, Singh AS, van Mechelen W, Chinapaw MJM. Sedentary behaviors and health outcomes among adults: a systematic review of prospective studies. Am J Prev Med. 2011;40(2):174–82. doi:10.1016/j.amepre.2010.10.015.
Thorp AA, Owen N, Neuhaus M, Dunstan DW. Sedentary behaviors and subsequent health outcomes in adults: a systematic review of longitudinal studies, 1996–2011. Am J Prev Med. 2011;41(2):207–15. doi:10.1016/j.amepre.2011.05.004.
Rhodes RE, Mark RS, Temmel CP. Adult sedentary behavior: a systematic review. Am J Prev Med. 2012;42(3):e3–e28. doi:10.1016/j.amepre.2011.10.020.
•• Rezende LFM, Rey-López JP, Matsudo VKR, Luiz OC. Sedentary behavior and health outcomes among older adults: a systematic review. BMC Public Health. 2014;14:333. 1471-2458/14/333. Systematic synthesis of evidence linking sedentary behaviour to poor health outcomes in older adults.
• McCormack GR, Virk JS. Driving towards obesity: a systematized literature review on the association between motor vehicle travel time and distance and weight status in adults. Prev Med. 2014;66:49–55. doi:10.1016/j.ypmed.2014.06.002. Review linking the sedentary behaviour of car travel with adiposity in adults.
•• Neuhaus M, Eakin EG, Straker L, Owen N, Dunstan DW, Reid N, et al. Reducing occupational sedentary time: a systematic review and meta-analysis of evidence on activity-permissive workstations. Obes Rev. 2014;15(10):822–38. doi:10.1111/obr.12201. Systematic review of interventions that have been used in the workplace, including sit-to-stand desks.
• Chastin S, Buck C, Freiberger E, Murphy M, Brug J, Cardon G, et al. Systematic literature review of determinants of sedentary behaviour in older adults: a DEDIPAC study. Int J Behav Nutr Phy. 2015;12(1):127. doi:10.1186/s12966-015-0292-3. Comprehensive review of correlates of sedentary behaviour in older adults—an age group of increasing focus in this area.
O'Donoghue G, Perchoux C, Mensah K, Lakerveld J, van der Ploeg H, Bernaards C, et al. A systematic review of correlates of sedentary behaviour in adults aged 18–65 years: a socio-ecological approach. BMC Public Health. 2016;16:163. doi:10.1186/s12889-016-2841-3.
•• Chastin SF, Egerton T, Leask C, Stamatakis E. Meta-analysis of the relationship between breaks in sedentary behavior and cardiometabolic health. Obesity. 2015;23(9):1800–10. doi:10.1002/oby.21180. First systematic review addressing the health effects of breaks in sedentary time.
Pedisic Z, Grunseit AC, Ding D, Chau JY, Banks E, Stamatakis E, et al. High sitting time or obesity: which came first? Bidirectional association in a longitudinal study of 31,787 Australian adults. Obesity. 2014;22(10):2126–30. doi:10.1002/oby.20817.
Rosenthal JA. Qualitative descriptors of strength of association and effect size. J Soc Serv Res. 1996;21(4):37–59.
Bell AC, Ge K, Popkin BM. The road to obesity or the path to prevention: motorized transportation and obesity in China. Obes Res. 2002;10(4):277–83.
Shrestha N, Pedisic Z, Neil-Sztramko S, Kukkonen-Harjula KT, Hermans V. The impact of obesity in the workplace: a review of contributing factors, consequences and potential solutions. Curr Obes Rep. 2016;5(3):344–60. doi:10.1007/s13679-016-0227-6.
Healy GN, Dunstan DW, Salmon J, Cerin E, Shaw JE, Zimmet PZ, et al. Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care. 2008;31(4):661–6. doi:10.2337/dc07-2046.
Hill AB. The environment and disease: association or causation? Proc Royal Soc Med. 1965;58(5):295–300.
Pulsford RM, Stamatakis E, Britton AR, Brunner EJ, Hillsdon MM. Sitting behavior and obesity: evidence from the Whitehall II study. Am J Prev Med. 2013;44(2):132–8. doi:10.1016/j.amepre.2012.10.009.
Pearson N, Biddle SJH. Sedentary behaviour and dietary intake in children, adolescents and adults: a systematic review. Am J Prev Med. 2011;41(2):178–88. doi:10.1016/j.amepre.2011.05.002.
• Pedisic Z. Measurement issues and poor adjustments for physical activity and sleep undermine sedentary behaviour research—the focus should shift to the balance between sleep, sedentary behaviour, standing and activity. Kinesiology. 2014;46(1):135–46. The first paper highlighting the importance of accounting for the full 24-h day in the measurement and analysis of sedentary behaviour and physical activity, in addition to looking at the displacement of one behaviour to another.
Hawari NSA, Al-Shayji I, Wilson J, Gill JMR. Frequency of breaks in sedentary time and postprandial metabolic responses. Med Sci Sport Exer. 2016;48(12):2495–502. doi:10.1249/mss0000000000001034.
Mansoubi M, Pearson N, Clemes SA, Biddle SJH, Bodicoat DH, Tolfrey K, et al. Energy expenditure during common sitting and standing tasks: examining the 1.5 MET definition of sedentary behaviour. BMC Public Health. 2015;15:516. doi:10.1186/s12889-015-1851-x.
Tucker LA, Bagwell M. Television viewing and obesity in adult females. Am J Public Health. 1991;81(7):908–11. doi:10.2105/AJPH.81.7.908.
Tucker LA, Friedman GM. Television viewing and obesity in adult males. Am J Public Health. 1989;79(4):516–8. doi:10.2105/AJPH.79.4.516.
• Martin A, Fitzsimons C, Jepson R, Saunders DH, van der Ploeg HP, Teixeira PJ, et al. Interventions with potential to reduce sedentary time in adults: systematic review and meta-analysis. Brit J Sport Med. 2015;49(16):1056–63. doi:10.1136/bjsports-2014-094524. Meta-analysis of the effects of interventions designed to reduce sedentary behaviour in adults.
Vernikos J. Sitting kills, moving heals. Fresno, CA: Quill Driver Books; 2011.
de Bruin A, Della SS. How biases inflate scientific evidence. The Psychologist. 2016;29(1):36–9.
Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev. 2010;38(3):105–13. doi:10.1097/JES.0b013e3181e373a2.
Khaw K, Wareham N, Bingham S, Welch A, Luben R, Day N. Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. PLoS Med. 2007;5(1) doi:10.1371/journal.pmed.0050012.
Hancox RJ, Poulton R. Watching television is associated with childhood obesity: but is it clinically important? Int J Obesity. 2005;30(1):171–5.
• Hobbs M, Pearson NL, Foster P, Biddle SJH. Sedentary behaviour and diet across the lifespan: an updated systematic review. Brit J Sport Med. 2015;49(18):1179–88. doi:10.1136/bjsports-2014-093754. An update of the Pearson & Biddle (2011) systematic review showing a link between TV/screen time as a sedentary behaviour and unhealthy dietary intake.
Spence JC, Rhodes RE, Carson V. Challenging the dual-hinge approach to intervening on sedentary behavior. Am J Prev Med. 2016. doi:10.1016/j.amepre.2016.10.019.
• Marshall SJ, Merchant G. Advancing the science of sedentary behavior measurement. Am J Prev Med. 2013;44(2):190–1. doi:10.1016/j.amepre.2012.11.001. Thoughful review of key issues concerning the measurement and conceptualisation of sedentary behaviour.
Bjork-Petersen C, Bauman A, Grønbæk M, Helge JW, Thygesen LC, Tolstrup JS. Total sitting time and risk of myocardial infarction, coronary heart disease and all-cause mortality in a prospective cohort of Danish adults. Int J Behav Nutr Phy. 2014;11:13. doi:10.1186/1479-5868-11-13.
•• Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388(10051):1302–10. doi:10.1016/S0140-6736(16)30370-1. Large scale meta-analysis suggesting that high levels of physical activity may be protective of deliterious health effects of sitting.
Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W, Ekelund U, et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380(9838):247–57. doi:10.1016/S0140-6736(12)60646-1.
Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sport Exer. 2008;40:181–8. doi:10.1249/mss.0b013e31815a51b.
Conflict of Interest
Stuart J.H. Biddle received a sit-to-stand desk from Ergotron from 2012 to 2014; consultancy fees from Halpern PR paid to Victoria University; professional advice has been requested by and offered to Active Working and Get Britain Standing; professional advice has been requested by and offered to Bluearth.
Enrique García Bengoechea declares that he has no conflict of interest.
Zeljko Pedisic declares that he has no conflict of interest.
Jason Bennie has a research fellowship partially funded by Fitness Australia, a not-for-profit, member-based industry association representing the interests of over 30,000 Australian registered exercise professionals, fitness service providers, and industry suppliers.
Ineke Vergeer declares that she has no conflict of interest.
Glen Wiesner declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
This article is part of the Topical Collection on Obesity Prevention
An erratum to this article is available at http://dx.doi.org/10.1007/s13679-017-0267-6.
About this article
Cite this article
Biddle, S.J., Bengoechea García, E., Pedisic, Z. et al. Screen Time, Other Sedentary Behaviours, and Obesity Risk in Adults: A Review of Reviews. Curr Obes Rep 6, 134–147 (2017). https://doi.org/10.1007/s13679-017-0256-9
- Sedentary behaviour
- Screen time
- TV viewing
- Sedentary breaks
- Systematic review
- Motorised transport