Can sitting be bad for your health? An overview of current research Stuart Biddle Professor of Physical Activity & Health School of Sport, Exercise & Health Sciences Loughborough University

2 and woman

5 Establish links between behaviour & health Measure behaviour Interventions Determinants or correlates Translation into practice Is sedentary behaviour associated with health outcomes? Can we help people sit less? What is sedentary behaviour and how do we measure it? What factors are associated with high or low levels of sitting? Can we ‘roll out’ behaviour change solutions?

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8 Sedentary and active behaviours Sleep Sedentary behaviour Light movement Moderate PA Vigorous PA Waking hours: Sitting, lying, very low energy expenditure ‘Physical activity’ research Energy Expenditure LOW HIGH

A big slice of the pie! 9

10 TV Sitting at school or work ComputersSocialising Motorised transport Sedentary behaviours Homework Screen time Reading; Listening to music

Sedentary time per day: US adults by accelerometry 11 Matthews et al: Am J Epi, 2008 NHANES N=6,329

Weekly hours of TV viewing: UK and Scotland - MALES 12 Physical activity statistics 2012, BHF

Weekly hours of TV viewing: UK and Scotland - FEMALES 13 Physical activity statistics 2012, BHF Trends: 1. Scotland > UK 2. Females > Males

Health outcomes of sedentary behaviour 14 Is sedentary behaviour bad for you?

15 Nov 21, 1953

16 ‘Sitting is the new smoking’

17 Establish links between behaviour & health Is sedentary behaviour associated with health outcomes?  All-cause mortality  CVD and mortality  Obesity  Metabolic health & diabetes risk  Mental health

18 All-cause mortality: Risk ratios for sitting time for adults Canada Fitness Survey (Katzmarzyk et al., MSSE, 2009)

Systematic Review and Meta-Analysis 19 Wilmot, et al., (2012). Diabetologia, 55(11), CV mortality: HR = 1.90 Wilmot, et al., (2012). Diabetologia, 55(11), CV mortality: HR = 1.90 (1.71) Adjusted for PA: HR = 1.40

20 Is waist thickness inversely related to TV thickness?? TV v. body fat: plausible but complex

Sedentary behaviour and weight status in adults  there is a reasonable level of evidence to conclude that sedentary behaviour during childhood and adolescence is a strong predictor of obesity during adulthood 21 Thorp, et al. (2011). Am J Prev Med, 41(2)

Is it sitting or eating, or both?  Clear associations between sedentary behaviour (usual screen time, and often TV viewing) and:  elements of a less healthy diet including – lower fruit and vegetable consumption higher consumption of energy-dense snacks, drinks and fast foods higher total energy intake 22 Pearson & Biddle (2011) Am J Prev Med, 41(2)

Maybe we always knew this … ?  ‘Writing and travel broaden your ass if not your mind, and I like to write standing up’ Ernest Hemingway Ernest Hemingway 23

24 Diabetes: HR=2.12 Controlling for PA=2.47 Wilmot, et al., (2012). Diabetologia, 55(11),

Scottish Health Survey data (Hamer et al., Am J Prev Med 2010) MCS: mental function GHQ: psych distress

Can sitting be bad for your health? An overview of current research Stuart Biddle

27Quality Physical Activity 1 Sedentary Behavior Frequency across the day Low; likely to be no more than once High; regular, prolonged bouts of sedentary behavior likely Duration Short, at least for structured exercise (e.g., 30 mins) Long, such as 2-3 hours of TV viewing or prolonged sitting at work EffortModerate-to-highLow Conscious processing Moderate-to-high; requires planning Low and habitual Possible differentiating qualities between physical activity and sedentary behaviour Biddle et al., in Roberts & Treasure (2012)