Patterns of sedentary behavior and mortality in US middle-aged and older adults: a national cohort study
Two pages on PainSci cite Diaz 2017: 1. The Trouble with Chairs 2. Fresh evidence that sitting is not “the new smoking”
PainSci commentary on Diaz 2017: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
This experiment measured the relationship between activity and mortality by motion-tracking 8000 middle aged people for four years — probably the biggest of its kind so far (but I’m sure much bigger ones are on the horizon as the technology gets ever cheaper). The results affirmed a link between inactivity and a higher risk of death (notably contradicting Pulsford et al). Some of the study subjects died: 340 of them, and those people spent more time overall not moving, and had longer periods of not moving. That danger was just not in the same league as smoking, not even close.
Note that this data still does not show that a lack of movement caused a higher risk of death — it’s a suggestive association.
The data also suggests that taking breaks was linked to lower risk. That is, the link to mortality was stronger when people had longer stretches of not moving, and therefore a weaker link when they had shorter stretches of inactivity.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: Excessive sedentary time is ubiquitous in Western societies. Previous studies have relied on self-reporting to evaluate the total volume of sedentary time as a prognostic risk factor for mortality and have not examined whether the manner in which sedentary time is accrued (in short or long bouts) carries prognostic relevance.
OBJECTIVE: To examine the association between objectively measured sedentary behavior (its total volume and accrual in prolonged, uninterrupted bouts) and all-cause mortality.
DESIGN: Prospective cohort study.
SETTING: Contiguous United States.
PARTICIPANTS: 7985 black and white adults aged 45 years or older.
MEASUREMENTS: Sedentary time was measured using a hip-mounted accelerometer. Prolonged, uninterrupted sedentariness was expressed as mean sedentary bout length. Hazard ratios (HRs) were calculated comparing quartiles 2 through 4 to quartile 1 for each exposure (quartile cut points: 689.7, 746.5, and 799.4 min/d for total sedentary time; 7.7, 9.6, and 12.4 min/bout for sedentary bout duration) in models that included moderate to vigorous physical activity.
RESULTS: Over a median follow-up of 4.0 years, 340 participants died. In multivariable-adjusted models, greater total sedentary time (HR, 1.22 [95% CI, 0.74 to 2.02]; HR, 1.61 [CI, 0.99 to 2.63]; and HR, 2.63 [CI, 1.60 to 4.30]; P for trend < 0.001) and longer sedentary bout duration (HR, 1.03 [CI, 0.67 to 1.60]; HR, 1.22 [CI, 0.80 to 1.85]; and HR, 1.96 [CI, 1.31 to 2.93]; P for trend < 0.001) were both associated with a higher risk for all-cause mortality. Evaluation of their joint association showed that participants classified as high for both sedentary characteristics (high sedentary time [≥12.5 h/d] and high bout duration [≥10 min/bout]) had the greatest risk for death.
LIMITATION: Participants may not be representative of the general U.S. population.
CONCLUSION: Both the total volume of sedentary time and its accrual in prolonged, uninterrupted bouts are associated with all-cause mortality, suggestive that physical activity guidelines should target reducing and interrupting sedentary time to reduce risk for death.
Primary Funding Source: National Institutes of Health.
related content
- “Associations of sitting behaviours with all-cause mortality over a 16-year follow-up: the Whitehall II study,” Pulsford et al, Int J Epidemiol, 2015.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.
- Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. Aasdahl 2021 BMC Musculoskelet Disord.
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.