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Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings

Sedentary behaviour (SB) has been proposed as an ‘independent’ risk factor for chronic disease risk, attracting much research and media attention. Many countries have included generic, non-quantitative reductions in SB in their public health guidelines and calls for quantitative SB targets are incre...

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Autores principales: Stamatakis, Emmanuel, Ekelund, Ulf, Ding, Ding, Hamer, Mark, Bauman, Adrian E, Lee, I-Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579498/
https://www.ncbi.nlm.nih.gov/pubmed/29891615
http://dx.doi.org/10.1136/bjsports-2018-099131
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author Stamatakis, Emmanuel
Ekelund, Ulf
Ding, Ding
Hamer, Mark
Bauman, Adrian E
Lee, I-Min
author_facet Stamatakis, Emmanuel
Ekelund, Ulf
Ding, Ding
Hamer, Mark
Bauman, Adrian E
Lee, I-Min
author_sort Stamatakis, Emmanuel
collection PubMed
description Sedentary behaviour (SB) has been proposed as an ‘independent’ risk factor for chronic disease risk, attracting much research and media attention. Many countries have included generic, non-quantitative reductions in SB in their public health guidelines and calls for quantitative SB targets are increasing. The aim of this narrative review is to critically evaluate key evidence areas relating to the development of guidance on sitting for adults. We carried out a non-systematic narrative evidence synthesis across seven key areas: (1) definition of SB, (2) independence of sitting from physical activity, (3) use of television viewing as a proxy of sitting, (4) interpretation of SB evidence, (5) evidence on ‘sedentary breaks’, (6) evidence on objectively measured sedentary SB and mortality and (7) dose response of sitting and mortality/cardiovascular disease. Despite research progress, we still know little about the independent detrimental health effects of sitting, and the possibility that sitting is mostly the inverse of physical activity remains. Unresolved issues include an unclear definition, inconsistencies between mechanistic and epidemiological studies, over-reliance on surrogate outcomes, a very weak epidemiological evidence base to support the inclusion of ‘sedentary breaks’ in guidelines, reliance on self-reported sitting measures, and misinterpretation of data whereby methodologically inconsistent associations are claimed to be strong evidence. In conclusion, public health guidance requires a consistent evidence base but this is lacking for SB. The development of quantitative SB guidance, using an underdeveloped evidence base, is premature; any further recommendations for sedentary behaviour require development of the evidence base and refinement of the research paradigms used in the field.
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spelling pubmed-65794982019-07-02 Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings Stamatakis, Emmanuel Ekelund, Ulf Ding, Ding Hamer, Mark Bauman, Adrian E Lee, I-Min Br J Sports Med Review Sedentary behaviour (SB) has been proposed as an ‘independent’ risk factor for chronic disease risk, attracting much research and media attention. Many countries have included generic, non-quantitative reductions in SB in their public health guidelines and calls for quantitative SB targets are increasing. The aim of this narrative review is to critically evaluate key evidence areas relating to the development of guidance on sitting for adults. We carried out a non-systematic narrative evidence synthesis across seven key areas: (1) definition of SB, (2) independence of sitting from physical activity, (3) use of television viewing as a proxy of sitting, (4) interpretation of SB evidence, (5) evidence on ‘sedentary breaks’, (6) evidence on objectively measured sedentary SB and mortality and (7) dose response of sitting and mortality/cardiovascular disease. Despite research progress, we still know little about the independent detrimental health effects of sitting, and the possibility that sitting is mostly the inverse of physical activity remains. Unresolved issues include an unclear definition, inconsistencies between mechanistic and epidemiological studies, over-reliance on surrogate outcomes, a very weak epidemiological evidence base to support the inclusion of ‘sedentary breaks’ in guidelines, reliance on self-reported sitting measures, and misinterpretation of data whereby methodologically inconsistent associations are claimed to be strong evidence. In conclusion, public health guidance requires a consistent evidence base but this is lacking for SB. The development of quantitative SB guidance, using an underdeveloped evidence base, is premature; any further recommendations for sedentary behaviour require development of the evidence base and refinement of the research paradigms used in the field. BMJ Publishing Group 2019-03 2018-06-10 /pmc/articles/PMC6579498/ /pubmed/29891615 http://dx.doi.org/10.1136/bjsports-2018-099131 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Review
Stamatakis, Emmanuel
Ekelund, Ulf
Ding, Ding
Hamer, Mark
Bauman, Adrian E
Lee, I-Min
Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings
title Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings
title_full Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings
title_fullStr Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings
title_full_unstemmed Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings
title_short Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings
title_sort is the time right for quantitative public health guidelines on sitting? a narrative review of sedentary behaviour research paradigms and findings
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579498/
https://www.ncbi.nlm.nih.gov/pubmed/29891615
http://dx.doi.org/10.1136/bjsports-2018-099131
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