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. 2018 May 25;16(1):74.
doi: 10.1186/s12916-018-1062-2.

A cut-off of daily sedentary time and all-cause mortality in adults: a meta-regression analysis involving more than 1 million participants

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A cut-off of daily sedentary time and all-cause mortality in adults: a meta-regression analysis involving more than 1 million participants

Po-Wen Ku et al. BMC Med. .

Abstract

Background: The appropriate limit to the amount of daily sedentary time (ST) required to minimize mortality is uncertain. This meta-analysis aimed to quantify the dose-response association between daily ST and all-cause mortality and to explore the cut-off point above which health is impaired in adults aged 18-64 years old. We also examined whether there are differences between studies using self-report ST and those with device-based ST.

Methods: Prospective cohort studies providing effect estimates of daily ST (exposure) on all-cause mortality (outcome) were identified via MEDLINE, PubMed, Scopus, Web of Science, and Google Scholar databases until January 2018. Dose-response relationships between daily ST and all-cause mortality were examined using random-effects meta-regression models.

Results: Based on the pooled data for more than 1 million participants from 19 studies, the results showed a log-linear dose-response association between daily ST and all-cause mortality. Overall, more time spent in sedentary behaviors is associated with increased mortality risks. However, the method of measuring ST moderated the association between daily ST and mortality risk (p < 0.05). The cut-off of daily ST in studies with self-report ST was 7 h/day in comparison with 9 h/day for those with device-based ST.

Conclusions: Higher amounts of daily ST are log-linearly associated with increased risk of all-cause mortality in adults. On the basis of a limited number of studies using device-based measures, the findings suggest that it may be appropriate to encourage adults to engage in less sedentary behaviors, with fewer than 9 h a day being relevant for all-cause mortality.

Keywords: Cut-point; Inactivity; Recommendation; Review; Sedentary behavior; Sitting.

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Flowchart of selection of studies for inclusion in meta-regression
Fig. 2
Fig. 2
Meta-regression of all-cause mortality risk on daily sedentary time (including all studies). Each study is represented by a circle. The size of each circle is proportional to that study’s weight. The center line and the upper and lower lines show the predicted values and their 95% confidence intervals. Note: The meta-regression model was adjusted for follow-up time of each study
Fig. 3
Fig. 3
Meta-regression of all-cause mortality risk on daily sedentary time based on studies with different measures (a subjective vs. b device-based). Each study is represented by a circle. The size of each circle is proportional to that study’s weight. The center line and the upper and lower lines show the predicted values and their 95% confidence intervals. Note: The meta-regression models were adjusted for follow-up time of each study

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