what contributes the most to tee in a sedentary person?
Korean J Fam Med. 2020 Nov; 41(six): 365–373.
Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks
Jung Ha Park
1Department of Family Medicine, Jeju National University Infirmary, Jeju, Korea
Ji Hyun Moon
iDepartment of Family Medicine, Jeju National University Hospital, Jeju, Korea
2Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
Hyeon Ju Kim
oneDepartment of Family Medicine, Jeju National Academy Hospital, Jeju, Korea
2Department of Family Medicine, Jeju National Academy Schoolhouse of Medicine, Jeju, Korea
Mi Hee Kong
1Department of Family unit Medicine, Jeju National University Infirmary, Jeju, Korea
2Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
Yun Hwan Oh
iSection of Family unit Medicine, Jeju National University Infirmary, Jeju, Korea
twoDepartment of Family Medicine, Jeju National University Schoolhouse of Medicine, Jeju, Korea
Received 2020 Jul 15; Accustomed 2020 Aug iv.
Abstract
Ane-third of the global population aged fifteen years and older engages in insufficient physical activities, which affects health. However, the health risks posed past sedentary behaviors are not well known. The hateful daily duration of sedentary behavior is 8.3 hours among the Korean population and seven.7 hours among the American adult population. Sedentary lifestyles are spreading worldwide because of a lack of available spaces for exercise, increased occupational sedentary behaviors such as part work, and the increased penetration of television and video devices. Consequently, the associated health issues are on the rising. A sedentary lifestyle affects the homo trunk through diverse mechanisms. Sedentary behaviors reduce lipoprotein lipase activity, musculus glucose, protein transporter activities, impair lipid metabolism, and diminish carbohydrate metabolism. Furthermore, it decreases cardiac output and systemic blood flow while activating the sympathetic nervous system, ultimately reducing insulin sensitivity and vascular function. It also alters the insulin-like growth factor axis and the apportionment levels of sex hormones, which elevates the incidence of hormone-related cancers. Increased sedentary time impairs the gravitostat, the body'southward weight homeostat, and weight gain, adiposity, and elevated chronic inflammation caused past sedentary beliefs are take chances factors for cancer. Sedentary behaviors have wide-ranging adverse impacts on the human body including increased all-cause mortality, cardiovascular affliction bloodshed, cancer take a chance, and risks of metabolic disorders such equally diabetes mellitus, hypertension, and dyslipidemia; musculoskeletal disorders such as arthralgia and osteoporosis; depression; and, cognitive impairment. Therefore, reducing sedentary behaviors and increasing physical activity are both important to promote public wellness.
Keywords: Sedentary Behavior, All-Cause Mortality, Cancer, Metabolic Affliction, Physical Activity, Exercise
INTRODUCTION
i. Epidemiology
Approximately 31% of the global population aged ≥15 years engages in insufficient concrete activity, and it is known to contribute to the death of approximately 3.two one thousand thousand people every twelvemonth [one]. In South korea, the concrete activity rate is on the decline among adults aged ≥19 years, irrespective of the type of activeness, including aerobic exercise, walking, and muscle training. Therefore, in 2017, the rates of aerobic exercise, walking, and muscle training in the Korean adult population were 48.5%, 39.0%, and 21.half dozen%, respectively, with the majority of the Korean population engaging in concrete inactivity [2]. In improver to concrete inactivity, sedentary behavior is as well a serious problem, and a substantial number of people engage in it for prolonged periods. For example, Americans spend 55% of their waking time (7.7 hours a twenty-four hours) engaged in sedentary behaviors whereas Europeans spend xl% of their leisure fourth dimension (2.vii hours a mean solar day) watching goggle box [3]. Similar patterns have been observed in Koreans, who have been reported to demonstrate long sedentary times. Co-ordinate to Korea Health Statistics of 2018, adults in Korea aged ≥19 years appoint in 8.3 hours of sedentary time. Only 8.9% of the developed population engaged in <iv hours of sedentary fourth dimension whereas 20.6% of the adults were involved in >12 hours of sedentary time [4].
2. Causes of Physical Inactivity and Sedentary Lifestyles
A poor participation in concrete activity is speculated to exist influenced by multiple factors. Some ecology factors include traffic congestion, air pollution, shortage of parks or pedestrian walkways, and a lack of sports or leisure facilities [one]. Television viewing, video viewing, and cell phone usage are positively correlated with an increasingly sedentary lifestyle [v]. Sedentary behaviors are projected to continue to rise on the ground of this socio-cultural groundwork.
Sedentary lifestyles have a major impact on the overall health of the global population. Many people worldwide appoint in sedentary lifestyles, and the prevalence of relevant non-communicable diseases is on the ascent. Information technology is well known that insufficient physical activeness, that is, physical inactivity, has a detrimental effect on health. Concrete inactivity is the 4th leading take a chance factor for global bloodshed, accounting for 6% of global mortality [half dozen]. Despite the fact that sedentary behavior poses a comparable risk to health and contributes to the prevalence of various diseases, most physical activeness-related pedagogy in clinical practice is focused on improving the physical activity levels, with less accent on lowering the sedentary behavior. In addition to understanding and informing patients about the health impact of a sedentary lifestyle, healthcare providers of various fields, including clinicians, should reflect upon its significance in policies. This report examined the effects of a sedentary lifestyle on health and the lifestyle-related improvements to be made to promote healthy living.
OVERVIEW OF SEDENTARY LIFESTYLE
1. The Concept of a Sedentary Lifestyle
Sedentary behavior is defined as whatsoever waking behavior such as sitting or leaning with an energy expenditure of 1.five metabolic equivalent task (MET) or less [7]. This definition, proposed by the Sedentary Beliefs Research Network in 2012, is currently the nearly widely used definition of sedentary behavior. Some examples of sedentary behavior include television viewing, playing video games, using a computer, sitting at school or piece of work, and sitting while commuting (Figure 1) [viii]. Co-ordinate to the 2011 Compendium of Physical Activities, MET is defined as the ratio of work metabolic rate to the standard resting metabolic rate (RMR) of i kcal/(kg/h). Ane MET is the RMR or free energy cost for a person at rest. When classified quantitatively based on their intensities, physical activities tin can exist classified into 1.0–1.5 METs (sedentary behavior), 1.six–2.nine METs (light intensity), three–5.9 (moderate intensity), and ≥6 METs (vigorous intensity) (Figure 2) [9].
Examples of sedentary behavior. (A) Playing a video game. (B) Watching telly. (C) Using a computer. (D) Reading a book.
Examples of moderate to vigorous concrete activity. (A) Riding a bicycle. (B) Running.
A sedentary lifestyle increases all-cause mortality and the risks for cardiovascular diseases (CVD), diabetes mellitus (DM), hypertension (HTN), and cancers (breast, colon, colorectal, endometrial, and epithelial ovarian cancer). This has been consistently documented in the literature [3,10,11]. There is no disagreement on the fact that prolonged total sedentary beliefs times are associated with poor disease outcomes. However, the patterns of sedentary time may differ even within the same full corporeality of time, and not much is known about the detail patterns of prolonged sedentary fourth dimension that pose more significant health hazards (for instance, continuous sedentary behavior without a suspension or intermittent sedentary behavior) [12]. One study reported that even if the total sedentary fourth dimension was equal, having short sedentary bouts and engaging in physical activities intermittently can take relative wellness benefits. The total sedentary time and moderate-to-vigorous physical activity (MVPA) have been reported to exist negatively correlated, where the waist circumference (standardized β, -0.16; 95% confidence interval [CI], -0.31 to -0.02; P=0.026), body mass alphabetize (β, -0.19; 95% CI, -0.35 to -0.02; P=0.026), triglyceride level (β, -0.eighteen; 95% CI, -0.34 to -0.02; P=0.029), and ii-hour postprandial plasma glucose level (β, -0.18; 95% CI, -0.34 to -0.02; P=0.025) decreased with increasing the number of breaks in the sedentary time [xiii]. Furthermore, when the sedentary time was interrupted with light- or moderate-intensity physical activity, the systolic and diastolic blood pressures dropped by 2–three mm Hg whereas interrupting the sedentary fourth dimension with light-intensity physical action (LIPA) or simple musculus training in patients with diabetes (88% of the population had HTN) decreased the systolic pressure level by 14–xvi mm Hg and the diastolic pressure by 8–10 mm Hg [14].
two. Physiological Features
The verbal mechanisms of the various adverse effects of sedentary behavior on the human body are currently unknown. However, several hypotheses accept been proposed for the overall understanding of the impact of sedentary behavior on the human body, which are described below.
Sedentary lifestyles are associated with metabolic dysfunctions, such as elevated plasma triglycerides and high-density lipoprotein (HDL) cholesterol and reduced insulin sensitivity [15,16]. Lipoprotein lipase (LPL) is a protein that interacts at the cellular level, and a low LPL concentration is known to subtract the plasma HDL cholesterol level, while affecting the prevalence of astringent HTN, diabetes-induced dyslipidemia, metabolic disorders caused by aging, metabolic syndrome, and coronary artery diseases. Moreover, LPL activeness is macerated by physical inactivity. Additionally, concrete inactivity inhibits LPL activity in skeletal muscles and apace signals for impaired lipid metabolism. In an experiment based on a rat model, the reduction of LPL activeness in rats that engaged in lite walking was merely nearly 10% of the LPL action in rats that were only placed in their cages [17]. The fact that musculus LPL activeness is highly sensitive to physical inactivity and low-intensity muscular contractile activity can serve every bit evidence supporting the theory that sedentary behavior is a chance gene for various metabolic disorders [18].
Physical inactivity reduces bone mineral density [19]. In a study on salubrious adult men and women, 12 weeks of bed balance decreased the mineral density of the lumbar spine, femoral neck, and greater trochanter by one%–4% [nineteen]. The balance betwixt bone resorption and bone deposition mediates the relationship between sedentary beliefs and the reduction of os mineral density. Co-ordinate to some studies, bed residue elevates os resorption markers and does not influence os germination markers [20-22].
Some studies have provided limited evidence that sedentary behavior has a negative impact on vascular health. A report on salubrious women reported that 56 days of caput-downwardly bed residue decreased the endothelium-dependent vasodilation while increasing the endothelial cell damage. Such alterations in vascular function were prevented through aerobic do and muscle grooming [23].
SEDENTARY LIFESTYLES AND Health RISKS
1. Sedentary Lifestyles, Mortality, and Morbidity (Cardiovascular Diseases and Other Causes)
A sedentary lifestyle is strongly associated with CVD, DM, cancer, and premature bloodshed. The total daily sedentary fourth dimension and television viewing time were correlated with an increased all-crusade mortality risk [24]. In a study analyzing the mortality rates of people with >x hours and <5 hours of sitting times a day, the sitting time was significantly correlated with all-cause bloodshed (odds ratio [OR], 1.16; 95% CI, i.04– 1.29; P<0.05) [25]. In a study that examined the correlation between the television viewing fourth dimension and all-crusade mortality, the people who watched goggle box for ≥6 hours a twenty-four hour period had a 2-fold higher all-cause mortality risk compared to the people who watched goggle box for <two hours a day (hazard ratio [HR], 1.98; 95% CI, one.25–3.15) [26] whereas the people who watched tv for ≥4 hours a day had a i.5 times higher all-cause mortality risk compared to the people who watched Goggle box for <2 hours a day (HR, i.48; 95% CI, 1.19–1.83) [27].
Sedentary time (sitting time, television or screen viewing fourth dimension, leisure time while sitting in a twenty-four hour period) is independently associated with allcause mortality, CVD incidence or mortality, incidence or mortality of sure cancers (breast, colon, colorectal, endometrial, and epithelial ovarian cancer), and type 2 DM. In particular, the adverse upshot of sedentary time was more evident among people who engaged in little concrete action compared to those who engaged in frequent physical action. The relative hazard (RR) for all-cause mortality was 30% higher with high physical activity (HR, 1.16; 95% CI, 0.84–1.59) compared to that with low physical activity (Hr, 1.46; 95% CI, 1.22–ane.75) [28].
ii. Sedentary Lifestyles and Metabolic Diseases
1) Diabetes mellitus
The fact that the prevalence of type 2 DM increases with increasing sedentary time has been consistently documented in various studies (HR, ane.91; 95% CI, 1.64–two.22) [28].
In an assessment of DM risk considering both sedentary time and concrete activeness, the DM risk increased with the increasing daily sedentary time (HR, one.13; 95% CI, one.04–1.22; P<0.001), and the effect was non kickoff by the level of physical action (Hr, 1.11; 95% CI, ane.01–1.19; P<0.001). The gamble for CVD also increased with the increasing daily sedentary time (60 minutes, i.29; 95% CI, 1.27–1.30; P<0.001), and although the physical activeness level slightly start this consequence, sedentary time still significantly increased the hazard (HR, one.11; 95% CI, ane.01–1.xix; P<0.001). This shows that the level of concrete action does not influence the affect of prolonged sedentary time on the risk for CVD and DM.
A few biological mechanisms can explain the impact of the total daily sedentary fourth dimension on CVD and DM adventure. Prolonged sitting is known to affect the content and activity of musculus glucose transporter proteins. An animal study observed that prolonged muscle inactivity reduces the LPL activity, which regulates blood lipid concentration and carbohydrate metabolism through cellular pathways that differ from the normal motor response; however, additional verification is required by human studies [29].
2) Hypertension
A sedentary lifestyle affects blood pressure through various mechanisms, and after changes the blood pressure past altering the cardiac output and full peripheral vascular resistance. A prolonged sedentary time reduces the metabolic demands and systemic blood flow, and by stimulating the sympathetic nervous organization, it decreases insulin sensitivity and vascular part while increasing the oxidative stress and promoting the low-grade inflammatory cascade [fourteen]. A report reported a straight association between sedentary behavior and a high risk of HTN (HR, 1.48; 95% CI, 1.01–2.18; P for trend=0.03). Amongst sedentary behaviors, not-interactive sedentary behaviors (watching television, sleeping) have been reported to further escalate the risk for HTN compared to interactive sedentary behaviors (driving, using a calculator) [30].
three) Dyslipidemia
Sedentary behaviors induce metabolic dysfunction characterized by elevated blood triglyceride levels, reduced HDL-cholesterol levels, and diminished insulin sensitivity [17]. A study reported that sedentary behaviors increased the rate of newly diagnosed dyslipidemias in women (OR, 1.17; 95% CI, ane.00–1.36) and increased the adventure for dyslipidemia in both men and women (men: OR, 1.21; 95% CI, i.02–1.44) (women: OR, 1.24; 95% CI, 1.04–1.48) [31]. In dissimilarity, MVPA was negatively associated with blood triglyceride levels (β, -0.eighteen; 95% CI, -0.36 to -0.01; P=0.038) [32].
4) Obesity
Sedentary fourth dimension is known to have significant correlations with waist circumference and clustered metabolic take chances scores independent of MVPA. The waist circumference increased by 3.1 cm with a 10% increase in the sedentary fourth dimension [32]. Obese patients tend to move less; therefore, increasing the action levels can exist utilized as a strategy in obesity treatment [33]. While this is a widely known fact, the underlying mechanism remains unknown. A study in 2020 reported that the reason for weight gain is a prolonged sedentary time [34]. According to a Swedish report that compared an experimental grouping which wore a heavy eleven-kg vest for eight hours a day and the control group which wore a light 1-kg belong for 8 hours a day, the experimental group had a weight loss of i.vi kg whereas the command group lost 0.3 kg 3 weeks after. An animate being report shed light on an energy balance system known every bit the "gravitostat" that maintains a consistent torso weight [35]. This regulation occurs partially due to an influence on appetite where the organisation requires a personal weighing machine for the proper performance of this regulation. This Swedish report plant that humans likewise feature a similar born calibration. An individual's calibration measures lower values with prolonged sitting, which explains why sitting is associated with obesity and poor health. A heavy vest tin increase the score on this, thereby inducing weight loss [34].
3. Sedentary Lifestyles and Cancer Risk
Sedentary behavior is besides closely related to the prevalence of cancer. Co-ordinate to a study that investigated the correlation between sedentary behavior and cancer prevalence, the cancer risk was 13% higher in the group with the longest sedentary time compared to that with the shortest sedentary time [28], and some other study reported that sedentary time increased the overall cancer risk past 20% [36].
Prolonged sitting increases colorectal, endometrial, ovarian, and prostate cancer risks, and information technology has been reported to increase cancer mortality particularly in women [37]. In that location was a meaning correlation between cancer mortality and the incidences of breast, colorectal, endometrial, and epithelial ovarian cancers [28]. An increased total sitting fourth dimension was positively correlated with colon cancer (RR, 1.24; 95% CI, ane.03–1.fifty) and endometrial cancer (RR, 1.32; 95% CI, i.08–1.61) [36]. Additionally, idiot box viewing fourth dimension was also positively correlated with colon cancer (RR, i.54; 95% CI, 1.19–1.98) and endometrial cancer (RR, 1.66; 95% CI, ane.21–two.28) [36]. Occupational sitting fourth dimension was positively correlated with but colon cancer (RR, 1.24; 95% CI, 1.09–1.41) [36].
Sedentary behavior leads to metabolic dysfunctions such equally hyperglycemia, hyperinsulinemia, insulin resistance, perturbation of insulin-like growth factor axis, and changes in the circulation levels of sex hormones. Altered circulation levels of sex hormones can be linked to hormone-related cancers such every bit chest and endometrial cancers [38]. Additionally, sedentary behavior induces low-grade chronic systemic inflammation, and sedentary fourth dimension is associated with inflammation-related markers such as C-reactive protein (β, 0.eighteen±0.06; P=0.002), interleukin vi (β, 0.24±0.06; P<0.001), leptin (β, 0.15±0.04; P<0.001), and the leptin: adiponectin ratio (β, 0.21±0.05; P<0.001) [39]. Chronic inflammation tin trigger cancer growth [40]. Adiposity tin also mediate the human relationship betwixt sedentary behavior and cancer, and obesity is a risk factor for several cancers [8].
four. Sedentary Lifestyles and Osteoporosis
Sedentary behavior is known to show a negative clan with the bone mineral density of the total femur and all hip sub-regions irrespective of MVPA, and the os mineral density (1000/cm2) of the full femur had a marked negative correlation with the sedentary time (β, -0.sixteen; 95% CI, -0.24 to -0.08) in developed women [41]. Os mineral density was correlated with the duration and not the frequency of sedentary behavior. In men, sedentary behavior was not markedly correlated with the bone mineral density of the hip and spine [41].
5. Sedentary Lifestyles and Musculoskeletal Diseases
A prolonged sedentary time was correlated with chronic human knee pain. In an analysis of the correlation between chronic knee hurting and the total daily sedentary time (<5, 5–vii, eight–ten, >10 hours), the results claimed that the incidence of chronic knee hurting was higher in individuals with longer sedentary times (P for trend=0.02) [42]. In particular, a sedentary fourth dimension >10 hours a day was markedly correlated with chronic articulatio genus hurting (adjusted OR, one.28; 95% CI, 1.02–1.61; P=0.03) [42]. People who engaged in greater physical activeness had less chronic knee pain (adjusted OR, 0.78; 95% CI, 0.67–0.91; P=0.00), only women with >x hours of sedentary time while engaging in greater physical activity were highly probable to experience chronic genu hurting (adjusted OR, 1.19; 95% CI, one.02–ane.39; P=0.03). The study recommends individuals to shorten their sedentary times to <10 hours a twenty-four hour period [42].
half dozen. Sedentary Lifestyles and Other Diseases
1) Depression
Mentally passive sedentary behaviors such as television viewing (RR, 1.xviii; 95% CI, one.07–i.30), sitting, listening to music, and talking while sitting were positively correlated with low risks (RR, i.17; 95% CI, 1.08–one.27). In dissimilarity, mentally active sedentary behaviors such equally reading books or newspapers, driving, attending a coming together, or knitting or sewing were not markedly correlated with depression risk (RR, 0.98; 95% CI, 0.83–i.15) [43]. Using a computer, which is a mentally agile sedentary behavior, was not correlated with depression chance in one study (RR, 0.99; 95% CI, 0.79–1.23) [43] but was positively correlated with depression chance in another study (RR, one.22; 95% CI, i.x–i.34) [44], and thus its correlation with depression remains controversial. The mechanism underlying the correlation between sedentary beliefs and depression may involve the post-obit: sedentary behaviors may increase the risk for depression past blocking direct communication and lowering social interactions, or by reducing the available time to engage in physical activities that aid to prevent and care for low [43].
ii) Cognitive office
The relationship between sedentary behavior and cognitive role is uncertain. A systematic review constitute marked alterations of cognition (improved in ii studies45,46) and impaired in 2 studies47,48)) in some studies merely no changes in cognitive function in some studies.49) However, the only long-term written report included in that systematic review suggested that a less-sedentary lifestyle and less sedentary work have benefits related to cognitive role.46) It is believed that replacing the sedentary time with concrete action can assist improve the cognitive role. In a randomized clinical trial that analyzed the cerebral changes after thirty minutes of sedentary behavior with other activities for six months in older adults with little physical activity, replacing the sedentary time with MVPA and sleep significantly improved cerebral functions, and replacing it with LIPA did not atomic number 82 to statistically significant changes [46].
SEDENTARY LIFESTYLES AND Physical Activeness
1. Discrepant Wellness Effects of Sedentary Lifestyle and Physical Activeness
By studies have observed that a prolonged sedentary lifestyle leads to poor wellness outcomes irrespective of physical activity. A sedentary lifestyle was independently correlated with mortality and was not compensated for past physical action [10]. The time spent in forepart of a screen was positively correlated with the presence of metabolic syndrome, independent of the level of physical activity (OR, 3.30; 95% CI, 2.04–5.34) [50].
2. The Attenuative Effect of Physical Activity on Sedentary Lifestyles
A few recent studies have reported that increasing physical activity tin can offset the agin impacts of sedentary beliefs. In particular, the starting time effect was more than evident in people with little physical activity.
A meta-analysis reported that mortality was not elevated in the people engaging in high levels of moderate-intensity concrete activity (60– 75 minutes of moderate-intensity physical activeness a mean solar day) fifty-fifty when they had >8 hours of sedentary time a day. There was no divergence in mortality between the most active people (>35.five MET-h/wk) with <4 hours of sedentary fourth dimension a solar day and equally agile people (>35.five MET-h/wk) with >eight hours of sedentary time a twenty-four hour period (60 minutes, 1.04; 95% CI, 0.99–1.x). However, television viewing for >3 hours a day increased the mortality regardless of physical activity, and the people who watched television set for ≥five hours a twenty-four hour period showed markedly high mortalities (HR, i.16; 95% CI, one.05–1.28) [51].
In one study, sitting time showed a dose-response with all-cause mortality and CVD mortality risk in the least active group (<150 MVPA min/wk) [51]. In contrast, the group with at least 8 hours of sedentary time a day showed a college mortality than the group with less than iv hours of sedentary time a day (Hour, one.52; 95% CI, 1.13–two.03). However, the group who met the essential MVPA criterion (150–299 MVPA min/ wk) or engaged in more physical activity did not show a consistent trend in the human relationship between increased sitting fourth dimension and CVD and all-crusade mortalities.
Similarly, a study showed that a sedentary time of over 9 hours per day in the low physical activity grouping (<600 METs-min/wk) had a significant association with an increased CVD hazard (OR, 1.29; 95% CI, one.04–ane.62). In the grouping with more than concrete activeness, sedentary time was not significantly associated with CVD risk [52].
In other words, while increased sedentary time increases the bloodshed amid people who engage in little concrete activeness, adequate physical activity seems to starting time the impact of increased sedentary time on mortality [53].
A study analyzed the correlation between all-cause mortality and net uncompensated sedentary behavior metabolic equivalent hours (USMh=MET/h [sedentary time]–MET/h [MVPA fourth dimension]), which was computed by subtracting METs for MVPA from METs for sedentary beliefs throughout a twenty-four hours. USMh was independently associated with all-crusade mortality when it was greater than 7 MET/h, and for television viewing, when it was greater than 3 MET/h. The mean increase in mortality per USMh was 1% (RR, 1.01; 95% CI, 1.00–1.02; P=0.01), and the mean increase in mortality per USMh for TV watching was 7% (RR, one.07; 95% CI, 1.04–1.ten; P<0.001). In other words, physical activity besides equally sedentary time should be assessed, and therefore, USMh was revealed to be a more practical index for assessing sedentary beliefs [54].
In the people with the to the lowest degree daily activity (≤17 min/d MVPA), replacing thirty minutes of the sitting time each twenty-four hours with low-cal physical activity reduced the bloodshed adventure by 14% (60 minutes, 0.86; 95% CI, 0.81–0.89), and replacing it with MVPA reduced the mortality risk by 45% (60 minutes, 0.55; 95% CI, 0.47–0.62). However, in the people with the highest daily activity (MVPA >38 min/d), replacing the sitting time with LIPA or MVPA was not linked with a reduced mortality chance [55].
Replacing the sedentary behavior with concrete activity also has an touch on on cancer-related mortality. A recently published study showed that sedentary behavior was independently associated with cancer bloodshed risk, where a higher sedentary time led to a greater cancer mortality risk. In this written report, the individuals in the meridian ane/three of the sedentary group showed a substantially higher cancer bloodshed risk than those in the bottom 1/3 (adapted HR, one.52; 95% CI, i.01–ii.27) [56]. However, replacing 30 minutes of sedentary time with LIPA reduced the cancer mortality by eight% (Hour, 0.92; 95% CI, 0.86–0.97) and replacing it with MVPA reduced information technology past 31% (60 minutes, 0.69; 95% CI, 0.48–0.97) [56].
CLINICAL PEARLS FOR SEDENTARY INDIVIDUALS
While the various countries have their ain guidelines for physical activity and sedentary behavior, overall, the recommendations are similar.
ane. Recommendations in the United States
Although the 2018 Advisory Commission revealed that sedentary beliefs is strongly correlated with all-cause and CVD mortalities in adults, the prove was insufficient to offering advice on the recommended daily sedentary time and duration of concrete activity. It could not make up one's mind the recommended daily sedentary time and frequency of concrete activity for adults or adolescents because the risks associated with sedentary behavior are related to the corporeality of MVPA.
It is advisable for inactive people non engaging in moderate concrete action (MPA) to lower their sedentary beliefs and replace their sedentary behavior with LIPA. Notwithstanding, LIPA lone is bereft to obtain health benefits; they volition be able to reduce their health risk by gradually increasing their physical activities to MPA or beyond. Inactive people who engage in insufficient concrete activity that does not meet the benchmark of 150–300 minutes of MPA per week would be able to obtain health benefits by increasing their MPA slightly and reap even greater wellness benefits past reducing their sedentary behaviors. Agile people who engage in sufficient physical activity (150–300 minutes of MPA per week) would proceeds more than benefits by lowering their sedentary behaviors. Highly active people who engage in more than than 300 minutes of MPA per week are recommended to maintain or better their levels of physical activity by participating in a variety of activities [57].
2. Recommendations in Australia
The Australian Government Section of Health presented age-specific recommendations for physical activity and sedentary behavior. According to the Australian concrete activity-sedentary behavior guidelines, individuals are recommended to minimize their sitting times, including sitting during work, commuting, and breaks, and to avert sitting for prolonged periods equally much as possible [58]. Infants and children aged less than 5 years are brash to non be spring in a stroller, machine seat, or high chair for more than 1 hour at a fourth dimension. While they engage in sedentary behaviors, they are recommended to spend time reading books, singing, solving puzzles, and talking with their caregivers as compared to watching telly or a DVD (digital video disc), playing on the figurer, or playing other video games [59]. For children between the ages of v and 17, the sedentary recreational screen time should be limited to 2 hours a twenty-four hour period, and they are advised to engage in positive social interactions and experiences. Older adults aged 65 years and more are brash to remain active as much every bit possible every solar day [sixty]. The recommended corporeality of physical activity for adults is 150–300 minutes of MPA or 75–150 minutes of vigorous physical activeness or an equivalent MVPA per week.
three. Recommendations in Korea
The guidelines for physical activity for the Korean population published by the Department of Health Promotion at the Ministry of Health and Welfare in October 2013 recommend that people limit their sedentary leisure time (eastward.g., computer, smartphone, and television) to 2 hours a twenty-four hour period and appoint in a low level of physical activeness. Children and adolescents are recommended to develop an active lifestyle overall, including sports, physical education, walking, and cycling at habitation and school. If older adults and people with chronic diseases are unable to engage in the recommended physical activities, these groups of people are advised to engage in physical activities to the extents permitted by their situations [61].
Decision
Since the beginning of the coronavirus pandemic, social distancing has become important, and engaging in physical activity in the postcorona era is difficult. Therefore, a study of the bug of sedentary lifestyle is considered more valuable at this betoken.
A sedentary lifestyle has an array of agin health effects, including elevated all-cause mortality, CVD mortality, cancer risk, risks for metabolic diseases such every bit DM, HTN, dyslipidemia, and musculoskeletal diseases such equally knee pain and osteoporosis.
It is indisputable that the negative wellness impacts intensify with increases in the total daily sedentary times. For this reason, it is important to reduce the sedentary time as much every bit possible.
The findings of studies determining the worst type of sedentary behavior varied across studies. Studies observed improve health outcomes with a short sedentary tour with intermittent concrete activity, with calorie-free physical activity or simple muscle preparation, intermittent interruptions of sedentary behavior during work, and residual with physical activity.
Health outcomes likewise vary depending on the type of sedentary behavior and watching television led to the worst outcomes. This may be attributable to the fact that telly watching is a passive sedentary behavior and that people often consume snacks while watching television. Therefore, among the various types of sedentary behaviors, individuals should refrain from watching television as much as possible, and snacking should be minimized while watching goggle box.
Even if the total daily sedentary fourth dimension cannot be reduced for unavoidable reasons, it is appropriate to appoint in sufficient exercise equivalent to or more than 150–300 minutes of MPA per week, as studies constitute that physical activity could start the adverse effects of sedentary behavior. If sufficient exercise cannot be performed, individuals should at to the lowest degree perform lite concrete activity, as opposed to not engaging in concrete activity at all as wellness benefits can be obtained even with lite concrete activeness, admitting insufficient; they should further try to increment their physical activity levels as their situations allow.
Footnotes
Disharmonize OF Interest
No potential conflict of interest relevant to this article was reported.
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Articles from Korean Journal of Family Medicine are provided here courtesy of Korean Academy of Family unit Medicine
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700832/
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