Association between various sedentary behaviours and all-cause, cardiovascular disease and cancer mortality: the Multiethnic Cohort Study

Int J Epidemiol. 2013 Aug;42(4):1040-56. doi: 10.1093/ije/dyt108.


Background: It has been proposed that time spent sitting increases all-cause mortality, but evidence to support this hypothesis, especially the relative effects of various sitting activities alone or in combination, is very limited.

Methods: The association between various sedentary behaviours (time spent: sitting watching television (TV); in other leisure activities; in a car/bus; at work; and at meals) and mortality (all-cause and cause-specific) was examined in the Multiethnic Cohort Study, which included 61 395 men and 73 201 women aged 45-75 years among five racial/ethnic groups (African American, Latino, Japanese American, Native Hawaiian and White) from Hawaii and Los Angeles, USA.

Results: Median follow-up was 13.7 years and 19 143 deaths were recorded. Total daily sitting was not associated with mortality in men, whereas in women the longest sitting duration (≥ 10 h/day vs <5 h/day) was associated with increased all-cause (11%) and cardiovascular (19%) mortality. Multivariate hazard ratios (HR) for ≥ 5 h/day vs <1 h/day of sitting watching TV were 1.19 in men (95% confidence interval (CI) 1.10-1.29) and 1.32 in women (95% CI 1.21-1.44) for all-cause mortality. This association was consistent across four racial/ethnic groups, but was not seen in Japanese Americans. Sitting watching TV was associated with an increased risk for cardiovascular mortality, but not for cancer mortality. Time spent sitting in a car/bus and at work was not related to mortality.

Conclusions: Leisure time spent sitting, particularly watching television, may increase overall and cardiovascular mortality. Sitting at work or during transportation was not related to mortality.

Keywords: Sedentary lifestyle; exercise; mortality; prospective studies; television.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • California / epidemiology
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / mortality*
  • Continental Population Groups / ethnology*
  • Epidemiologic Methods
  • Exercise / physiology
  • Female
  • Hawaii / epidemiology
  • Humans
  • Leisure Activities
  • Male
  • Middle Aged
  • Neoplasms / ethnology
  • Neoplasms / mortality*
  • Sedentary Behavior*
  • Time Factors