Replacing Sitting Time With Standing or Stepping: Associations With Cardio-Metabolic Risk Biomarkers

Eur Heart J. 2015 Oct 14;36(39):2643-9. doi: 10.1093/eurheartj/ehv308. Epub 2015 Jul 30.

Abstract

Aims: While excessive sitting time is related adversely to cardio-metabolic health, it is unknown whether standing is a suitable replacement activity or whether ambulatory movement is required. Using isotemporal substitution analyses, we modelled cross-sectional associations with cardio-metabolic risk biomarkers of reallocating time (2 h/day) from sitting to standing or to stepping.

Methods and results: A subsample of participants from the 2011/12 Australian Diabetes, Obesity, and Lifestyle Study wore the posture-based activPAL3 monitor [36-80 years (mean 57.9, SD 9.9 years); 57% women; n = 698 with data]. Associations of activPAL3-derived mean daily time sitting/lying (sitting), standing and stepping with body mass index (BMI), waist circumference, blood pressure, HbA1c, fasting glucose and lipids (high-density lipoprotein-, HDL, and low-density lipoprotein-cholesterol, total/HDL-cholesterol ratio, and triglycerides), and 2-h plasma glucose were examined. Adjusted for relevant confounders, sitting-to-standing reallocations were only significantly (P < 0.05) associated with approximately 2% lower fasting plasma glucose, 11% lower triglycerides, 6% lower total/HDL-cholesterol ratio, and 0.06 mmol/L higher HDL-cholesterol per 2 h/day. Sitting-to-stepping reallocations were only significantly associated with approximately 11% lower BMI, 7.5 cm lower waist circumference, 11% lower 2-h plasma glucose, 14% lower triglycerides, and 0.10 mmol/L higher HDL-cholesterol per 2 h/ day, while standing-to-stepping reallocations were only significantly associated with ∼10% lower BMI, 7 cm lower waist circumference, and 11% lower 2-h plasma glucose.

Conclusion: Findings suggested that sitting-reduction strategies targeting increased standing, stepping, or both, may benefit cardio-metabolic health. Standing is a simple alternative to sitting, and requires further examination in prospective and intervention studies.

Keywords: Adult; Cardio-metabolic; Cross-sectional; Isotemporal; Sitting; Standing.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / metabolism
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cross-Sectional Studies
  • Exercise Therapy / instrumentation
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Metabolic Diseases / blood
  • Metabolic Diseases / etiology
  • Metabolic Diseases / prevention & control*
  • Middle Aged
  • Monitoring, Ambulatory
  • Prospective Studies
  • Sedentary Behavior*
  • Waist Circumference

Substances

  • Biomarkers