Sitting and chronic disease: where do we go from here?

Excerpt

In this issue of Diabetologia, van der Berg et al report the results of an interesting observational study [1]. The authors examined the cross-sectional associations of objectively measured sitting with type 2 diabetes and cardiometabolic risk in a sample of nearly 2,500 middle-aged Dutch adults enriched with type 2 diabetes patients. This study is an important addition to the literature aiming to examine the health consequences of sedentary behaviour, recently defined as any waking activity with low energy expenditure and performed in a sitting or reclining posture [2]. The most important asset of the work by van der Berg et al [1] is the implementation, in a large participant sample, of a thigh-worn activity monitor that accurately discriminates between sitting/lying and non-sitting/lying postures. Using this methodology the authors were able to relate total sitting time and indicators of sitting patterns (i.e. the manner in which sitting time is accumulated) to glucose metabolism status and prevalence of criteria of the metabolic syndrome. They found that each additional hour daily of sitting time was significantly associated with increased odds of having type 2 diabetes (1.22, 95% CI 1.13, 1.32) and the metabolic syndrome (1.39, 95% CI 1.27, 1.53). This finding was irrespective of time spent in higher intensity activity and a wide range of socio-demographic, behavioural and health-related confounding factors. The accumulation patterns of this sitting time, whether examined as number of interruptions in sitting, number of prolonged (i.e. ≥30 min) sitting bouts or average sitting bout duration, however, showed much weaker associations. …