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Replacing Sedentary Behavior Time With Physical Activities, Recommended Physical Activity, and Incident Coronary Heart Disease

  • Xiang Li
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
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  • Hao Ma
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
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  • Tao Zhou
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA

    Department of Epidemiology and Biostatistics, School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, Guangdong, China
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  • Lu Qi
    Correspondence
    Correspondence: Address to Lu Qi, MD, PhD, Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, Ste 1724, New Orleans, LA 70112 ().
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA

    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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Published:December 02, 2022DOI:https://doi.org/10.1016/j.mayocp.2022.06.031

      Abstract

      Objective

      To prospectively analyze the associations with coronary heart disease (CHD) risk of reallocating time from sedentary behavior to various physical activities using the isotemporal substitution model, particularly according to whether the participants meet the recommended physical activity level.

      Methods

      We included 455,298 UK Biobank participants free of CHD at baseline (March 13, 2006, to October 10, 2010). Sedentary behavior time was quantified by summing up the time spent on television watching, computer (not at work), and driving. Physical activities were categorized as daily-life activities (walking for pleasure, light do-it-yourself, and heavy do-it-yourself) and structured exercise (strenuous sports and other exercise).

      Results

      During a median follow-up of 11 years, 20,162 incident CHD cases were documented. Sedentary behavior time was significantly associated with a higher risk of CHD, independent of physical activity. Replacing 30 min/d of sedentary behavior with an equal time of various physical activities was associated with a 3% to 12% risk reduction of CHD. Replacing 1 h/d of sedentary behavior with different types of physical activities was associated with a 6% to 23% risk reduction of CHD. Sedentary behavior to strenuous sports reallocations showed the largest benefit. Reallocations of sedentary behavior to various physical activities showed particularly greater benefits among those who did not meet the physical activity recommendations.

      Conclusions

      Replacing sedentary behavior time with various daily-life activities or structured exercise is associated with significant reductions in CHD risk.

      Abbreviations and Acronyms:

      CHD (coronary heart disease), DIY (do-it-yourself), GRS (genetic risk score), HR (hazard ratio), MET (metabolic equivalent of task), SNP (single-nucleotide polymorphism)
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