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Title: Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings
Authors: Stamatakis, Emmanuel
Ekelund, Ulf
Ding, Ding
Hamer, Mark
Bauman, Adrian
Lee, I-Min
Keywords: Sedentary behaviour
Sitting
Physical activity
Epidemiological evidence
Evaluation
Guidelines
Public health
Recommendations
Issue Date: 2018
Publisher: © The authors. Published by BMJ Publishing Group
Citation: STAMATAKIS, E. ...et al., 2018. Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings. British Journal of Sports Medicine, In Press.
Abstract: Sedentary behaviour (SB) has been proposed as an ’independent’ risk factor for chronic disease risk, attracting much research and media attention. Many countries have included generic, non-quantitative reductions in SB in their public health guidelines and calls for quantitative SB targets are increasing. The aim of this narrative review is to critically evaluate key evidence areas relating to the development of guidance on sitting for adults. We carried out a non-systematic narrative evidence synthesis across seven key areas: (1) definition of SB, (2) independence of sitting from physical activity, (3) use of television viewing as a proxy of sitting, (4) interpretation of SB evidence, (5) evidence on ’sedentary breaks’, (6) evidence on objectively measured sedentary SB and mortality and (7) dose response of sitting and mortality/cardiovascular disease. Despite research progress, we still know little about the independent detrimental health effects of sitting, and the possibility that sitting is mostly the inverse of physical activity remains. Unresolved issues include an unclear definition, inconsistencies between mechanistic and epidemiological studies, over-reliance on surrogate outcomes, a very weak epidemiological evidence base to support the inclusion of ’sedentary breaks’ in guidelines, reliance on self-reported sitting measures, and misinterpretation of data whereby methodologically inconsistent associations are claimed to be strong evidence. In conclusion, public health guidance requires a consistent evidence base but this is lacking for SB. The development of quantitative SB guidance, using an underdeveloped evidence base, is premature; any further recommendations for sedentary behaviour require development of the evidence base and refinement of the research paradigms used in the field.
Description: This is an Open Access Article. It is published by BMJ under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC). Full details of this licence are available at: http://creativecommons.org/licenses/by-nc/4.0/
Sponsor: ES is funded by the National Health and Medical Research Council (Australia) through a Senior Research Fellowship and partly supported by a University of Sydney SOAR Fellowship. DD is supported by a Future Leader Fellowship from the National Heart Foundation (Australia); and partly supported by a University of Sydney SOAR Fellowship.
Version: Published
DOI: 10.1136/bjsports-2018-099131
URI: https://dspace.lboro.ac.uk/2134/33420
Publisher Link: http://dx.doi.org/10.1136/bjsports-2018-099131
ISSN: 1473-0480
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)

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