Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adultsResearch in context
Summary: Background: In Chinese adults, there is a considerable burden of sedentary behaviour. This study aimed to estimate the implications of reallocating sedentary leisure-time to non-sedentary behaviours for incident cardiometabolic diseases. Methods: A prospective cohort study of 462,370 Chine...
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Elsevier
2025-04-01
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| Series: | The Lancet Regional Health. Western Pacific |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606525000616 |
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| author | Paul J. Collings Mengyao Wang Harrison Hin Sheung Ho Shiu Lun Au Yeung Parco M. Siu Benjamin J. Cowling Stephen J. Sharp Søren Brage Nicholas J. Wareham Huaidong Du Derrick A. Bennett Youngwon Kim |
| author_facet | Paul J. Collings Mengyao Wang Harrison Hin Sheung Ho Shiu Lun Au Yeung Parco M. Siu Benjamin J. Cowling Stephen J. Sharp Søren Brage Nicholas J. Wareham Huaidong Du Derrick A. Bennett Youngwon Kim |
| author_sort | Paul J. Collings |
| collection | DOAJ |
| description | Summary: Background: In Chinese adults, there is a considerable burden of sedentary behaviour. This study aimed to estimate the implications of reallocating sedentary leisure-time to non-sedentary behaviours for incident cardiometabolic diseases. Methods: A prospective cohort study of 462,370 Chinese adults (mean age 51 years; 59% female) who were free from diabetes and cardiovascular diseases at baseline. Isotemporal substitution Cox regression models were used to estimate the associations of reallocating self-reported sedentary leisure-time to the same amount of sleep, housework, Taichi, or conventional exercise (e.g., walking, jogging, ball games, swimming) with the risk of incident diabetes, stroke, and myocardial infarction (MI). The results are reported as adjusted hazard ratios and 95% confidence intervals per 30 min/day time exchanges. Potential impact fractions were calculated to estimate the proportional reductions in incident disease cases associated with time substitutions, assuming causality. Findings: During >5.25 million person-years of follow-up, 19,738 incident diabetes, 51,460 stroke, and 6767 MI cases were accrued. Lower disease risks were found for replacement of sedentary leisure-time by sleep (diabetes: 0.97 [0.95–0.99], stroke: 0.98 [0.97–0.99], MI: 0.97 [0.94–0.99]; in participants who slept <7 h/day), housework (diabetes: 0.97 [0.97–0.98], stroke: 0.99 [0.98–0.99], MI: 0.97 [0.95–0.98]), Taichi (diabetes: 0.97 [0.95–0.99], stroke: 0.98 [0.97–0.99], MI: 0.95 [0.92–0.98]), or conventional exercise (diabetes: 0.97 [0.95–0.99], stroke: 0.97 [0.95–0.98], MI: 0.92 [0.88–0.96]). Potential impact fractions ranged from an estimated 3.5% (95% confidence interval: 3.1–3.9%) fewer cases of incident stroke when replacing sedentary leisure-time with housework, to an estimated 9.6% (5.9–13.3%) fewer cases of incident MI when reallocating sedentary leisure-time to conventional exercise. Interpretation: Replacing sedentary leisure-time with behaviours such as housework, Taichi, sleep (in short sleepers) and conventional exercise is associated with lower risks of common cardiometabolic diseases in Chinese adults. Prevention strategies should be developed to promote movement behaviours and optimal levels of sleep at the expense of sedentary leisure-time. Funding: This analysis was supported by a Health and Medical Research Fund (HMRF) Research Fellowship (grant no: 06200087). |
| format | Article |
| id | doaj-art-a77bb5821fb243beb05aefd359b5dcaf |
| institution | DOAJ |
| issn | 2666-6065 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
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| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj-art-a77bb5821fb243beb05aefd359b5dcaf2025-08-20T02:41:30ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652025-04-015710152410.1016/j.lanwpc.2025.101524Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adultsResearch in contextPaul J. Collings0Mengyao Wang1Harrison Hin Sheung Ho2Shiu Lun Au Yeung3Parco M. Siu4Benjamin J. Cowling5Stephen J. Sharp6Søren Brage7Nicholas J. Wareham8Huaidong Du9Derrick A. Bennett10Youngwon Kim11School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of ChinaSchool of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of ChinaSchool of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of ChinaSchool of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of ChinaSchool of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of ChinaSchool of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of ChinaMRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UKMRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UKMRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UKNuffield Department of Population Health (NDPH), University of Oxford, Oxford, UKNuffield Department of Population Health (NDPH), University of Oxford, Oxford, UKSchool of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China; Corresponding author. Rm 301D, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region of China.Summary: Background: In Chinese adults, there is a considerable burden of sedentary behaviour. This study aimed to estimate the implications of reallocating sedentary leisure-time to non-sedentary behaviours for incident cardiometabolic diseases. Methods: A prospective cohort study of 462,370 Chinese adults (mean age 51 years; 59% female) who were free from diabetes and cardiovascular diseases at baseline. Isotemporal substitution Cox regression models were used to estimate the associations of reallocating self-reported sedentary leisure-time to the same amount of sleep, housework, Taichi, or conventional exercise (e.g., walking, jogging, ball games, swimming) with the risk of incident diabetes, stroke, and myocardial infarction (MI). The results are reported as adjusted hazard ratios and 95% confidence intervals per 30 min/day time exchanges. Potential impact fractions were calculated to estimate the proportional reductions in incident disease cases associated with time substitutions, assuming causality. Findings: During >5.25 million person-years of follow-up, 19,738 incident diabetes, 51,460 stroke, and 6767 MI cases were accrued. Lower disease risks were found for replacement of sedentary leisure-time by sleep (diabetes: 0.97 [0.95–0.99], stroke: 0.98 [0.97–0.99], MI: 0.97 [0.94–0.99]; in participants who slept <7 h/day), housework (diabetes: 0.97 [0.97–0.98], stroke: 0.99 [0.98–0.99], MI: 0.97 [0.95–0.98]), Taichi (diabetes: 0.97 [0.95–0.99], stroke: 0.98 [0.97–0.99], MI: 0.95 [0.92–0.98]), or conventional exercise (diabetes: 0.97 [0.95–0.99], stroke: 0.97 [0.95–0.98], MI: 0.92 [0.88–0.96]). Potential impact fractions ranged from an estimated 3.5% (95% confidence interval: 3.1–3.9%) fewer cases of incident stroke when replacing sedentary leisure-time with housework, to an estimated 9.6% (5.9–13.3%) fewer cases of incident MI when reallocating sedentary leisure-time to conventional exercise. Interpretation: Replacing sedentary leisure-time with behaviours such as housework, Taichi, sleep (in short sleepers) and conventional exercise is associated with lower risks of common cardiometabolic diseases in Chinese adults. Prevention strategies should be developed to promote movement behaviours and optimal levels of sleep at the expense of sedentary leisure-time. Funding: This analysis was supported by a Health and Medical Research Fund (HMRF) Research Fellowship (grant no: 06200087).http://www.sciencedirect.com/science/article/pii/S2666606525000616Sedentary behaviourSleepPhysical activityIsotemporal substitutionCardiovascular diseasesProspective study |
| spellingShingle | Paul J. Collings Mengyao Wang Harrison Hin Sheung Ho Shiu Lun Au Yeung Parco M. Siu Benjamin J. Cowling Stephen J. Sharp Søren Brage Nicholas J. Wareham Huaidong Du Derrick A. Bennett Youngwon Kim Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adultsResearch in context The Lancet Regional Health. Western Pacific Sedentary behaviour Sleep Physical activity Isotemporal substitution Cardiovascular diseases Prospective study |
| title | Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adultsResearch in context |
| title_full | Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adultsResearch in context |
| title_fullStr | Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adultsResearch in context |
| title_full_unstemmed | Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adultsResearch in context |
| title_short | Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adultsResearch in context |
| title_sort | associations of reallocating sedentary leisure time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0 5 million chinese adultsresearch in context |
| topic | Sedentary behaviour Sleep Physical activity Isotemporal substitution Cardiovascular diseases Prospective study |
| url | http://www.sciencedirect.com/science/article/pii/S2666606525000616 |
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