Replacing sedentary leisure time with alternative movement behaviours in Chinese adults: associations with cardiometabolic diseases

Oral

Abstract Overview

Purpose: To estimate the impact of reallocating sedentary leisure time to other movement behaviours on associations with incident cardiometabolic diseases.

Methods: A prospective observational study of 462,370 Chinese adults (mean age 51y; 59% female) who were free from diabetes and cardiovascular diseases at baseline. Isotemporal substitution Cox regression models were used to estimate the influence of replacing sedentary leisure time with more sleep, housework, Taichi, or conventional exercise on the rates of incident diabetes (ICD-10: E10-14), myocardial infarction (MI; I21-23), and stroke (I60-I61 & I63-I64). The results are reported as adjusted hazard ratios and 95% confidence intervals per 20-minute time exchanges. Potential impact fractions were calculated to estimate the proportional changes in incident disease cases associated with time substitutions, assuming causality.

Results: During >5.25 million person-years of follow-up there were 19,738 incident diabetes, 6,767 MI, and 51,460 stroke cases. Replacing sedentary leisure time with sleep (diabetes: 0.94 (0.90-0.97), MI: 0.93 (0.89-0.99), stroke: 0.96 (0.94-0.98)), housework (diabetes: 0.95 (0.93-0.96), MI: 0.93 (0.91-0.96), stroke: 0.98 (0.97-0.99)) or Taichi (diabetes: 0.95 (0.91-0.98), MI: 0.89 (0.84-0.95), stroke: 0.97 (0.95-0.99)) was associated with lower disease risks. The more substantial associations were obtained when replacing sedentary leisure time with conventional exercise (diabetes: 0.94 (0.89-0.99), MI: 0.84 (0.76-0.92), stroke: 0.93 (0.91-0.96)). Potential impact fractions ranged from 3.5% (sedentary leisure time to housework for incident stroke) to 16.5% (sedentary leisure time to conventional exercise for incident MI).

Conclusions: Replacing sedentary leisure time with conventional exercise or non-exercise behaviours is associated with lower rates of cardiometabolic diseases.

Practical implications: Substantial public health benefits could be gained by replacing sedentary leisure time with small amounts of exercise, including feasible non-exercise behaviours.

Funding: The China Kadoorie Biobank has received funding from numerous bodies (https://www.ckbiobank.org/about-us/funding); this analysis was supported by a Health and Medical Research Fund (HMRF) Research Fellowship (grant no: 06200087).

Additional Authors

Name: Harrison Hin Sheung Ho
Affiliation: School of Public Health, University of Hong Kong
Presenting Author: no
Name: Mengyao Wang
Affiliation: School of Public Health, University of Hong Kong
Presenting Author: no
Name: Shiu Lun Au Yeung
Affiliation: School of Public Health, University of Hong Kong
Presenting Author: no
Name: Stephen Sharp
Affiliation: MRC Epidemiology Unit, University of Cambridge
Presenting Author: no
Name: Huaidong Du
Affiliation: Nuffield Department of Population Health, University of Oxford
Presenting Author: no
Name: Derrick Bennett
Affiliation: Nuffield Department of Population Health, University of Oxford
Presenting Author: no
Name: Youngwon Kim
Affiliation: School of Public Health, University of Hong Kong
Presenting Author: no

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Information

Study Type: Epidemiology
Subtheme: 24 hours
Population Group: Adults
Setting: Not Applicable

Submitting Author

Paul Collings
Post-doctoral Fellow
University of Hong Kong
United Kingdom

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