The Influence of Sitting, Standing, and Stepping Bouts on Cardiometabolic Health Markers in Older Adults

in Journal of Aging and Physical Activity
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Aside from total time spent in physical activity behaviors, how time is accumulated is important for health. This study examined associations between sitting, standing, and stepping bouts, with cardiometabolic health markers in older adults. Participants from the Mitchelstown Cohort Rescreen Study (N = 221) provided cross-sectional data on activity behaviors (assessed via an activPAL3 Micro) and cardiometabolic health. Bouts of ≥10-, ≥30-, and ≥60-min sitting, standing, and stepping were calculated. Linear regression models were fitted to examine the associations between bouts and cardiometabolic health markers. Sitting (≥10, ≥30, and ≥60 min) and standing (≥10 and ≥30 min) bouts were detrimentally associated with body composition measures, lipid markers, and fasting glucose. The effect for time spent in ≥60-min sitting and ≥30-min standing bouts was larger than shorter bouts. Fragmenting sitting with bouts of stepping may be targeted to benefit cardiometabolic health. Further insights for the role of standing need to be elicited.

Verswijveren and Powell contributed equally to this work. Verswijveren and Ridgers are with the Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia. Powell is with the Performance Department, Swim Ireland, Irish Sport HQ, Dublin, Ireland. Powell, Carson, and Donnelly are with the Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland. Chappel is with the Appleton Institute for Behavioural Science, Central Queensland University, Wayville, South Australia, Australia. Carson and Donnelly are with the Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland. Dowd is with the Department of Sport and Health Sciences, Athlone Institute of Technology, Westmeath, Ireland. Perry, Kearney, and Harrington are with the HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland.

Verswijveren (s.verswijveren@deakin.edu.au) is corresponding author.

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  • Altenburg, T.M., Rotteveel, J., Serné, E.H., & Chinapaw, M.J.M. (2019). Standing is not enough: A randomized crossover study on the acute cardiometabolic effects of variations in sitting in healthy young men. Journal of Science and Medicine in Sport, 22(7), 790796. PubMed ID: 30651222 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Archer, E., Shook, R.P., Thomas, D.M., Church, T.S., Katzmarzyk, P.T., Hebert, J.R., … Blair, S.N. (2013). 45-Year trends in women’s use of time and household management energy expenditure. PLoS One, 8(2), e56620. PubMed ID: 23437187 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Australian Institute of Health and Welfare. (2014).  Australia’s Health 2014. Australia’s health series no. 14. Cat. no. AUS 178. Canberra, Australia: Author. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bailey, D.P., & Locke, C.D. (2015). Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not. Journal of Science and Medicine in Sport, 18(3), 294298. PubMed ID: 24704421 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bankoski, A., Harris, T.B., McClain, J.J., Brychta, R.J., Caserotti, P., Chen, K.Y., … Koster, A. (2011). Sedentary activity associated with metabolic syndrome independent of physical activity. Diabetes Care, 34(2), 497503. PubMed ID: 21270206 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bellettiere, J., LaMonte, M.J., Evenson, K.R., Rillamas-Sun, E., Kerr, J., Lee, I.M., … LaCroix, A.Z. (2019). Sedentary behavior and cardiovascular disease in older women: The objective physical activity and cardiovascular health (OPACH) Study. Circulation, 139(8), 10361046. PubMed ID: 31031411 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bellettiere, J., Winkler, E.A.H., Chastin, S.F.M., Kerr, J., Owen, N., Dunstan, D.W., & Healy, G.N. (2017). Associations of sitting accumulation patterns with cardio-metabolic risk biomarkers in Australian adults. PLoS One, 12(6), e0180119. PubMed ID: 28662164 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Benatti, F.B., & Ried-Larsen, M. (2015). The effects of breaking up prolonged sitting time: A review of experimental studies. Medicine & Science in Sports & Exercise, 47(10), 20532061. PubMed ID: 26378942 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Blair, S.N. (2009). Physical inactivity: The biggest public health problem of the 21st century. British Journal of Sports Medicine, 43(1), 12. PubMed ID: 19136507

    • Search Google Scholar
    • Export Citation
  • Buckley, J.P., Hedge, A., Yates, T., Copeland, R.J., Loosemore, M., Hamer, M., … Dunstan, D.W. (2015). The sedentary office: An expert statement on the growing case for change towards better health and productivity. British Journal of Sports Medicine, 49(21), 13571362. PubMed ID: 26034192 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bucksch, J. (2005). Physical activity of moderate intensity in leisure time and the risk of all cause mortality. British Journal of Sports Medicine, 39(9), 632638. PubMed ID: 16118301 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bull, F.C., Al-Ansari, S.S., Biddle, S., Borodulin, K., Buman, M.P., Cardon, G., … Willumsen, J.F. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 14511462. PubMed ID: 33239350 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Carr, L.J., Swift, M., Ferrer, A., & Benzo, R. (2016). Cross-sectional examination of long-term access to sit-stand desks in a professional office setting. American Journal of Preventive Medicine, 50(1), 96100. PubMed ID: 26437867 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Carson, V., Wong, S.L., Winkler, E., Healy, G.N., Colley, R.C., & Tremblay, M.S. (2014). Patterns of sedentary time and cardiometabolic risk among Canadian adults. Preventive Medicine, 65, 2327. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chaput, J.P., Saunders, T.J., Tremblay, M.S., Katzmarzyk, P.T., Tremblay, A., & Bouchard, C. (2015). Workplace standing time and the incidence of obesity and type 2 diabetes: A longitudinal study in adults. BMC Public Health, 15, 111. PubMed ID: 25885707 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Danquah, I.H., Pedersen, E.S.L., Petersen, C.B., Aadahl, M., Holtermann, A., & Tolstrup, J.S. (2018). Estimated impact of replacing sitting with standing at work on indicators of body composition: Cross-sectional and longitudinal findings using isotemporal substitution analysis on data from the Take a Stand! study. PLoS One, 13(6), e0198000. PubMed ID: 29897943 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Diaz, K.M., Howard, V.J., Hutto, B., Colabianchi, N., Vena, J.E., Blair, S.N., & Hooker, S.P. (2016). Patterns of sedentary behavior in US middle-age and older adults: The REGARDS study. Medicine & Science in Sports & Exercise, 48(3), 430438. PubMed ID: 26460633 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Edwardson, C.L., Winkler, E.A.H., Bodicoat, D.H., Yates, T., Davies, M.J., Dunstan, D.W., & Healy, G.N. (2016). Considerations when using the activPAL monitor in field-based research with adult populations. Journal of Sport and Health Science, 6(2), 162178. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ekelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B.H., Jefferis, B., Fagerland, M.W., … Lee, I.M. (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis. BMJ, 366, l4570. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Elhakeem, A., Cooper, R., Whincup, P., Brage, S., Kuh, D., & Hardy, R. (2018). Physical activity, sedentary time, and cardiovascular disease biomarkers at age 60 to 64 years. Journal of the American Heart Association, 7(16), e007459. PubMed ID: 30369324 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Garcia, M.G., Läubli, T., & Martin, B.J. (2018). Muscular and vascular issues induced by prolonged standing with different work-rest cycles with active or passive breaks. Hum Factors, 60(6), 806821. PubMed ID: 29648891 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gennuso, K.P., Gangnon, R.E., Thraen-Borowski, K.M., & Colbert, L.H. (2015). Dose-response relationships between sedentary behaviour and the metabolic syndrome and its components. Diabetologia, 58(3), 485492. PubMed ID: 25476524 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gomes, M., Figueiredo, D., Teixeira, L., Poveda, V., Paúl, C., Santos-Silva, A., & Costa, E. (2016). Physical inactivity among older adults across Europe based on the SHARE database. Age and Ageing, 46(1), 7177. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gray, D.S., & Bauer, M. (1991). The relationship between body fat mass and fat-free mass. Journal of the American College of Nutrition, 10(1), 6368. PubMed ID: 2010581 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Haga, M., Vrotsou, K., & Bredland, E. (2018). Visualizing physical activity patterns among community-dwelling older adults: A pilot study. Sports, 6(4), 135. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Harrington, J., Fitzgerald, A.P., Layte, R., Lutomski, J., Molcho, M., & Perry, I.J. (2011). Sociodemographic, health and lifestyle predictors of poor diets. Public Health Nutrition, 14(12), 21662175. PubMed ID: 21729473 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Harvey, J.A., Chastin, S.F., & Skelton, D.A. (2015). How sedentary are older people? A systematic review of the amount of sedentary behavior. Journal of Aging and Physical Activity, 23(3), 471487. PubMed ID: 25387160 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Healy, G.N., Winkler, E.A., Owen, N., Anuradha, S., & Dunstan, D.W. (2015). Replacing sitting time with standing or stepping: Associations with cardio-metabolic risk biomarkers. European Heart Journal, 36(39), 26432649. PubMed ID: 26228867 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Holtermann, A., Hansen, J.V., Burr, H., Søgaard, K., & Sjøgaard, G. (2012). The health paradox of occupational and leisure-time physical activity. British Journal of Sports Medicine, 46(4), 291295. PubMed ID: 21459873 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Holtermann, A., Krause, N., van der Beek, A.J., & Straker, L. (2018). The physical activity paradox: Six reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does. British Journal of Sports Medicine, 52(3), 149150. PubMed ID: 28798040 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Judice, P.B., Silva, A.M., & Sardinha, L.B. (2015). Sedentary bout durations are associated with abdominal obesity in older adults. Journal of Nutrition, Health and Aging, 19(8), 798804. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kearney, P.M., Harrington, J.M., Mc Carthy, V.J., Fitzgerald, A.P., & Perry, I.J. (2013). Cohort profile: The cork and kerry diabetes and heart disease study. International Journal of Epidemiology, 42(5), 12531262. PubMed ID: 22984148 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kozey-Keadle, S., Libertine, A., Lyden, K., Staudenmayer, J., & Freedson, P.S. (2011). Validation of wearable monitors for assessing sedentary behavior. Medicine & Science in Sports & Exercise, 43(8), 15611567. PubMed ID: 21233777 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lyden, K., Kozey Keadle, S.L., Staudenmayer, J.W., & Freedson, P.S. (2012). Validity of two wearable monitors to estimate breaks from sedentary time. Medicine & Science in Sports & Exercise, 44(11), 22432252. PubMed ID: 22648343 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Maddison, R., Jiang, Y., Foley, L., Scragg, R., Direito, A., & Olds, T. (2015). The association between the activity profile and cardiovascular risk. Journal of Science and Medicine in Sport, 19(8), 605610. PubMed ID: 26320386 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Messerli, F.H. (1982). Cardiovascular effects of obesity and hypertension. Lancet, 1(8282), 11651168. PubMed ID: 6122945 doi:

  • Naeye, R.L., & Roode, P. (1970). The sizes and numbers of cells in visceral organs in human obesity. American Journal of Clinical Pathology, 54(2), 251253. PubMed ID: 5453216 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ng, S.W., & Popkin, B.M. (2012). Time use and physical activity: A shift away from movement across the globe. Obesity Reviews, 13(8), 659680. PubMed ID: 22694051 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Owen, N., Healy, G.N., Matthews, C.E., & Dunstan, D.W. (2010). Too much sitting: The population health science of sedentary behavior. Exercise and Sport Sciences Reviews, 38(3), 105113. PubMed ID: 20577058 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Parry, S., Straker, L., Gilson, N.D., & Smith, A.J. (2013). Participatory workplace interventions can reduce sedentary time for office workers—A randomised controlled trial. PLoS One, 8(11), e78957. PubMed ID: 24265734 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Powell, C., Browne, L.D., Carson, B.P., Dowd, K.P., Perry, I.J., Kearney, P.M., … Donnelly, A.E. (2020). Use of compositional data analysis to show estimated changes in cardiometabolic health by reallocating time to light-intensity physical activity in older adults. Sports Medicine, 50(1), 205217. PubMed ID: 31350674 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Powell, C., Herring, M.P., Dowd, K.P., Donnelly, A.E., & Carson, B.P. (2018). The cross-sectional associations between objectively measured sedentary time and cardiometabolic health markers in adults—A systematic review with meta-analysis component. Obesity Reviews, 19(3), 381395. PubMed ID: 29178252 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Powell, K.E., Paluch, A.E., & Blair, S.N. (2011). Physical activity for health: What kind? How much? How intense? On top of what? Annual Review of Public Health, 32, 349365. PubMed ID: 21128761 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Santos, R., Mota, J., Okely, A.D., Pratt, M., Moreira, C., Coelho, E.S.M.J., … Sardinha, L.B. (2013). The independent associations of sedentary behaviour and physical activity on cardiorespiratory fitness. British Journal of Sports Medicine, 48(20), 15081512. PubMed ID: 23410883 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schlaff, R.A., Baruth, M., Boggs, A., & Hutto, B. (2017). Patterns of sedentary behavior in older adults. American Journal of Health Behavior, 41(4), 411418. PubMed ID: 28601100 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Smith, P., Ma, H., Glazier, R.H., Gilbert-Ouimet, M., & Mustard, C. (2017). The relationship between occupational standing and sitting and incident heart disease over a 12-year period in Ontario, Canada. American Journal of Epidemiology, 187(1), 2733. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stephens, B.R., Granados, K., Zderic, T.W., Hamilton, M.T., & Braun, B. (2011). Effects of 1 day of inactivity on insulin action in healthy men and women: Interaction with energy intake. Metabolism, 60(7), 941949. PubMed ID: 21067784 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sun, F., Norman, I.J., & While, A.E. (2013). Physical activity in older people: A systematic review. BMC Public Health, 13, 449. PubMed ID: 23648225 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tremblay, M.S., Aubert, S., Barnes, J.D., Saunders, T.J., Carson, V., Latimer-Cheung, A.E., … Chinapaw M.J.M. on behalf of SBRN Terminology Consensus Project Participants. (2017). Sedentary behavior research network (SBRN)—Terminology consensus project process and outcome. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 75. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tremblay, M.S., Colley, R.C., Saunders, T.J., Healy, G.N., & Owen, N. (2010). Physiological and health implications of a sedentary lifestyle. Applied Physiology, Nutrition, and Metabolism, 35(6), 725740. PubMed ID: 21164543 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • U.S. Department of Health and Human Services. (2018). 2018 physical activity guidelines advisory committee scientific report. Washington, DC: Author.

    • Search Google Scholar
    • Export Citation
  • Van Der Berg, J.D., Van Der Velde, J.H.P.M., Waard, E.A.C., Bosma, H., Savelberg, H.H.C.M., Schaper, N.C., … Koster, A. (2017). Replacement effects of sedentary time on metabolic outcomes: The Maastricht study. Medicine & Science in Sports & Exercise, 49(7), 13511358. PubMed ID: 28263284 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • van der Ploeg, H.P., Chey, T., Ding, D., Chau, J.Y., Stamatakis, E., & Bauman, A.E. (2014). Standing time and all-cause mortality in a large cohort of Australian adults. Preventive Medicine, 69, 187191. PubMed ID: 25456805 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Warburton, D.E., Nicol, C.W., & Bredin, S.S. (2006). Health benefits of physical activity: The evidence. CMAJ, 174(6), 801809. PubMed ID: 16534088 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • World Health Organization. (2010). 2010 Global recommendations of physical activity for health. Geneva, Switzerland: Author.

  • Wijndaele, K., & Healy, G.N. (2016). Sitting and chronic disease: Where do we go from here? Diabetologia, 59(4), 688691. PubMed ID: 26850177 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Willett, W., & Stampfer, M.J. (1986). Total energy intake: Implications for epidemiologic analyses. American Journal of Epidemiology, 124(1), 1727. PubMed ID: 3521261 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Winkler, E.A., Bodicoat, D.H., Healy, G.N., Bakrania, K., Yates, T., Owen, N., … Edwardson, C.L. (2016). Identifying adults’ valid waking wear time by automated estimation in activPAL data collected with a 24 h wear protocol. Physiological Measurement, 37(10), 16531668. PubMed ID: 27652827 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
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