title: Sedentary behavior, cardiorespiratory fitness, physical activity, and cardiometabolic risk in men: the cooper center longitudinal study.
abstract: OBJECTIVE
  To examine the association between sedentary behavior and cardiometabolic risk, while taking into account cardiorespiratory fitness (fitness) and physical activity.
  
  
  METHODS
  We examined the association of sedentary behavior, physical activity, and fitness (exposure variables) to cardiometabolic biomarkers and metabolic syndrome (outcome measures) among a historic cohort (January 2, 1981, through October 16, 2012) of men. First, we estimated the association (cross-sectionally and longitudinally) of sedentary behavior along with physical activity and fitness to lipids and lipoproteins, glucose, blood pressure, and markers of adiposity, including body mass index, waist circumference, and body fat percentage. We then prospectively examined the effects of baseline sedentary time on the incidence of metabolic syndrome, while adjusting for physical activity, fitness, and other covariates in multivariate models.
  
  
  RESULTS
  Multivariate analysis of baseline data revealed that in comparison with the reference group (≤9 h/wk of sedentary time), more sedentary behavior was significantly associated with a higher triglyceride level, a higher triglycerides-high-density lipoprotein cholesterol ratio, and a higher body mass index, waist circumference, and body fat percentage (P<.05 for trend), after adjusting for physical activity and covariates. When adjusting for fitness and covariates, prolonged sedentary time was only associated with a higher triglyceride-high-density lipoprotein cholesterol ratio (P=.02 for trend). Sedentary time was not associated with the incidence of metabolic syndrome in multivariate models. Longitudinal analyses revealed that a 1-metabolic equivalent increase in fitness was significantly (P<.05) associated with almost all biomarkers when adjusting for sedentary behavior, with little moderation observed.
  
  
  CONCLUSIONS
  The association between prolonged sedentary time and cardiometabolic biomarkers is markedly less pronounced when taking fitness into account. Further exploration of the effects of sedentary behavior on cardiometabolic risk is warranted in cohorts with available fitness data. Furthermore, our findings underscore the need to encourage achieving higher fitness levels through meeting physical activity guidelines to decrease disease risk factors.
authors.affiliation: Intramural Research Department, American Cancer Society, Atlanta, GA. Electronic address: kerem.shuval@cancer.org.
authors.forename: Kerem
authors.initials: K
authors.lastname: Shuval
authors.affiliation: The Cooper Institute, Dallas, TX.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Finley
authors.affiliation: Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Dallas; The Cooper Institute, Dallas, TX.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Barlow
authors.affiliation: Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Austin.
authors.forename: Kelley Pettee
authors.initials: KP
authors.lastname: Gabriel
authors.affiliation: The Cooper Institute, Dallas, TX.
authors.forename: David
authors.initials: D
authors.lastname: Leonard
authors.affiliation: Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Austin; Department of Kinesiology and Health Education, University of Texas at Austin.
authors.forename: Harold W
authors.initials: HW
authors.lastname: Kohl
mesh_terms: D050154:Adiposity; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002320:Cardiovascular Physiological Phenomena; D006801:Humans; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology*; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D015999:Multivariate Analysis; D010809:Physical Fitness / Q000502:physiology*; D012143:Respiratory Physiological Phenomena; D012307:Risk Factors; D057185:Sedentary Behavior; D013781:Texas
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids