title: Standing, Obesity, and Metabolic Syndrome: Findings From the Cooper Center Longitudinal Study.
abstract: OBJECTIVE
  To examine the cross-sectional relationships between standing time, obesity, and metabolic syndrome alongside and independent of leisure-time physical activity (LTPA).
  
  
  METHODS
  The primary study sample consisted of 7075 adult patients (aged 20-79 years) from Cooper Clinic (Dallas, Texas). In this cross-sectional study we assessed the associations between reported standing time and directly measured obesity (body mass index ≥ 30), elevated waist circumference (men: ≥ 102 cm; women: ≥ 88 cm), body fat percentage (men: ≥ 25%; women ≥ 30%), and metabolic syndrome (yes/no). In addition, the joint associations of standing and LTPA on each outcome were examined. Multivariable logistic regression adjusting for confounders was used for statistical analyses.
  
  
  RESULTS
  Standing a quarter of the time or more was significantly associated with reduced odds of an elevated body fat percentage in men (P < .001) and a reduced likelihood of obesity (P < .009) and abdominal obesity (P=.04) in women. In addition, joint association analyses indicated that compared with the reference group (ie, not meeting the physical activity guidelines/standing almost none of the time), men and women who met the physical activity guidelines had lower odds of all obesity outcomes and metabolic syndrome with incremental additions of standing time (ie, a dose-response relationship).
  
  
  CONCLUSIONS
  Standing a quarter of the time per day or more is associated with reduced odds of obesity. The inverse relationship of standing to obesity and metabolic syndrome is more robust when combined with health-promoting LTPA. Prospective studies are warranted to confirm these findings and establish a causal relationship.
authors.affiliation: Department of Intramural Research, 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: Carolyn E
authors.initials: CE
authors.lastname: Barlow
authors.affiliation: The Cooper Institute, Dallas, TX.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Finley
authors.affiliation: University of Texas School of Public Health, Austin.
authors.forename: Kelley Pettee
authors.initials: KP
authors.lastname: Gabriel
authors.affiliation: Department of Kinesiology, College of Education, University of Georgia, Athens.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Schmidt
authors.affiliation: The Cooper Institute, Dallas, TX.
authors.forename: Laura F
authors.initials: LF
authors.lastname: DeFina
mesh_terms: D000273:Adipose Tissue; D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009765:Obesity / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011187:Posture / Q000502:physiology; D011446:Prospective Studies; D013223:Statistics as Topic; D013781:Texas; D055105:Waist Circumference