Journal article
Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adults
- Abstract:
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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 6,767 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 hours/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).
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.1MB, Terms of use)
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- Publisher copy:
- 10.1016/j.lanwpc.2025.101524
+ Medical Research Council
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- Funder identifier:
- https://ror.org/03x94j517
- Grant:
- MC_U137686851
- MC_UU_00006/1
- MC_UU_00017/1
- MC_UU_12026/2
- MC_UU_00006/4
+ NIHR Cambridge Biomedical Research Centre
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- Funder identifier:
- https://ror.org/05m8dr349
- Grant:
- NIHR203312
+ British Heart Foundation
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- Funder identifier:
- https://ror.org/02wdwnk04
- Grant:
- CH/1996001/9454
+ Cancer Research UK
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- Funder identifier:
- https://ror.org/054225q67
- Grant:
- C16077/A29186
- C500/A16896
+ National Natural Science Foundation of China
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- Funder identifier:
- https://ror.org/01h0zpd94
- Grant:
- 82192900
- 82192901
- 82192904
- Publisher:
- Elsevier
- Journal:
- Lancet Regional Health - Western Pacific More from this journal
- Volume:
- 57
- Article number:
- 101524
- Publication date:
- 2025-03-23
- Acceptance date:
- 2025-03-03
- DOI:
- EISSN:
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2666-6065
- Language:
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English
- Keywords:
- Pubs id:
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2095319
- Local pid:
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pubs:2095319
- Deposit date:
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2025-03-19
Terms of use
- Copyright holder:
- Collings et al.
- Copyright date:
- 2025
- Rights statement:
- © 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- Notes:
- This research was funded in whole, or in part, by the Wellcome Trust (212946/Z/18/Z, 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z). For the purpose of Open Access, the author has applied a CC-BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
- Licence:
- CC Attribution (CC BY)
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