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Replacement Effects of Sedentary Time on Metabolic Outcomes - The Maastricht Study.

van der Berg JD, van der Velde JH, de Waard EA, Bosma H, Savelberg HH, Schaper NC, van den Bergh JP, Geusens PP, Schram MT, Sep SJ, van der Kallen CJ, Henry RM, Dagnelie PC, Eussen SJ, van Dongen MC, Köhler S, Kroon AA, Stehouwer CD, Koster A.



Sedentary time has been associated with detrimental health effects, so in some countries guidelines to reduce sedentary time have been developed. As reducing sedentary time inevitably results in more non-sedentary time, effects of this reduction may depend on the activity with which it is replaced.


To examine associations of theoretical reallocations of sedentary time to standing or stepping with cardio-metabolic outcomes and type 2 diabetes.


We included 2,213 participants (52% men, age (mean±SD): 60.0±8.1 years) of The Maastricht Study who were asked to wear an accelerometer 24h/day for a week. We calculated daily sedentary, standing, and stepping time. An isotemporal substitution modelling approach was applied to examine effects on waist circumference, BMI, cholesterol, triacylglycerol, glucose, and insulin levels, metabolic syndrome and type 2 diabetes.


Replacement of sedentary time (30 min/day) with stepping was associated with lower odds for metabolic syndrome (OR= 0.72 (95%CI=0.66, 0.78)) and type 2 diabetes (OR= 0.79 (0.72, 0.87)), more favorable waist circumference (B= -1.42, (-1.78,-1.06)) and BMI (B= -0.48 (-0.62,-0.35)), and improved cholesterol, triacylglycerol, glucose, and insulin levels. Replacing sedentary time with standing was associated with lower odds for metabolic syndrome and type 2 diabetes, and favorable outcomes in waist circumference, cholesterol, triacylglycerol and insulin levels.


Theoretical replacements of sedentary time with non-sedentary time (both standing and stepping) were associated with lower odds for metabolic syndrome, type 2 diabetes, and beneficial metabolic outcomes. These results could be important for the general population, including those who cannot meet physical activity guidelines. Consideration should be given to developing recommendations for daily reallocating sedentary time.

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