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Trends in Sedentary Behavior Among the US Population, 2001-2016

Educational Objective
To understand temporal trends in sedentary behavior among US children, adolescents, and adults from 2001 to 2016.
1 Credit CME
Key Points

Question  What were the levels and changes of sedentary behaviors among the US population from 2001 through 2016?

Findings  In this serial cross-sectional study that included 51 896 participants, the estimated prevalence of sitting watching television or videos at least 2 h/d was high in 2015-2016 (ranging from 59% to 65%); the estimated prevalence of computer use outside school or work for at least 1 h/d increased from 2001 to 2016 (from 43% to 56% for children, from 53% to 57% among adolescents, and from 29% to 50% for adults); and estimated total sitting time increased from 2007 to 2016 (from 7.0 to 8.2 h/d among adolescents and from 5.5 to 6.4 h/d among adults).

Meaning  In the US population, sedentary behaviors generally remained stable and high or increased from 2001 through 2016, depending on the specific activity.

Abstract

Importance  Prolonged sitting, particularly watching television or videos, has been associated with increased risk of multiple diseases and mortality. However, changes in sedentary behaviors over time have not been well described in the United States.

Objective  To evaluate patterns and temporal trends in sedentary behaviors and sociodemographic and lifestyle correlates in the US population.

Design, Setting, and Participants  A serial, cross-sectional analysis of the US nationally representative data from the National Health and Nutrition Examination Survey (NHANES) among children aged 5 through 11 years (2001-2016); adolescents, 12 through 19 years (2003-2016); and adults, 20 years or older (2003-2016).

Exposures  Survey cycle.

Main Outcomes and Measures  Prevalence of sitting watching television or videos for 2 h/d or more, computer use outside work or school for 1 h/d or more, and total sitting time (h/d in those aged ≥12 years).

Results  Data on 51 896 individuals (mean, 37.2 years [SE, 0.19]; 25 968 [50%] female) were analyzed from 2001-2016 NHANES data, including 10 359 children, 9639 adolescents, and 31 898 adults. The estimated prevalence of sitting watching television or videos for 2 h/d or more was high among all ages (children, 62% [95% CI, 57% to 67%]; adolescents, 59% [95% CI, 54% to 65%]; adults, 65% [95% CI, 61% to 69%]; adults aged 20-64 years, 62% [95% CI, 58% to 66%]; and ≥65 years, 84% [95% CI, 81% to 88%] in the 2015-2016 cycle). From 2001 through 2016, the trends decreased among children over time (difference, −3.4% [95% CI, −11% to 4.5%]; P for trend =.004), driven by non-Hispanic white children; were stable among adolescents (−4.8% [95% CI, −12% to 2.3%]; P for trend =.60) and among adults aged 20 through 64 years (−0.7% [95% CI, −5.6% to 4.1%]; P for trend =.82); but increased among adults aged 65 years or older (difference, 3.5% [95% CI, −1.2% to 8.1%]; P for trend =.03). The estimated prevalence of computer use outside school or work for 1 h/d or more increased in all ages (children, 43% [95% CI, 40% to 46%] to 56% [95% CI, 49% to 63%] from 2001 to 2016; difference, 13% [95% CI, 5.6% to 21%]; P for trend <.001; adolescents, 53% [95% CI, 47% to 58%] to 57% [95% CI, 53% to 62%] from 2003 to 2016, difference, 4.8% [95% CI, −1.8% to 11%]; P for trend =.002; adults, 29% [27% to 32%] to 50% [48% to 53%] from 2003 to 2016, difference, 21% [95% CI, 18% to 25%]; P for trend <.001). From 2007 to 2016, total hours per day of sitting time increased among adolescents (7.0 [95% CI, 6.7 to 7.4] to 8.2 [95% CI, 7.9 to 8.4], difference, 1.1 [95% CI, 0.7 to 1.5]) and adults (5.5 [95% CI, 5.2 to 5.7] to 6.4 [95% CI, 6.2 to 6.6]; difference, 1.0 [95% CI, 0.7 to 1.3]; P for trend <.001 for both).

Conclusions and Relevance  In this nationally representative survey of the US population from 2001 through 2016, the estimated prevalence of sitting watching television or videos for at least 2 hours per day generally remained high and stable. The estimated prevalence of computer use during leisure-time increased among all age groups, and the estimated total sitting time increased among adolescents and adults.

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Article Information

Corresponding Author: Yin Cao, MPH, ScD, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8100, St Louis, MO 63110 (yin.cao@wustl.edu).

Accepted for Publication: March 18, 2019.

Author Contributions: Dr Yang and Mr Cao had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Dr Yang and Mr Cao contributed equally. Drs Matthews, Colditz, and Cao contributed equally.

Concept and design: Yang, C. Cao, Matthews, Colditz, Y. Cao.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Yang, C. Cao, Y. Cao.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Yang, C. Cao, Y. Cao.

Administrative, technical, or material support: Y. Cao.

Supervision: Matthews, Colditz, Y. Cao.

Conflict of Interest Disclosures: Dr Kantor reported receiving grants from the National Cancer Institute. Dr Colditz reported receiving grants from the National Cancer Institute. No other disclosures were reported.

Funding/Support: Dr Kantor’s effort on this project is supported by grant P30CA008748 from the National Cancer Institute. Dr Colditz is supported by grant P30CA091842 from the National Cancer Institute and Biostatistics Shared Resource, a component of the Cancer Center Support grant.

Role of the Funder/Sponsor: The study sponsors had no role in the study design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

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