Trends in US Sedentary Behavior, 2001-2016

Study Questions:

Have sedentary behaviors changed over the past two decades?

Methods:

Data from the National Health and Nutrition Examination Survey (NHANES 2001-2016) were used for the serial, cross-sectional analysis of US residents from children aged 5-11 years (2001-2016); adolescents, 12-19 years (2003-2016); and adults, ≥20 years (2003-2016). Prevalence of sedentary behaviors was examined. Sedentary behaviors included sitting watching television or videos for ≥2 hours/day, computer use outside work or school for ≥1 hour/day, and total sitting time (hours/day in those aged ≥12 years).

Results:

Data from 51,896 individuals (mean age 37.2 years, 50% female) were included in this study including 10,359 children, 9,639 adolescents, and 31,898 adults. The estimated prevalence of sitting watching television or videos for ≥2 hours/day was high among all ages (children, 62% [95% CI, 57-67%]; adolescents, 59% [95% CI, 54-65%]; adults, 65% [95% CI, 61-69%]; adults aged 20-64 years, 62% [95% CI, 58-66%]; and ≥65 years, 84% [95% CI, 81-88%] in the 2015-2016 cycle). From 2001-2016, the trends decreased among children over time (difference, −3.4% [95% CI, −11% to 4.5%]; p for trend = 0.004), driven by non-Hispanic white children. Sedentary trends were stable among adolescents (−4.8% [95% CI, −12% to 2.3%]; p for trend = 0.60) and among adults aged 20-64 years (−0.7% [95% CI, −5.6% to 4.1%]; p for trend = 0.82). Sedentary behaviors increased among adults aged ≥65 years (difference, 3.5% [95% CI, −1.2% to 8.1%]; p for trend = 0.03). The estimated prevalence of computer use outside school or work for ≥1 hour/day increased in all ages including children (difference, 13% [95% CI, 5.6-21%]); adolescents (difference, 4.8% [95% CI, −1.8% to 11%]); and adults (difference, 21% [95% CI, 18-25%]). From 2007 to 2016, total hours per day of sitting time increased among adolescents and adults by 1 hour to 8.2 hours (95% CI, 7.9-8.4) for adolescents, and to 6.4 (95% CI, 6.2-6.6) for adults.

Conclusions:

The investigators concluded that in this nationally representative survey of the US population from 2001-2016, the estimated prevalence of sitting watching television or videos for ≥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.

Perspective:

Given the risks of cardiovascular disease related to sedentary behaviors, these data are concerning. Efforts to reduce sedentary behaviors in addition to the promotion of regular physical activities are critical to improving public health in the United States.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Prevention, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Exercise

Keywords: Adolescent, Child, Computers, Exercise, Leisure Activities, Primary Prevention, Public Health, Risk, Sedentary Behavior, Television


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