Stillasittande och ohälsa - Statens folkhälsoinstitut

cer mortality, risk of diabetes type 2, metabolic syndrome, mental health, unhealthy
body composition, incidence of cardiovascular and cancer diseases, biomarkers for
cardiovascular diseases. A large number of different measures were used as markers
for sedentary behaviour, e.g., tv­viewing hours/day, sitting at work hours/day, total
sitting hours/day. Most measures were self­reported.
There appears to be sound scientific evidence for a link between sedentary
behaviours and increased risk of all­cause mortality, cardiovascular mortality, risk
of cardiovascular diseases and risk of endometrial cancer (lining of the uterus).
There also appears to be a link with diabetes type 2, cancer mortality in women
and biomarkers for cardiovascular disease. For other health outcomes, the scientific
literature seems more uncertain, mainly due to inconsistencies between studies
or few published studies.
The literature also examines differences between women and men regarding
health risks with high levels of television viewing, although more research is needed
to establish whether the higher risk established for women is due to methodological
weaknesses or not. According to the studies, the link between sedentary behaviours,
mortality and health outcomes may be independent of moderate to vigorous
physical activity, and suggest dose­response relationships in the areas of all­cause­
and cardiovascular mortality. Effect sizes were generally on a moderate (RR: 1.20–
1.49) to high (> 1.50) level, although methodological differences and weaknesses
made it difficult to compare effect sizes between studies and areas.
Conclusion
This literature review has identified a significant knowledge base regarding the
re lationship between sedentary behaviours and increased risk of mortality (all­cause,
cardiovascular), incidence of cardiovascular diseases, endometrial cancer, as well as
with diabetes type 2, cancer mortality in women and biomarkers for cardiovascular
disease to justify conducting a systematic grading of the evidence. This grading may
then serve as a base for forming eventual recommendations regarding the need for
interventions in sedentary behaviour patterns and examination of health effects in
adults. More research is needed for other health outcomes as well as for investigating
dose­response issues and establishing effect sizes. Most studies have used subjective
measures (e.g., self­reported tv­viewing) to investigate the link with health
out comes, and the future use of objective measures is recommended to improve
the knowledge base. More intervention research is needed to investigate the independent
health effects of reducing sedentary behaviours among adults.
10 STILLASITTANDE OCH OHÄLSA