Leandro F M Rezende1, Dong Hoon Lee2, Gerson Ferrari3, Edward Giovannucci4. 1. Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventiva, Sao Paulo, SP, Brazil. Electronic address: leandro.rezende@unifesp.br. 2. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 3. Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago, Chile. 4. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Abstract
PURPOSE: We examined the influence of confounding due to pre-existing diseases in prospective studies on sedentary behavior and all-cause mortality. METHODS: We analyzed 25 studies included in systematic reviews. The risk of confounding due to pre-existing diseases was assessed by five methodologic characteristics. RESULTS: Sedentary behavior was associated with higher all-cause mortality. Studies with short average follow-up length had stronger magnitudes of association: 1 to less than 5 years (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.28-1.94), 5 to 9 years (HR, 1.24; 95% CI, 1.16-1.31), and 10 years or more of follow-up (HR, 1.20; 95% CI, 1.10-1.31). Studies that did not adjust for diseases at baseline, did not exclude deaths in the first years of follow-up, and did not exclude participants with diseases/conditions showed stronger associations. Studies with higher risk of confounding because of pre-existing diseases (HR, 1.40; 95% CI, 1.27-1.54) showed stronger association than lower risk studies (HR, 1.18; 95% CI, 1.10-1.27). Studies excluding participants with diseases at baseline had weaker associations compared with studies adjusting for diseases in models. CONCLUSIONS: Sedentary behavior was associated with increased all-cause mortality, although confounding due to pre-existing diseases may bias the magnitude of the association.
PURPOSE: We examined the influence of confounding due to pre-existing diseases in prospective studies on sedentary behavior and all-cause mortality. METHODS: We analyzed 25 studies included in systematic reviews. The risk of confounding due to pre-existing diseases was assessed by five methodologic characteristics. RESULTS: Sedentary behavior was associated with higher all-cause mortality. Studies with short average follow-up length had stronger magnitudes of association: 1 to less than 5 years (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.28-1.94), 5 to 9 years (HR, 1.24; 95% CI, 1.16-1.31), and 10 years or more of follow-up (HR, 1.20; 95% CI, 1.10-1.31). Studies that did not adjust for diseases at baseline, did not exclude deaths in the first years of follow-up, and did not exclude participants with diseases/conditions showed stronger associations. Studies with higher risk of confounding because of pre-existing diseases (HR, 1.40; 95% CI, 1.27-1.54) showed stronger association than lower risk studies (HR, 1.18; 95% CI, 1.10-1.27). Studies excluding participants with diseases at baseline had weaker associations compared with studies adjusting for diseases in models. CONCLUSIONS: Sedentary behavior was associated with increased all-cause mortality, although confounding due to pre-existing diseases may bias the magnitude of the association.
Authors: Dong Hoon Lee; Leandro F M Rezende; Hee-Kyung Joh; NaNa Keum; Gerson Ferrari; Juan Pablo Rey-Lopez; Eric B Rimm; Fred K Tabung; Edward L Giovannucci Journal: Circulation Date: 2022-07-25 Impact factor: 39.918
Authors: Gerson Ferrari; Adilson Marques; Tiago V Barreira; Irina Kovalskys; Georgina Gómez; Attilio Rigotti; Lilia Yadira Cortés; Martha Cecilia Yépez García; Rossina G Pareja; Marianella Herrera-Cuenca; Viviana Guajardo; Ana Carolina B Leme; Juan Guzmán Habinger; Pedro Valdivia-Moral; Mónica Suárez-Reyes; Andreas Ihle; Elvio R Gouveia; Mauro Fisberg Journal: Int J Environ Res Public Health Date: 2021-04-27 Impact factor: 3.390
Authors: Jakob Tarp; Morten W Fagerland; Knut Eirik Dalene; Jostein Steene Johannessen; Bjørge H Hansen; Barbara J Jefferis; Peter H Whincup; Keith M Diaz; Steven Hooker; Virginia J Howard; Ariel Chernofsky; Martin G Larson; Nicole L Spartano; Ramachandran S Vasan; Ing-Mari Dohrn; Maria Hagströmer; Charlotte Edwardson; Thomas Yates; Eric J Shiroma; Paddy C Dempsey; Katrien Wijndaele; Sigmund A Anderssen; I-Min Lee; Ulf Ekelund Journal: Br J Sports Med Date: 2021-12-07 Impact factor: 18.473