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New global guidelines on sedentary behaviour and health for adults: broadening the behavioural targets

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posted on 2021-06-23, 11:52 authored by PC Dempsey, SJH Biddle, MP Buman, S Chastin, U Ekelund, CM Friedenreich, PT Katzmarzyk, MF Leitzmann, E Stamatakis, HP Van der Ploeg, J Willumsen, F Bull
Background: In 2018, the World Health Organisation (WHO) commenced a program of work to update the 2010 Global Recommendations on Physical Activity for Health, for the first-time providing population-based guidelines on sedentary behaviour. This paper briefly summarizes and highlights the scientific evidence behind the new sedentary behaviour guidelines for all adults and discusses its strengths and limitations, including evidence gaps/research needs and potential implications for public health practice. Methods: An overview of the scope and methods used to update the evidence is provided, along with quality assessment and grading methods for the eligible new systematic reviews. The literature search update was conducted for WHO by an external team and reviewers used the AMSTAR 2 (Assessment of Multiple Systematic Reviews) tool for critical appraisal of the systematic reviews under consideration for inclusion. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to rate the certainty (i.e. very low to high) of the evidence. Results: The updated systematic review identified 22 new reviews published from 2017 up to August 2019, 14 of which were incorporated into the final evidence profiles. Overall, there was moderate certainty evidence that higher amounts of sedentary behaviour increase the risk for all-cause, cardiovascular disease (CVD) and cancer mortality, as well as incidence of CVD, cancer, and type 2 diabetes. However, evidence was deemed insufficient at present to set quantified (time-based) recommendations for sedentary time. Moderate certainty evidence also showed that associations between sedentary behaviour and all-cause, CVD and cancer mortality vary by level of moderate-to-vigorous physical activity (MVPA), which underpinned additional guidance around MVPA in the context of high sedentary time. Finally, there was insufficient or low-certainty systematic review evidence on the type or domain of sedentary behaviour, or the frequency and/or duration of bouts or breaks in sedentary behaviour, to make specific recommendations for the health outcomes examined. Conclusions: The WHO 2020 guidelines are based on the latest evidence on sedentary behaviour and health, along with interactions between sedentary behaviour and MVPA, and support implementing public health programmes and policies aimed at increasing MVPA and limiting sedentary behaviour. Important evidence gaps and research opportunities are identified.

Funding

The Public Health Agency of Canada and the Government of Norway provided financial support to update the WHO guidelines on physical activity and sedentary behaviour. PCD is supported by a National Health and Medical Research Council (NHMRC) of Australia Fellowship (#1142685) and the UK Medical Research Council [MC_UU_12015/3]. ES is funded by a NHMRC of Australia Senior Research Fellowship (#1110526) and an Investigator Grant (#1194510), and PAL Technologies (Scotland) who develop equipment measuring sedentary behaviour.

History

Citation

Int J Behav Nutr Phys Act 17, 151 (2020)

Author affiliation

Diabetes Research Centre

Version

  • VoR (Version of Record)

Published in

International Journal of Behavioral Nutrition and Physical Activity

Volume

17

Publisher

BioMed Central

eissn

1479-5868

Acceptance date

2020-10-23

Copyright date

2020

Available date

2020-11-26

Spatial coverage

England

Language

English

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