Department of Epidemiology and Health Statistics, School of Public Health, Wenzhou Medical University, Zhejiang, China.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
JAMA Netw Open. 2024 Jun 3;7(6):e2416300. doi: 10.1001/jamanetworkopen.2024.16300.
Sleep duration and moderate-to-vigorous physical activity (MVPA) are associated with healthy aging, but the associations of sedentary behaviors and light-intensity physical activity (LPA) with healthy aging are still unclear.
To examine the independent association of sedentary behaviors and LPA with healthy aging, and to estimate the theoretical association of replacing sedentary behavior with LPA, MVPA, or sleep with healthy aging.
DESIGN, SETTING, AND PARTICIPANTS: In this cohort study using data from the Nurses' Health Study, participants aged 50 years or older and free of major chronic diseases in 1992 were prospectively followed up for 20 years. Data were analyzed from January to May 2022.
Three measures for sedentary behaviors (hours watching television, sitting at work, and other sitting at home) and 2 measures for LPA (hours of standing or walking around at home [LPA-Home] and at work [LPA-Work]).
Healthy aging was defined as survival to at least age 70 years with maintenance of 4 health domains (ie, no major chronic diseases and no impairment in subjective memory, physical function, or mental health). The isotemporal substitution model was used to evaluate the potential impact on healthy aging of replacing 1 hour of 1 behavior with equivalent duration of another.
Among 45 176 participants (mean [SD] age, 59.2 [6.0] years), 3873 (8.6%) women achieved healthy aging. After adjustment for covariates including MVPA, each increment of 2 hours per day in sitting watching television was associated with a 12% (95% CI, 7%-17%) reduction in the odds of healthy aging. In contrast, each increase of 2 hours per day in LPA-Work was associated with a 6% (95% CI, 3%-9%) increase in the odds of healthy aging. Replacing 1 hour of sitting watching television with LPA-Home (OR, 1.08; 95% CI, 1.05-1.12), LPA-Work (OR, 1.10; 95% CI, 1.07-1.14), or MVPA (OR, 1.28; 95% CI, 1.23-1.34) was associated with increased odds of healthy aging. Among participants who slept 7 hours per day or less, replacing television time with sleep was also associated with increased odds of healthy aging.
In this cohort study, longer television watching time decreased odds of healthy aging, whereas LPA and MVPA increased odds of healthy aging and replacing sitting watching television with LPA or MVPA, or with sleep in those who slept 7 hours per day or less, was associated with increased odds of healthy aging, providing evidence for rearranging 24-hour behavior to promote overall health.
睡眠时长和中等至剧烈强度的身体活动（MVPA）与健康衰老有关，但久坐行为和低强度身体活动（LPA）与健康衰老的关联仍不清楚。
研究久坐行为和 LPA 与健康衰老的独立关联，并估计用 LPA、MVPA 或睡眠替代久坐行为对健康衰老的理论关联。
设计、地点和参与者：这是一项使用护士健康研究数据的队列研究，参与者年龄在 50 岁或以上，并且在 1992 年没有重大慢性疾病，前瞻性随访 20 年。数据于 2022 年 1 月至 5 月进行分析。
久坐行为的三个测量指标（看电视的时间、工作时坐着的时间和其他在家坐着的时间）和 LPA 的两个测量指标（在家时站立或走动的时间[LPA-Home]和在工作时站立或走动的时间[LPA-Work]）。
健康衰老定义为至少活到 70 岁且保持 4 个健康领域（即没有重大慢性疾病和没有主观记忆、身体功能或心理健康受损）。使用等时替代模型评估用 1 小时的 1 种行为替代另 1 种行为的潜在影响对健康衰老的影响。
在 45176 名参与者（平均[标准差]年龄，59.2[6.0]岁）中，3873 名（8.6%）女性实现了健康衰老。在调整包括 MVPA 在内的协变量后，每天增加 2 小时坐着看电视与健康衰老的几率降低 12%（95%CI，7%-17%）相关。相比之下，每天增加 2 小时 LPA-Work 与健康衰老的几率增加 6%（95%CI，3%-9%）相关。用 LPA-Home（OR，1.08；95%CI，1.05-1.12）、LPA-Work（OR，1.10；95%CI，1.07-1.14）或 MVPA（OR，1.28；95%CI，1.23-1.34）替代 1 小时坐着看电视与健康衰老的几率增加相关。在每天睡眠 7 小时或更少的参与者中，用睡眠替代看电视时间也与健康衰老的几率增加相关。
在这项队列研究中，看电视时间延长会降低健康衰老的几率，而 LPA 和 MVPA 则会增加健康衰老的几率，用 LPA 或 MVPA 或睡眠替代每天睡眠 7 小时或更少的时间与健康衰老的几率增加相关，这为重新安排 24 小时的行为以促进整体健康提供了证据。
