Collings Paul J, Wang Mengyao, Ho Harrison Hin Sheung, Au Yeung Shiu Lun, Siu Parco M, Cowling Benjamin J, Sharp Stephen J, Brage Søren, Wareham Nicholas J, Du Huaidong, Bennett Derrick A, Kim Youngwon
School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China.
MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Lancet Reg Health West Pac. 2025 Mar 23;57:101524. doi: 10.1016/j.lanwpc.2025.101524. eCollection 2025 Apr.
In Chinese adults, there is a considerable burden of sedentary behaviour. This study aimed to estimate the implications of reallocating sedentary leisure-time to non-sedentary behaviours for incident cardiometabolic diseases.
A prospective cohort study of 462,370 Chinese adults (mean age 51 years; 59% female) who were free from diabetes and cardiovascular diseases at baseline. Isotemporal substitution Cox regression models were used to estimate the associations of reallocating self-reported sedentary leisure-time to the same amount of sleep, housework, Taichi, or conventional exercise (e.g., walking, jogging, ball games, swimming) with the risk of incident diabetes, stroke, and myocardial infarction (MI). The results are reported as adjusted hazard ratios and 95% confidence intervals per 30 min/day time exchanges. Potential impact fractions were calculated to estimate the proportional reductions in incident disease cases associated with time substitutions, assuming causality.
During >5.25 million person-years of follow-up, 19,738 incident diabetes, 51,460 stroke, and 6767 MI cases were accrued. Lower disease risks were found for replacement of sedentary leisure-time by sleep (diabetes: 0.97 [0.95-0.99], stroke: 0.98 [0.97-0.99], MI: 0.97 [0.94-0.99]; in participants who slept <7 h/day), housework (diabetes: 0.97 [0.97-0.98], stroke: 0.99 [0.98-0.99], MI: 0.97 [0.95-0.98]), Taichi (diabetes: 0.97 [0.95-0.99], stroke: 0.98 [0.97-0.99], MI: 0.95 [0.92-0.98]), or conventional exercise (diabetes: 0.97 [0.95-0.99], stroke: 0.97 [0.95-0.98], MI: 0.92 [0.88-0.96]). Potential impact fractions ranged from an estimated 3.5% (95% confidence interval: 3.1-3.9%) fewer cases of incident stroke when replacing sedentary leisure-time with housework, to an estimated 9.6% (5.9-13.3%) fewer cases of incident MI when reallocating sedentary leisure-time to conventional exercise.
Replacing sedentary leisure-time with behaviours such as housework, Taichi, sleep (in short sleepers) and conventional exercise is associated with lower risks of common cardiometabolic diseases in Chinese adults. Prevention strategies should be developed to promote movement behaviours and optimal levels of sleep at the expense of sedentary leisure-time.
This analysis was supported by a Health and Medical Research Fund (HMRF) Research Fellowship (grant no: 06200087).
在中国成年人中，久坐行为的负担相当大。本研究旨在评估将久坐休闲时间重新分配为非久坐行为对新发心脑血管疾病的影响。
对462370名中国成年人（平均年龄51岁；59%为女性）进行前瞻性队列研究，这些参与者在基线时无糖尿病和心血管疾病。采用等时替代Cox回归模型，估计将自我报告的久坐休闲时间重新分配为相同时长的睡眠、家务、太极拳或传统运动（如散步、慢跑、球类运动、游泳）与新发糖尿病、中风和心肌梗死（MI）风险之间的关联。结果以每30分钟/天时间交换的调整后风险比和95%置信区间报告。假设存在因果关系，计算潜在影响分数以估计与时间替代相关的新发疾病病例的比例减少。
在超过525万人年的随访期间，共发生19738例新发糖尿病、51460例中风和6767例MI病例。用睡眠（糖尿病：0.97[0.95 - 0.99]，中风：0.98[0.97 - 0.99]，MI：0.97[0.94 - 0.99]；在每天睡眠不足7小时的参与者中）、家务（糖尿病：
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