Hartman Sheri J, LaCroix Andrea Z, Sears Dorothy D, Natarajan Loki, Zablocki Rong W, Chen Ruohui, Patterson Jeffrey S, Dillon Lindsay, Sallis James F, Schenk Simon, Dunstan David W, Owen Neville, Rosenberg Dori E
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla. (S.J.H., A.Z.L., L.N., R.W.Z., R.C., L.D., J.F.S.).
Moores Cancer Center, University of California San Diego, La Jolla. (S.J.H., D.D.S., L.N.).
Circulation. 2025 Jul 25. doi: 10.1161/CIRCULATIONAHA.124.073385.
Public health and clinical guidelines identify the importance of sedentary behaviors for cardiovascular diseases, particularly among postmenopausal women. The goal of this trial was to compare the behavioral and physiological impacts of 2 distinct approaches to changing sedentary behaviors.
Overweight or obese sedentary postmenopausal women (N=407) were randomly assigned to 1 of 3 study conditions for 3 months: (1) healthy living (control), (2) reduce sitting time (sit less), and (3) increase sit-to-stand transitions (STSTs; sit-to-stand). Each study arm received 7 individual health coach sessions across 12 weeks. At baseline and 3 months, participants had fasting blood drawn, had blood pressure measured, and wore thigh (activPal) and hip (ActiGraph) accelerometers for 7 days. Linear mixed models evaluated each intervention arm compared with the control (healthy living) arm.
A total of 388 women (95%) completed the 3-month trial. The sit less arm reduced total sitting time by 58 minutes per day more than the healthy living arm (95% CI, -82.9 to -33.6; <0.001) but did not change STSTs (-1 STST/day [95% CI, -9.4 to 6.5]; =0.72). Conversely, the sit-to-stand arm significantly increased STST by 26 STST per day more than the healthy living arm (95% CI, 17.71 to 33.64; <0.001) but did not differ in change to sitting time (-10 min/day [95% CI, -34.6 to 14.9]; =0.44). The sit-to-stand arm had significant decreases in diastolic blood pressure compared with the healthy living arm (-2.24 mm Hg [95% CI, -4.08 to -0.40]; =0.02) and similar decreases in systolic blood pressure compared with the healthy living arm (-3.33 mm Hg [95% CI, -6.32 to -0.33]; =0.03), although it did not reach the a priori significance threshold of <0.025. There were no significant intervention effects on blood pressure for the sit less arm and no intervention effects for the glucoregulatory outcomes for either arm.
This trial demonstrated the feasibility of changing sedentary behaviors as well as the distinct nature of sitting time and STST. Increasing STST improved blood pressure in overweight and obese postmenopausal women within 3 months. Focusing on increasing STST may be an achievable behavioral target to reduce cardiovascular disease risk in postmenopausal women.
URL: https://www.clinicaltrials.gov; Unique identifier: NCT03473145.
公共卫生和临床指南指出久坐行为对心血管疾病的重要性，尤其是在绝经后女性中。本试验的目的是比较两种不同改变久坐行为方法的行为和生理影响。
超重或肥胖的久坐绝经后女性（N = 407）被随机分配到3种研究条件中的1种，为期3个月：（1）健康生活（对照组），（2）减少久坐时间（少坐），（3）增加坐立转换次数（STSTs；坐立）。每个研究组在12周内接受7次个人健康教练指导。在基线和3个月时，参与者进行空腹采血、测量血压，并佩戴大腿（activPal）和臀部（ActiGraph）加速度计7天。线性混合模型评估每个干预组与对照组（健康生活组）相比的情况。
共有388名女性（95%）完成了3个月的试验。少坐组每天的总久坐时间比健康生活组减少了58分钟（95%CI，-82.9至-33.6；<0.001），但坐立转换次数没有变化（每天-1次坐立转换[95%CI，-9.4至6.5]；P = 0.72）。相反，坐立组每天的坐立转换次数比健康生活组显著增加了26次（95%CI，17.71至33.64；<0.001），但久坐时间的变化没有差异（每天-10分钟[95%CI，-34.6至14.9]；P = 0.44）。与健康生活组相比，坐立组的舒张压显著降低（-2.24 mmHg[95%CI，-4.08至-0.40]；P = 0.02），收缩压与健康生活组相比也有类似程度的降低（-3.33 mmHg[95%CI，-6.32至-0.33]；P = 0.03），尽管未达到预先设定的<0.025的显著性阈值。少坐组对血压没有显著干预效果，且两组对血糖调节指标均无干预效果。
本试验证明了改变久坐行为的可行性以及久坐时间和坐立转换次数的不同性质。在3个月内增加坐立转换次数可改善超重和肥胖绝经后女性的血压。关注增加坐立转换次数可能是降低绝经后女性心血管疾病风险的一个可实现的行为目标。
