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Sitting behaviour and physical activity: two sides of the same cardiovascular health coin?
  1. Emmanuel Stamatakis1,2,
  2. Jason M R Gill3
  1. 1 Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
  2. 2 School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
  3. 3 Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
  1. Correspondence to Professor Emmanuel Stamatakis, Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia; emmanuel.stamatakis{at}

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Sedentary behaviour, or too much sitting, is considered an emerging risk factor for cardiovascular disease (CVD); however, little is known about its interplay with physical activity (PA). In other words, does sitting elevate CVD risk in those who are highly physically active? In this issue of BJSM, Ekelund and colleagues1 present results from a large pooled analysis on the associations between sedentary behaviour (sitting time and TV time) and cause-specific mortality across different levels of moderate to vigorous physical activity (MVPA). Here, we comment specifically on the associations of sitting time with CVD mortality in nine pooled studies including over 850 000 participants.

This very large data set1 highlights that high levels of MVPA may eliminate the associations between sitting and CVD mortality. Dose-response of CVD mortality risk with sitting was evident only in the least active quartile which corresponds to those people who undertake <5 min of MVPA per day.1

Importantly, and good news for the many recreationally active office workers, the association of sitting with CVD death was eliminated at the top MVPA quartile (which corresponded to over approximately 65 min/day1). For the two middle quartiles (that is, those in a wide span from ≥5 through to 65 MVPA …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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