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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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