01: Grasping the Sedentary Lifestyle

The Dangers of Prolonged Sitting

In today's world, many of us spend long hours sitting - whether at a desk, in a car, or on the couch. However, this seemingly innocuous habit can pose significant health risks. Prolonged sitting has been linked to several chronic health conditions, including cardiovascular disease (CVD), diabetes, and certain types of cancer. When we sit for extended periods, our lower body muscles are inactive, leading to reduced insulin sensitivity and slower metabolism. This inactivity can increase blood sugar levels, contributing to the development of type 2 diabetes.

Furthermore, sitting for too long can cause poor posture, resulting in musculoskeletal issues such as back pain and neck strain. When we slouch, additional pressure is placed on our spine and muscles, leading to discomfort and chronic pain over time. Additionally, prolonged sitting can reduce blood flow, increasing the risk of deep vein thrombosis (DVT), where blood clots form in the veins, often in the legs.

Studies have also shown a correlation between extended sitting and a higher risk of premature death. This is because sitting for long hours can contribute to weight gain and obesity, significant risk factors for many chronic diseases. Moreover, sedentary behavior is associated with higher levels of inflammation and oxidative stress, both of which play a role in the development of cardiovascular disease.

Exploring the Step Count Study

Understanding the need to counteract the effects of prolonged sitting, researchers conducted a comprehensive study published in the British Journal of Sports Medicine. This study aimed to determine the optimal number of daily steps required to mitigate the adverse health effects of a sedentary lifestyle.

The study involved 72,174 participants who wore wrist accelerometers to measure their daily physical activity and sedentary time accurately. Participants were tracked over several years, allowing researchers to gather extensive data on their movement patterns and health outcomes. The primary goal was to find out how many daily steps are necessary to offset the harmful effects of prolonged sitting.

Researchers categorized participants into different groups based on their daily step counts and the amount of time they spent sitting each day. They then analyzed the data to identify any correlations between step counts, sedentary time, and health outcomes, particularly focusing on mortality rates and the incidence of cardiovascular disease.

Vital Insights from the Study

The findings of the study were enlightening and hold significant implications for public health. The researchers concluded that taking between 9,000 and 10,000 steps daily can significantly reduce the risks of mortality and cardiovascular disease, regardless of the amount of time spent sitting. This range of steps was associated with a 21% reduction in the risk of cardiovascular disease and a 39% reduction in the risk of mortality.

For those with highly sedentary lifestyles, even a lower step count of 4,000 to 4,500 steps per day was found to offer substantial health benefits. This is particularly important for individuals with desk jobs or those who spend a lot of time sitting for other reasons. The study emphasized that every step counts towards improving health outcomes, and even modest increases in physical activity can make a significant difference.

One of the most compelling aspects of the study is its practical application. By providing a clear, quantifiable goal for daily steps, it offers a straightforward strategy for individuals looking to improve their health. Unlike more abstract health advice, the recommendation of a specific step count is easy to understand and implement.

Moreover, the study highlights the importance of incorporating movement into our daily routines. It suggests that even if we cannot avoid prolonged periods of sitting, we can still take steps - literally - to mitigate the associated health risks. This could involve simple actions like taking regular breaks to walk around, using a standing desk, or engaging in short bursts of physical activity throughout the day.

Quiz Your Knowledge: Grasping the Sedentary Lifestyle

Question 1:
Which health risks are linked to a sedentary lifestyle?
A) Obesity
B) Cardiovascular Disease
C) Diabetes
D) All of the above

Click here to reveal the answer.

Correct Answer: D) All of the above

Explanation:
Prolonged sitting is associated with several health risks, including obesity, cardiovascular disease, and diabetes.

Question 2:
What was the primary aim of the study in the British Journal of Sports Medicine?
A) To find a new exercise routine
B) To identify the optimal number of daily steps to mitigate the health risks of sitting
C) To promote a sedentary lifestyle
D) To analyze dietary habits

Click here to reveal the answer.

Correct Answer: B) To identify the optimal number of daily steps to mitigate the health risks of sitting

Explanation:
The study aimed to determine the optimal number of daily steps needed to offset the health risks associated with prolonged sitting.

Question 3:
How many steps per day are suggested by the study to reduce mortality risk?
A) 5,000 steps
B) 7,000 steps
C) 9,000 - 10,000 steps
D) 12,000 steps

Click here to reveal the answer.

Correct Answer: C) 9,000 - 10,000 steps

Explanation:
The study found that taking between 9,000 and 10,000 steps daily is optimal for reducing mortality and cardiovascular disease risk.

Question 4:
Can individuals with high sedentary lifestyles benefit from fewer than 10,000 steps per day?
A) Yes
B) No
C) Only if they exercise vigorously
D) Only on weekends

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Correct Answer: A) Yes

Explanation:
Even highly sedentary individuals can benefit from taking as few as 4,000 to 4,500 steps per day.

02: Tailored Step Recommendations

Debunking the 10,000 Steps Myth

The magic number of 10,000 steps a day has become a widely accepted goal, but do you know where it originated? Contrary to popular belief, it wasn't born from rigorous scientific research. Instead, it emerged from a marketing campaign in Japan during the 1960s to promote a pedometer named "Manpo-kei," which translates to "10,000-step meter." While catchy and easy to remember, this number was more of a marketing strategy than a scientifically validated health recommendation.

Recent studies have revealed that while 10,000 steps can be a beneficial goal, it's not a one-size-fits-all solution. The number of steps needed for significant health benefits can vary based on individual health conditions, lifestyle, and other factors. Research published in the Journal of the American Medical Association found that even walking 4,400 steps per day significantly reduced mortality rates among older women compared to those who walked fewer than 2,700 steps. Therefore, while aiming for 10,000 steps is great, it's essential to recognize that fewer steps can still offer substantial health benefits.

Why Every Step Matters

Understanding the profound impact of each step can transform how we approach our daily activity. Increasing your step count can lead to numerous health improvements, making it crucial to weave more movement into your routine.

Cardiovascular Health: Regular walking helps to strengthen the heart and improve circulation. A study in the American Heart Association Journal found that individuals who walked more steps daily had a significantly lower risk of heart disease and stroke. Walking increases heart rate, improves blood flow, and helps manage blood pressure and cholesterol levels.

Mood Enhancement: Physical activity, including walking, triggers the release of endorphins, the body's natural mood lifters. Research from Harvard Medical School indicates that walking can reduce symptoms of depression and anxiety, offering a natural way to boost mental health. The rhythmic nature of walking also promotes mindfulness, reducing stress and enhancing overall well-being.

Weight Management: Walking is an excellent way to burn calories and maintain a healthy weight. It boosts metabolism and helps in regulating appetite. Studies have shown that individuals who walk regularly are more likely to maintain a stable weight compared to those who are sedentary. The Centers for Disease Control and Prevention (CDC) states that regular physical activity, including walking, helps control weight, reduce the risk of obesity, and enhance metabolic health.

Chronic Disease Prevention: Regular physical activity, such as walking, reduces the risk of developing chronic diseases like type 2 diabetes, hypertension, and certain cancers. A study published in the British Journal of Sports Medicine highlighted that even moderate increases in daily steps could lower the incidence of chronic diseases, promoting a longer, healthier life.

Easy Ways to Add Steps

Incorporating more steps into your daily routine doesn't have to be daunting. Here are some practical strategies to increase your step count effortlessly:

Short Walks: Integrate brief walks into your daily schedule. Take a 10-minute walk during your lunch break or a stroll after dinner. These small increments can add up quickly.

Stairs Over Elevators: Opt for stairs whenever possible. Climbing stairs is an excellent way to boost your step count and improve cardiovascular fitness.

Active Commutes: If possible, walk or cycle to work. For those using public transport, try getting off a stop early and walking the rest of the way. This not only increases steps but also reduces your carbon footprint.

Walking Meetings: Transform your meetings into walking sessions. This can increase creativity, reduce stress, and help you stay active throughout the day.

Use Fitness Trackers: Technology can be a powerful motivator. Use fitness trackers or smartphone apps to monitor your steps, set goals, and track your progress. Many devices offer reminders to move if you've been sedentary for too long.

Quiz Your Knowledge: Understanding Sedentary Lifestyles and Health Risks

Question 1:
Where did the 10,000 steps recommendation originate?
A) Scientific research
B) A marketing strategy
C) Government guidelines
D) A fitness guru

Click here to reveal the answer.

Correct Answer: B) A marketing strategy

Explanation:
The 10,000 steps recommendation was initially a marketing strategy, not based on scientific evidence.

Question 2:
What are some benefits of increasing daily steps?
A) Improved cardiovascular health
B) Enhanced mood
C) Better weight management
D) All of the above

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Correct Answer: D) All of the above

Explanation:
Increasing daily steps offers numerous health benefits, including better cardiovascular health, mood enhancement, and weight management.

Question 3:
Which strategy helps increase daily steps?
A) Using the elevator
B) Taking short walks during breaks
C) Sitting during meetings
D) Driving everywhere

Click here to reveal the answer.

Correct Answer: B) Taking short walks during breaks

Explanation:
Taking short walks during breaks is an effective way to boost your daily step count.

Question 4:
How can fitness trackers assist in increasing steps?
A) By providing distraction
B) By monitoring steps and setting goals
C) By recommending sedentary activities
D) By tracking sleep only

Click here to reveal the answer.

Correct Answer: B) By monitoring steps and setting goals

Explanation:
Fitness trackers help monitor your steps and set achievable goals, encouraging more movement.

03: The Impact of Sedentary Time

Health Risks of Excessive Sitting

The modern lifestyle often involves extensive sitting, whether it's at a desk, in a car, or on the couch. However, spending more than 10.5 hours a day sitting is a significant health risk. According to research published by the American Heart Association, high sedentary time is linked to poor metabolic health, elevated blood pressure, and increased body fat, all of which elevate the risk of cardiovascular disease (CVD) and early death. This study highlights the various adverse health outcomes associated with prolonged sitting, emphasizing the importance of incorporating more movement into our daily routines.

Excessive sitting can slow down your metabolism, leading to an accumulation of visceral fat - fat that wraps around your internal organs. This type of fat is particularly dangerous as it contributes to insulin resistance, inflammation, and metabolic syndrome, which increases the risk of developing type 2 diabetes and heart disease. Moreover, prolonged sitting can cause muscles to burn less fat and blood to flow more sluggishly, increasing the risk of arterial blockage and hypertension.

Beyond metabolic health, sitting for long periods can also negatively affect musculoskeletal health. Poor posture from extended sitting can lead to chronic back, neck, and shoulder pain. Inactivity can cause muscle degeneration and weaken the core muscles, leading to poor balance and increased risk of injury.

Strategies to Reduce Sedentary Time

Addressing the health risks of excessive sitting requires proactive strategies to incorporate more movement into your day. Here are several effective methods to reduce sedentary time:

Standing Desks: One simple yet effective solution is using a standing desk. Studies, such as those from the Journal of Occupational and Environmental Medicine, have shown that standing desks can reduce back and neck pain while increasing overall energy levels. Alternating between sitting and standing throughout the day can help reduce the strain on your body.

Regular Breaks: Set a timer to remind yourself to take short breaks every hour. Use these breaks to stand up, stretch, or take a quick walk. These mini-breaks can significantly reduce the negative impacts of prolonged sitting.

Active Workstations: Consider using active workstations, such as treadmill desks or under-desk ellipticals. These can help you stay active while you work, promoting better circulation and reducing sedentary time.

Movement Integration: Incorporate more movement into your daily routine. Take phone calls while standing or walking, use stairs instead of elevators, and walk to communicate with colleagues instead of emailing or messaging.

Stretching Exercises: Engage in stretching exercises regularly. Simple stretches for your back, neck, and shoulders can alleviate tension and improve flexibility.

Combining Steps with Less Sitting

Maximizing the health benefits of physical activity involves a combination of increasing your daily steps and reducing sedentary time. While taking more steps is beneficial, long periods of sitting can negate some of these benefits. Therefore, it’s essential to balance both strategies for optimal health outcomes.

Integrate Movement: Try integrating movement into tasks that are usually sedentary. For instance, stand or walk while reading, watching TV, or during meetings. This approach helps break up long periods of inactivity.

Set Daily Goals: Use fitness trackers to set and achieve daily step goals. Aim for at least 4,000 to 4,500 steps if you're highly sedentary, gradually increasing to 9,000 to 10,000 steps as you become more active.

Active Lifestyle Habits: Develop habits that encourage an active lifestyle. Park farther from your destination, take a walk during lunch breaks, and choose physically engaging hobbies like gardening, dancing, or playing a sport.

Real-Life Success Stories

The effectiveness of reducing sedentary time combined with increasing steps can be seen through numerous real-life examples. Here are a few success stories:

Corporate Wellness Programs: Many companies have implemented wellness programs that include standing desks, walking meetings, and regular break reminders. Employees participating in these programs report higher energy levels, reduced back pain, and improved productivity. A study by the Harvard Medical School highlighted that employees using standing desks showed a 53% improvement in lower back and neck pain after just four weeks.

Community Walking Programs: In various communities, walking programs have been established to encourage residents to be more active. These programs often include organized group walks, step challenges, and educational workshops on the benefits of physical activity. Participants typically experience significant improvements in their health, including weight loss, lower blood pressure, and enhanced mood.

Personal Transformations: Individuals who have adopted active lifestyles share inspiring stories of transformation. For example, a desk-bound office worker who started using a standing desk and taking regular walking breaks lost 20 pounds and reported feeling more energetic and focused at work. Another individual incorporated daily walks into their routine, reducing their risk of developing type 2 diabetes and significantly improving their cardiovascular health.

Quiz Your Knowledge: The Impact of Sedentary Time

Question 1:
What is considered high sedentary time?
A) More than 5 hours per day
B) More than 7 hours per day
C) More than 10.5 hours per day
D) More than 12 hours per day

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Correct Answer: C) More than 10.5 hours per day

Explanation:
High sedentary time is defined as spending more than 10.5 hours per day sitting, which is associated with various health risks.

Question 2:
Which strategy can help reduce sedentary time?
A) Using a standing desk
B) Watching TV for extended periods
C) Driving instead of walking
D) Sitting through long meetings

Click here to reveal the answer.

Correct Answer: A) Using a standing desk

Explanation:
Using a standing desk is an effective strategy to reduce sedentary time, helping to alleviate back and neck pain and increase energy levels.

Question 3:
What combination provides the best health outcomes?
A) High step count and high sedentary time
B) Low step count and low sedentary time
C) High step count and reduced sedentary time
D) Low step count and high sedentary time

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Correct Answer: C) High step count and reduced sedentary time

Explanation:
Combining a high step count with reduced sedentary time yields the best health outcomes by promoting movement and minimizing the negative effects of prolonged sitting.

Question 4:
What benefit did employees report from using standing desks?
A) Increased fatigue
B) Reduced energy levels
C) Improved energy levels
D) Increased back pain

Click here to reveal the answer.

Correct Answer: C) Improved energy levels

Explanation:
Employees using standing desks reported higher energy levels and reduced back pain, contributing to overall better health and productivity.

04: Practical Recommendations for Increasing Daily Steps

Easy Strategies to Increase Steps

Boosting your daily step count doesn’t require drastic changes. Here are some simple yet effective strategies to weave more steps into your daily routine:

Take Short Walks: Break up long periods of sitting with short walks. Aim to walk for five minutes every hour. Setting a timer can help remind you to get up and move.

Use Stairs Instead of Elevators: Whenever possible, choose stairs over elevators. This small change can significantly increase your daily step count.

Park Farther Away: Parking at the far end of parking lots increases your walking distance. This small adjustment can easily add a few hundred steps to your day.

Walk and Talk: Make phone calls while walking or suggest walking meetings. This can be an excellent way to stay active during work hours.

Combine Errands: Instead of driving, consider walking to nearby stores or combining errands into a single trip to maximize your walking.

Utilizing Technology for Step Tracking

With the advancement of technology, tracking your daily steps has never been easier. Here’s how wearable devices and apps can help:

Overview of Popular Devices: Wearable devices like Fitbit, Apple Watch, and Garmin provide accurate step counts and other health metrics. These devices are user-friendly and can sync with your smartphone for detailed insights.

Benefits of Tracking Steps: Monitoring your step count can keep you motivated and accountable. Setting daily goals and tracking your progress helps maintain consistency and make informed decisions about your physical activity.

Choosing the Right Device: When selecting a wearable device, consider factors like battery life, comfort, accuracy, and the specific features that suit your needs. Some devices offer additional functionalities like heart rate monitoring, sleep tracking, and GPS.

Wearable technology provides real-time feedback and can be an effective tool to encourage more movement, making it easier to reach your daily step goals.

Quiz Your Knowledge: Practical Recommendations for Increasing Daily Steps

Question 1:
What is one simple strategy to increase daily steps?
A) Use elevators instead of stairs
B) Take walking meetings
C) Sit during lunch breaks
D) Drive short distances

Click here to reveal the answer.

Correct Answer: B) Take walking meetings

Explanation:
Taking walking meetings is an effective way to increase daily steps.

Question 2:
Which of the following is a benefit of using wearable devices for tracking steps?
A) They are less expensive
B) They require less effort
C) They provide continuous and objective data
D) They eliminate the need for physical activity

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Correct Answer: C) They provide continuous and objective data

Explanation:
Wearable devices offer continuous and objective tracking of physical activity, which is more accurate than self-reported data.

Question 3:
How can workplaces help employees reduce sedentary time?
A) Provide comfortable chairs
B) Offer standing desks
C) Encourage long meetings
D) Limit break times

Click here to reveal the answer.

Correct Answer: B) Offer standing desks

Explanation:
Providing standing desks encourages employees to stand and move more, reducing sedentary time.

Question 4:
What is one recommended way to add steps to your daily routine?
A) Skip exercise
B) Walk short distances instead of driving
C) Avoid walking breaks
D) Increase screen time

Click here to reveal the answer.

Correct Answer: B) Walk short distances instead of driving

Explanation:
Choosing to walk short distances rather than driving helps increase daily step count.

05: Sustaining Long-Term Benefits

Beyond Step Counts

Regular walking extends far beyond merely increasing your step count. Its benefits permeate various aspects of your life, leading to a healthier, more fulfilling existence. Walking is a natural mood enhancer. According to a study published in the Journal of Medical Internet Research, regular walking can significantly reduce symptoms of anxiety and depression, thanks to the endorphins released during physical activity. These natural mood lifters help combat stress and improve overall mental health.

Furthermore, walking boosts your immune system. A study from Appalachian State University found that those who walked briskly for 30 to 45 minutes daily had 43% fewer sick days than those who didn't exercise. Regular physical activity increases the circulation of immune cells in your body, helping you fend off illnesses more effectively.

Beyond mental health and immunity, walking enhances overall well-being. It can improve sleep quality, enhance cognitive function, and even boost creativity. Research from Stanford University reveals that walking can increase creative output by 60%. This means that regular walkers often experience improved problem-solving skills and a greater capacity for innovative thinking.

Building a Sustainable Routine

Creating a sustainable walking routine is essential for reaping long-term health benefits. Here’s how to establish a routine that you can stick to:

Set Realistic Goals: Start with achievable goals based on your current fitness level. For instance, if you're new to walking, begin with a goal of 5,000 steps a day and gradually increase it.

Gradually Increase Activity Levels: Avoid the temptation to overdo it at the beginning. Gradually increase your daily step count to prevent burnout and reduce the risk of injury. Incremental progress ensures that your routine is sustainable.

Make Physical Activity a Habit: Incorporate walking into your daily schedule until it becomes a habit. Consistency is crucial. Aim to walk at the same time each day, whether it's in the morning, during lunch breaks, or after dinner.

Variety and Enjoyment: Keep your walks interesting by changing your routes, walking in different environments, or listening to music or podcasts. Enjoyable activities are more likely to become long-term habits.

Overcoming Obstacles

Identifying and overcoming obstacles to physical activity can help you maintain a consistent walking routine. Here are some common challenges and strategies to address them:

Lack of Time: Time constraints are one of the most common barriers to regular physical activity. Overcome this by incorporating walking into your daily routine. Walk to work, take short walks during breaks, or integrate walking into your commute.

Lack of Motivation: Staying motivated can be challenging. Set short-term and long-term goals, track your progress, and reward yourself for achievements. Joining a walking group or finding a walking buddy can also boost motivation through social support and accountability.

Finding Enjoyable Activities: Physical activity should be enjoyable. Experiment with different walking routes, explore nature trails, or walk in new neighborhoods. Combining walking with activities you enjoy, such as photography or bird watching, can make it more appealing.

Support from Friends and Family: Engage your friends and family in your walking routine. Their support can provide encouragement and make walking a social activity that you look forward to.

Monitoring Progress and Adjusting Goals

Regularly tracking your progress and adjusting your goals are crucial for maintaining motivation and ensuring continuous improvement. Here's how to effectively monitor and adapt your walking routine:

Track Your Progress: Use fitness trackers, smartphone apps, or even a simple journal to record your daily steps and physical activity. Keeping track of your progress helps you stay accountable and motivated.

Set Incremental Goals: Break down your long-term goals into smaller, manageable milestones. Celebrate these milestones to keep your motivation high. Each achievement is a step closer to your ultimate goal.

Adjust Goals as Needed: As you become more fit, adjust your goals to challenge yourself further. If you find your current routine too easy or too hard, modify your step count or walking intensity to maintain a balance that is both challenging and achievable.

Celebrate Milestones: Recognize and celebrate your progress. Whether it's reaching a new step count, completing a walking challenge, or noticing improvements in your health, celebrating milestones reinforces your commitment to a healthier lifestyle.

By understanding the various aspects of a sedentary lifestyle and the importance of increasing daily steps, you can make informed decisions to enhance your health. Incorporating practical strategies, leveraging technology, and harnessing social support can help you build and sustain a healthy, active lifestyle. Celebrate your progress, adjust your goals as needed, and enjoy the journey towards better health and well-being.

Quiz Your Knowledge: Sustaining Long-Term Benefits

Question 1:
What are the long-term benefits of regular physical activity?
A) Improved mental health
B) Boosted immune function
C) Enhanced overall well-being
D) All of the above

Click here to reveal the answer.

Correct Answer: D) All of the above

Explanation:
Regular physical activity offers various long-term benefits, including improved mental health, boosted immune function, and enhanced overall well-being.

Question 2:
How can you build a sustainable physical activity routine?
A) Setting unrealistic goals
B) Gradually increasing activity levels
C) Being inconsistent
D) Ignoring personal preferences

Click here to reveal the answer.

Correct Answer: B) Gradually increasing activity levels

Explanation:
Building a sustainable routine involves setting realistic goals and gradually increasing activity levels.

Question 3:
What is a common barrier to physical activity?
A) Lack of time
B) High motivation
C) Access to walking areas
D) Enjoyable activities

Click here to reveal the answer.

Correct Answer: A) Lack of time

Explanation:
Lack of time is a common barrier to physical activity, which can be managed with effective time management strategies.

Question 4:
Why is tracking progress important?
A) To lose motivation
B) To celebrate milestones and adjust goals
C) To avoid setting new goals
D) To remain stagnant

Click here to reveal the answer.

Correct Answer: B) To celebrate milestones and adjust goals

Explanation:
Tracking progress helps you celebrate milestones, adjust goals, and stay motivated.

References

• Ahmadi, M. N., Rezende, L. F. M., Ferrari, G., Del Pozo Cruz, B., Lee, I.-M., & Stamatakis, E. (2024). Do the associations of daily steps with mortality and incident cardiovascular disease differ by sedentary time levels? A device-based cohort study. British Journal of Sports Medicine, 58, 261-268. https://dx.doi.org/10.1136/bjsports-2023-107221
• Lee, I.-M., Shiroma, E. J., Kamada, M., et al. (2019). Association of step volume and intensity with all-cause mortality in older women. JAMA Internal Medicine, 179(8), 1105-1112. https://dx.doi.org/10.1001/jamainternmed.2019.0899
• Paluch, A. E., Bajpai, S., Bassett, D. R., et al. (2022). Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. Lancet Public Health, 7(3), e219-e228. https://dx.doi.org/10.1016/S2468-2667(21)00302-9
• Del Pozo Cruz, B., Ahmadi, M. N., Lee, I.-M., et al. (2022). Prospective associations of daily step counts and intensity with cancer and cardiovascular disease incidence and mortality and all-cause mortality. JAMA Internal Medicine, 182(11), 1139-1148. https://dx.doi.org/10.1001/jamainternmed.2022.4000
• Del Pozo Cruz, B., Gallardo-Gomez, D., Del Pozo-Cruz, J., et al. (2022). How many steps a day to reduce the risk of all-cause mortality? A dose–response meta-analysis. Journal of Internal Medicine, 291(5), 519-521. https://dx.doi.org/10.1111/joim.13413
• Ekelund, U., Tarp, J., Steene-Johannessen, J., et al. (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ, 366, l4570. https://dx.doi.org/10.1136/bmj.l4570
• Pandey, A., Salahuddin, U., Garg, S., et al. (2016). Continuous dose-response association between sedentary time and risk for cardiovascular disease. JAMA Cardiology, 1(5), 575-583. https://dx.doi.org/10.1001/jamacardio.2016.1567
• Patterson, R., McNamara, E., Tainio, M., et al. (2018). Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. European Journal of Epidemiology, 33(9), 811-829. https://dx.doi.org/10.1007/s10654-018-0380-1
• Biswas, A., Oh, P. I., Faulkner, G. E., et al. (2015). Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of Internal Medicine, 162(2), 123-132. https://dx.doi.org/10.7326/M14-1651
• Young, D. R., Hivert, M.-F., Alhassan, S., et al. (2016). Sedentary behavior and cardiovascular morbidity and mortality: a science advisory from the American Heart Association. Circulation, 134(13), e262-e279. https://dx.doi.org/10.1161/CIR.0000000000000440
• Arnett, D. K., Khera, A., & Blumenthal, R. S. (2021). 2019 ACC / AHA guideline on the primary prevention of cardiovascular disease: part 1. Lifestyle and Behavioral Factors. Journal of the American College of Cardiology, 74(9), 1043-1044.
• Del Pozo-Cruz, J., García-Hermoso, A., Alfonso-Rosa, R. M., et al. (2018). Replacing sedentary time: meta-analysis of objective-assessment studies. American Journal of Preventive Medicine, 55(3), 395-402. https://dx.doi.org/10.1016/j.amepre.2018.04.042
• Ku, P. W., Steptoe, A., Liao, Y., et al. (2019). A threshold of objectively-assessed daily sedentary time for all-cause mortality in older adults: a meta-regression of prospective cohort studies. Journal of Clinical Medicine, 8(4), 564. https://dx.doi.org/10.3390/jcm8040564
• Mañas, A., Del Pozo-Cruz, B., García-García, F. J., et al. (2017). Role of objectively measured sedentary behaviour in physical performance, frailty and mortality among older adults: a short systematic review. European Journal of Sport Science, 17(7), 940-953. https://dx.doi.org/10.1080/17461391.2017.1327983
• Xu, C., Furuya-Kanamori, L., Liu, Y., et al. (2019). Sedentary behavior, physical activity, and all-cause mortality: dose-response and intensity weighted time-use meta-analysis. Journal of the American Medical Directors Association, 20(9), 1206-1212. https://dx.doi.org/10.1016/j.jamda.2019.05.001
• Bailey, D. P., Hewson, D. J., Champion, R. B., et al. (2019). Sitting time and risk of cardiovascular disease and diabetes: a systematic review and meta-analysis. American Journal of Preventive Medicine, 57(3), 408-416. https://dx.doi.org/10.1016/j.amepre.2019.04.015
• Ekelund, U., Brown, W. J., Steene-Johannessen, J., et al. (2019). Do the associations of sedentary behaviour with cardiovascular disease mortality and cancer mortality differ by physical activity level? A systematic review and harmonised meta-analysis of data from 850,060 participants. British Journal of Sports Medicine, 53(14), 886-894. https://dx.doi.org/10.1136/bjsports-2017-098963
• Stamatakis, E., Gale, J., Bauman, A., et al. (2019). Sitting time, physical activity, and risk of mortality in adults. Journal of the American College of Cardiology, 73(16), 2062-2072. https://dx.doi.org/10.1016/j.jacc.2019.02.031
• Ekelund, U., Steene-Johannessen, J., Brown, W. J., et al. (2016). Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet, 388(10051), 1302-1310. https://dx.doi.org/10.1016/S0140-6736(16)30370-1
• Ekelund, U., Tarp, J., Fagerland, M. W., et al. (2020). Joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality: a harmonised meta-analysis in more than 44,000 middle-aged and older individuals. British Journal of Sports Medicine, 54(24), 1499-1506. https://dx.doi.org/10.1136/bjsports-2020-103270
• Stamatakis, E., Ahmadi, M., Murphy, M. H., et al. (2023). Journey of a thousand miles: from 'Manpo-Kei' to the first steps-based physical activity recommendations. British Journal of Sports Medicine, 57(15), 1227-1228. https://dx.doi.org/10.1136/bjsports-2023-106869
• Gill, J. M. R., Chico, T. J. A., Doherty, A., et al. (2023). Potential impact of wearables on physical activity guidelines and interventions: opportunities and challenges. British Journal of Sports Medicine, 57(15), 1223-1225. https://dx.doi.org/10.1136/bjsports-2023-106869
• Ahmadi, M. N., Nathan, N., Sutherland, R., et al. (2020). Non-wear or sleep? Evaluation of five non-wear detection algorithms for raw accelerometer data. Journal of Sports Sciences, 38(4), 399-404. https://dx.doi.org/10.1080/02640414.2019.1703301
• Sipos, M., Paces, P., Rohac, J., et al. (2012). Analyses of triaxial accelerometer calibration algorithms. IEEE Sensors Journal, 12(5), 1157-1165. https://dx.doi.org/10.1109/JSEN.2011.2167319
• Pavey, T. G., Gilson, N. D., Gomersall, S. R., et al. (2017). Field evaluation of a random forest activity classifier for wrist-worn accelerometer data. Journal of Science and Medicine in Sport, 20(1), 75-80. https://dx.doi.org/10.1016/j.jsams.2016.06.003