Objectively-measured sedentary time and cardiometabolic health in adults with severe obesity

Wendy C. King, Jia Yuh Chen, Anita P. Courcoulas, James E. Mitchell, Bruce M. Wolfe, Emma J. Patterson, William B. Inabnet, Gregory F. Dakin, David R. Flum, Brian Cook, Steven H. Belle

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


It is unknown whether sedentary behavior is independently associated with the cardiometabolic health of adults with severe obesity. Additionally, there is debate regarding how best to derive meaningful indices of sedentary time (ST) from activity monitor data. A convenience sample of adults with severe obesity (N=927; 79% female, median age 45 y, median body mass index (BMI) 46 kg/m2) completed a research assessment at one of ten US hospitals in 2006-2009 prior to bariatric surgery. Cardiometabolic health was assessed via physical measures, fasting blood samples and medication use. Indices of ST were derived from StepWatch™ activity monitor data with minimum bout durations of 1 min, 10 min and 30 min. Cross-sectional associations were examined. Median (25th, 75th percentile) ST was 9.3 h/d (8.1, 10.5) in ≥1 min bouts, 6.5 h/d (5.2, 8.0) in ≥10min bouts, or 3.2 h/d (2.1, 4.5) in ≥30 min bouts. Associations with ST were generally strongest with the ≥10 min bout duration. Independent of moderate-to-vigorous intensity physical activity, BMI and other potential confounders, 1h/day ST in ≥10min bouts was associated with higher odds of diabetes by 15% (95%CI: 1.05-1.26), metabolic syndrome by 12% (95%CI: 1.01-1.24) and elevated blood pressure by 14% (95%CI: 1.02-1.26), and was associated with 1.4 cm (95%CI: 0.9-1.9) larger waist circumference. Findings indicate the importance of considering ST as a distinct health risk among adults with severe obesity, and suggest a 10 min minimum duration may be preferable to 1 min or 30 min for establishing ST from activity monitor data.

Original languageEnglish
Pages (from-to)12-18
Number of pages7
JournalPreventive Medicine
StatePublished - Mar 1 2016

Bibliographical note

Funding Information:
The first author would like to thank the Egyptian Government for the financial support.We express our sincere gratitude toMrs. AminaMoss for reading the manuscript.

Funding Information:
Dr. Courcoulas has received research grants from Covidien, Ethicon, Nutrisystem and PCORI, and consultant fees from Apollo Endosurgery. Dr. Flum has had an advisor role with Pacira Pharmaceuticals, has provided expert testimony for Surgical Consulting LLC, and has received travel expenses from Patient Centered outcomes research institute. Dr. Patterson is a consultant for Apollo and Ethicon. Dr. Wolfe has received consultant fees from Enteromedics. Drs. Belle, Cook, Dakin, Inabnet, King, Mitchell, and Ms. Chen have no disclosures to report.

Funding Information:
This clinical study was a cooperative agreement funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) . Grant numbers: DCC - U01 DK066557 ; Columbia - U01-DK66667 (in collaboration with Cornell University Medical Center CTRC , Grant UL1-RR024996 ); University of Washington - U01-DK66568 (in collaboration with CTRC , Grant M01RR-00037 ); Neuropsychiatric Research Institute - U01-DK66471 ; East Carolina University – U01-DK66526 ; University of Pittsburgh Medical Center – U01-DK66585 (in collaboration with CTRC, Grant UL1-RR024153 ); Oregon Health & Science University – U01-DK66555 .

Publisher Copyright:
© 2015 Elsevier Inc.


  • Ambulatory monitoring
  • Diabetes mellitus, type 2
  • Metabolic syndrome X
  • Methods
  • Obesity
  • Physical activity
  • Risk factors
  • Sedentary bout length
  • Sedentary lifestyle

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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