Sedentary behavior and medical multimorbidity
Introduction
Considerable research demonstrates that physical activity (PA) is associated with improved health (e.g., reduced risk of cardiovascular disease) [1]. There is also emerging research demonstrating that sedentary behavior (SB) is associated with various individual health outcomes, independent of PA [2]. At this point, most outcome-based research examines individual health outcomes, as opposed to the concurrent presence of multiple chronic diseases (hereafter ‘multimorbidity’), despite at least 23.2% of adults having 2 or more chronic diseases [3]. Limited research has examined the relationship of SB and multimorbidity [4]. This is concerning as not only is multimorbidity prevalent, but multimorbidity is associated with premature mortality [5], reduced functional status [6], [7], [8], and increased utilization of inpatient and ambulatory health care [9], [10]. Therefore, the purpose of this short communication was to examine the association between SB (independent of PA) and multimorbidity in a national sample of U.S. adults.
Section snippets
Study design and participants
Data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES) cycle was used; this is the only present NHANES cycle with available data on all the study variables (including sleep behavior). NHANES study procedures were approved by the NCHS ethics review board, with informed consent obtained from all participants. In the 2005–2006 NHANES, 2048 adult (≥ 20 yrs) participants provided data on the study variables.
Multimorbidity
A multimorbidity index [11] variable was calculated based on the
Results
Table 1 reports the weighted characteristics of the analyzed sample. In a multivariable logistic regression, and after adjustments, for every 60 min increase in SB, participants had an 11% (ORadjusted = 1.11; 95% CI: 1.01, 1.21; P = .03) increased odds of being multimorbid (i.e., having ≥ 2 morbidities). In a multivariable linear regression, and after adjustments, for every 60 min/day increase in SB, participants had a higher multimorbidity index (βadjusted = 0.08; 95% CI: 0.04, 0.11, P < .001). After
Discussion
These findings that demonstrate a relationship between SB (independent of adherence to light-intensity PA and adherence to MVPA guidelines) and multimorbidity are in support of the accumulating research demonstrating that SB is independently associated with various individual chronic diseases [2]. Given the inability to ascertain temporality with the NHANES cross-sectional design, it is equally plausible to suggest that in this sample, multimorbid patients engaged in more SB because of the
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