Export file:


  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text


  • Citation Only
  • Citation and Abstract

Where to Sit? Type of Sitting Matters for the Framingham Cardiovascular Risk Score

1 National Institute for Health and Welfare, PO Box 30, FI-00271 Helsinki, Finland;
2 UKK-Institute for Research and Health Promotion, PO Box 30, FI-33501 Tampere, Finland

Special Issues: Advances in sedentary behavior research and translation

Background: Current evidence on associations of type-specific sedentary behavior with cardiovascular disease (CVD) is limited to mainly screen-time sedentary behavior (SB). We aimed to study the associations of type-specific and total time spent sitting with the Framingham 10-year cardiovascular disease risk score (Framingham score) in Finnish adults. Methods: Data comprise the National FINRISK 2007 and 2012 health examination surveys with 10,185 participants aged 25-74 years, apparently free of CVD. Participants reported average daily time spent sitting in different locations: work-related sitting, at home in front of television (TV), at home in front of computer, in a vehicle, and elsewhere. Total SB time was calculated from these context-specific self-reports. Accelerometer-based sedentary time was assessed in 988 FINRISK 2012 participants. Framingham score was calculated using information on blood pressure and its medication, cholesterol levels, age, diabetes status, and smoking. Analyses were adjusted for age, study year, education, employment status, leisure time physical activity, and body mass index. Results: Out of several type-specific sitting behaviors, only TV sitting showed systematic associations with the Framingham score in both genders. The lowest Framingham risk was found for TV sitting from 6 minutes to less than 1 hour daily. Of other types of sitting, computer sitting was inversely associated with the Framingham risk in men only. Total self-reported sitting time did not show significant associations with the Framingham score, but instead higher objectively assessed sedentary time showed higher Framingham risk in men. Conclusions: TV sitting showed most systematic associations with CVD risk score. This suggests that of all types of SB, reducing TV sitting should be targeted for reducing CVD risk.
  Article Metrics

Keywords sedentary behavior; type-specific sitting; the Framingham risk score; cardiovascular health

Citation: Heini Wennman, Tommi Vasankari, Katja Borodulin. Where to Sit? Type of Sitting Matters for the Framingham Cardiovascular Risk Score. AIMS Public Health , 2016, 3(3): 577-591. doi: 10.3934/publichealth.2016.3.577


  • 1. Dunstan DW, Howard B, Healy GN, et al. (2012) Too much sitting — A health hazard. Diabetes Res Clin Pract 97: 368-376.    
  • 2. Grontved A, Hu FB (2011) Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis. JAMA 305: 2448-2455.    
  • 3. Katzmarzyk PT, Church TS, Craig CL, et al. (2009) Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc 41: 998-1005.    
  • 4. van Uffelen JG, Wong J, Chau JY, et al. (2010) Occupational sitting and health risks: a systematic review. Am J Prev Med 39: 379-388.    
  • 5. Thorp AA, Owen N, Neuhaus M, et al. (2011) Theme: The science of sedentary behavior: Sedentary Behaviors and Subsequent Health Outcomes in Adults. A Systematic Review of Longitudinal Studies, 1996-2011. Am J Prev Med 41: 207-215.
  • 6. Same RV, Feldman DI, Shah N, et al. (2016) Relationship Between Sedentary Behavior and Cardiovascular Risk. Curr Cardiol Rep 18: 1-7.    
  • 7. Borodulin K, Karki A, Laatikainen T, et al. (2014) Daily Sedentary Time and Risk of Cardiovascular Disease: The National FINRISK 2002 Study. J Phys Act Health 12: 904-908.
  • 8. Chau JY, van HP, Merom D, et al. (2012) Cross-sectional associations between occupational and leisure-time sitting, physical activity and obesity in working adults. Prev Med 54: 195-200.    
  • 9. Gardiner PA, Healy GN, Eakin EG, et al. (2011) Associations Between Television Viewing Time and Overall Sitting Time with the Metabolic Syndrome in Older Men and Women: The Australian Diabetes Obesity and Lifestyle Study. J Am Geriatr Soc 59: 788-796.    
  • 10. Stamatakis E, Davis M, Stathi A, et al. (2012) Associations between multiple indicators of objectively-measured and self-reported sedentary behaviour and cardiometabolic risk in older adults. Prev Med 54: 82-87.    
  • 11. Staiano AE, Harrington DM, Barreira TV, et al. (2014) Sitting time and cardiometabolic risk in US adults: associations by sex, race, socioeconomic status and activity level. Br J Sports Med 48: 213-219.    
  • 12. Tremblay MS, Colley RC, Saunders TJ, et al. (2010) Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab 35: 725-740.    
  • 13. Brocklebank LA, Falconer CL, Page AS, et al. (2015) Accelerometer-measured sedentary time and cardiometabolic biomarkers: A systematic review. Prev Med 76: 92-102.    
  • 14. Dempsey PC, Owen N, Biddle SJ, et al. (2014) Managing sedentary behavior to reduce the risk of diabetes and cardiovascular disease. Curr Diab Rep 14: 1-11.
  • 15. Pulsford RM, Stamatakis E, Britton AR, et al. (2015) Associations of sitting behaviours with all-cause mortality over a 16-year follow-up: the Whitehall II study. Int J Epidemiol 44: 1909-1916.    
  • 16. Chau JY, Grunseit AC, Chey T, et al. (2013) Daily sitting time and all-cause mortality: a
    meta-analysis. PLoS One 8: e80000.    
  • 17. Wilmot EG, Edwardson CL, Achana FA, et al. (2012) Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia 55: 2895-2905.    
  • 18. Chau JY, Grunseit A, Midthjell K, et al. (2014) Cross-sectional associations of total sitting and leisure screen time with cardiometabolic risk in adults. Results from the HUNT Study, Norway. J Sci Med Sport 17: 78-84.
  • 19. Owen N, Salmon J, Koohsari MJ, et al. (2014) Sedentary behaviour and health: mapping environmental and social contexts to underpin chronic disease prevention. Br J Sports Med 48: 174-177.    
  • 20. Rosenberg DE, Lee IM, Young DR, et al. (2015) Novel strategies for sedentary behavior research. Med Sci Sports Exerc 47: 1311-1315.    
  • 21. Kim Y, Wilkens LR, Park SY, et al. (2013) Association between various sedentary behaviours and all-cause, cardiovascular disease and cancer mortality: the Multiethnic Cohort Study. Int J Epidemiol 42: 1040-1056.    
  • 22. Stamatakis E, Chau JY, Pedisic Z, et al. (2013) Are sitting occupations associated with increased all-cause, cancer, and cardiovascular disease mortality risk? A pooled analysis of seven British population cohorts. PLoS One 8: e73753.
  • 23. Hayashi R, Iso H, Cui R, et al. (2016) Occupational physical activity in relation to risk of cardiovascular mortality: The Japan Collaborative Cohort Study for Evaluation for Cancer Risk (JACC Study). Prev Med 89: 286-291.    
  • 24. Liao Y, Tsai HH, Wang HS, et al. (2015) Traveling by Private Motorized Vehicle and Physical Fitness in Taiwanese Adults. Int J Behav Med 1-7.
  • 25. Swanson KC, McCormack GR (2012) The relations between driving behavior, physical activity and weight status among Canadian adults. J Phys Act Health 9: 352-359.    
  • 26. Sugiyama T, Wijndaele K, Koohsari MJ, et al. (2016) Adverse associations of car time with markers of cardio-metabolic risk. Prev Med 83: 26-30.    
  • 27. Hsueh MC, Liao Y, Chang SH (2016) Associations of Total and Domain-Specific Sedentary Time With Type 2 Diabetes in Taiwanese Older Adults. J Epidemiol 26: 348-354.    
  • 28. Crichton GE, Alkerwi A (2014) Association of sedentary behavior time with ideal cardiovascular health: the ORISCAV-LUX study. PLoS One 9: e99829.    
  • 29. Rhodes RE, Mark RS, Temmel CP (2012) Review and special article: Adult Sedentary Behavior. A Systematic Review. Am J Prev Med 42: 3-e28.
  • 30. Healy GN, Clark BK, Winkler EAH, et al. (2011) Measurement of Adults' Sedentary Time in Population-Based Studies. Am J Prev Med 41: 216-227.    
  • 31. D'Agostino RBS, Vasan RS, Pencina MJ, et al. (2008) General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 117: 743-753.    
  • 32. Fitzgerald JD, Johnson L, Hire DG, et al. (2015) Association of objectively measured physical activity with cardiovascular risk in mobility-limited older adults. J Am Heart Assoc 4: 10.1161/JAHA.114.001288.
  • 33. LaMonte MJ, Durstine JL, Addy CL, et al. (2001) Physical activity, physical fitness, and Framingham 10-year risk score: the cross-cultural activity participation study. J Cardiopulm Rehabil 21: 63-70.    
  • 34. Hu G, Tuomilehto J, Borodulin K, et al. (2007) The joint associations of occupational, commuting, and leisure-time physical activity, and the Framingham risk score on the 10-year risk of coronary heart disease. Eur Heart J 28: 492-498.    
  • 35. Wennman H, Kronholm E, Partonen T, et al. (2015) Interrelationships of Physical Activity and Sleep with Cardiovascular Risk Factors: a Person-Oriented Approach. Int J Behav Med 735-747.
  • 36. Borodulin K, Vartiainen E, Peltonen M, et al. (2014) Forty-year trends in cardiovascular risk factors in Finland. Eur J Public Health 25: 539-546.
  • 37. World Health Organization. (1988) The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol 41: 105-114.
  • 38. Tolonen H, Kuulasmaa K, Laatikainen T, et al. (2002) European Health Risk Monitoring Project. Recommendation for indicators, international collaboration, protocol and manual of operations for chronic disease risk factor surveys.
  • 39. Marshall AL, Miller YD, Burton NW, et al. (2010) Measuring total and domain-specific sitting: a study of reliability and validity. Med Sci Sports Exerc 42: 1094-1102.
  • 40. Hu G, Jousilahti P, Borodulin K, et al. (2007) Occupational, commuting and leisure-time physical activity in relation to coronary heart disease among middle-aged Finnish men and women. Atherosclerosis 194: 490-497.    
  • 41. Fagt S, Andersen LF, Anderssen SA, et al. (2011) Nordic Monitoring of diet, physical activity and overweight. Validation of indicators. TemaNord 2011: 556.
  • 42. Aittasalo M, Vaha-Ypya H, Vasankari T, et al. (2015) Mean amplitude deviation calculated from raw acceleration data: a novel method for classifying the intensity of adolescents' physical activity irrespective of accelerometer brand. BMC Sports Sci Med Rehabil 7: 1-7.    
  • 43. Vaha-Ypya H, Vasankari T, Husu P, et al. (2015) A universal, accurate intensity-based classification of different physical activities using raw data of accelerometer. Clin Physiol Funct Imaging 35: 64-70.    
  • 44. Carson V, Janssen I (2011) Volume, patterns, and types of sedentary behavior and
    cardio-metabolic health in children and adolescents: a cross-sectional study. BMC Public Health 11: 274-283.    
  • 45. Vandelanotte C, Sugiyama T, Gardiner P, et al. (2009) Associations of leisure-time internet and computer use with overweight and obesity, physical activity and sedentary behaviors:
    cross-sectional study. J Med Internet Res 11: e28.    
  • 46. Clark BK, Sugiyama T, Healy GN, et al. (2009) Validity and reliability of measures of television viewing time and other non-occupational sedentary behaviour of adults: a review. Obes Rev 10: 7-16.    
  • 47. Loprinzi PD (2016) Sedentary behavior and predicted 10-yr risk for a first atherosclerotic cardiovascular disease (ASCVD) event using the pooled cohort risk equations among US adults. Int J Cardiol 203: 443-444.    
  • 48. Stamatakis E, Hamer M, Tilling K, et al. (2012) Sedentary time in relation to cardio-metabolic risk factors: differential associations for self-report vs accelerometry in working age adults. Int J Epidemiol 41: 1328-1337.    
  • 49. Lee PH, Wong FK (2015) The association between time spent in sedentary behaviors and blood pressure: a systematic review and meta-analysis. Sports Med 45: 867-880.    
  • 50. Ford ES, Caspersen CJ (2012) Sedentary behaviour and cardiovascular disease: a review of prospective studies. Int J Epidemiol 41: 1338-1353.    
  • 51. Morris JN, Heady JA, Raffle PA, et al. (1953) Coronary heart-disease and physical activity of work. Lancet 265: 1111-1120.
  • 52. Picavet HS, Pas LW, van Oostrom SH, et al. (2016) The Relation between Occupational Sitting and Mental, Cardiometabolic, and Musculoskeletal Health over a Period of 15 Years — The Doetinchem Cohort Study. PLoS One 11: e0146639.    
  • 53. van der Ploeg HP, Moller SV, Hannerz H, et al. (2015) Temporal changes in occupational sitting time in the Danish workforce and associations with all-cause mortality: results from the Danish work environment cohort study. Int J Behav Nutr Phys Act 12: 1-9.    
  • 54. Warren TY, Barry V, Hooker SP, et al. (2010) Sedentary behaviors increase risk of cardiovascular disease mortality in men. Med Sci Sports Exerc 42: 879-885.    
  • 55. McCormack GR, Virk JS (2014) Driving towards obesity: a systematized literature review on the association between motor vehicle travel time and distance and weight status in adults. Prev Med 66: 49-55.    
  • 56. O'Neil C, Dogra S (2015) Different Types of Sedentary Activities and Their Association With Perceived Health and Wellness Among Middle-Aged and Older Adults: A Cross-Sectional Analysis. Am J Health Promot 30.
  • 57. Owen N, Sugiyama T, Eakin EE, et al. (2011) Adults' sedentary behavior determinants and interventions. Am J Prev Med 41: 189-196.    
  • 58. Bauman A, Ainsworth BE, Sallis JF, et al. (2011) The descriptive epidemiology of sitting. A
    20-country comparison using the International Physical Activity Questionnaire (IPAQ). Am J Prev Med 41: 228-235.
  • 59. Harrington DM, Barreira TV, Staiano AE, et al. (2014) The descriptive epidemiology of sitting among US adults, NHANES 2009/2010. J Sci Med Sport 17: 371-375.    
  • 60. Diaz KM, Howard VJ, Hutto B, et al. (2016) Patterns of Sedentary Behavior in US Middle-Age and Older Adults: The REGARDS Study. Med Sci Sports Exerc 48: 430-438.
  • 61. Tolonen H, Helakorpi S, Talala K, et al. (2006) 25-year trends and socio-demographic differences in response rates: Finnish adult health behaviour survey. Eur J Epidemiol 21: 409-415.    
  • 62. Harald K, Salomaa V, Jousilahti P, et al. (2007) Non-participation and mortality in different socioeconomic groups: the FINRISK population surveys in 1972-92. J Epidemiol Community Health 61: 449-454.    


This article has been cited by

  • 1. Marta Regina Cezar-Vaz, Clarice Alves Bonow, Marlise Capa Verde Almeida de Mello, Daiani Modernel Xavier, Jordana Cezar Vaz, Maria Denise Schimith, Use of Global Risk Score for Cardiovascular Evaluation of Rural Workers in Southern Brazil, The Scientific World Journal, 2018, 2018, 1, 10.1155/2018/3818065

Reader Comments

your name: *   your email: *  

Copyright Info: 2016, Heini Wennman, et al., licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Copyright © AIMS Press All Rights Reserved