Table 1 Summary of the findings from the studies assessing mortality outcomes

Chomistek et al. [50]

Men (n = 44,551) from The Health Professionals Follow-up Study, USA; prospective cohort

LPA, MPA, VPA – self report; sleep, SB – not assessed

Sum of total CVD risk factors, total cancer, or other nontraumatic death.

Mekary et al. [12]/10 MET h-wk^− 1

Smoking, aspirin use, vitamin E supplement use, parental history of myocardial infarction or cancer, alcohol consumption, energy-adjusted intake of polyunsaturated fat, trans fatty acids, omega-3 fatty acids, fiber, diabetes, hypertension, and hypercholesterolemia.

HR (95% CI)

MPA → VPA: 0.96 (0.93, 0.99)

Fishman et al. [54]

Adults (n = 3029) from the 2003–2004 and 2005–2006 waves of the National Health and Nutrition Examination Survey, USA; prospective cohort

SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed

Mortality risk

Mekary et al. [12]/10, 30 and 60 min

Age, sex, race/ethnicity, education, and minutes of device wear time (model 1). Model 2 includes BMI, smoking, the presence of diabetes, coronary heart disease, congestive heart failure, stroke, cancer, and mobility limitation. In model 3 those with prevalent chronic illnesses (diabetes, coronary heart disease, congestive heart failure, stroke, and cancer) or mobility limitations at baseline were excluded.

HR (95% CI)

10 min reallocation

Model 1

SB → LPA: 0.90 (0.88, 0.93)

SB → MVPA: 0.73 (0.57, 0.94)

MVPA → LPA: 1.23 (0.96, 1.58)

MVPA → SB: 1.36 (1.06, 1.75)

Model 2

SB → LPA: 0.92 (0.89, 0.94)

SB → MVPA: 0.79 (0.63, 0.99)

MVPA → LPA: 1.15 (0.92, 1.44)

MVPA → SB: 1.26 (1.01, 1.58)

Model 3

SB → LPA: 0.91 (0.86, 0.96)

SB → MVPA: 0.70 (0.57, 0.85)

MVPA → LPA: 1.30 (1.06, 1.59)

MVPA → SB: 1.43 (1.17, 1.74)

Reallocating 30 or 60 min from SB to LPA or MVPA was associated with a reduction in mortality risk after 5 years of follow-up.

Lee [62]

Adults (n = 7006) from the National Health and Nutrition Examination Survey, USA; prospective cohort

SB, LPA, MPA, VPA – waist-worn accelerometers; sleep – not assessed

All-cause mortality

Mekary et al. [12]/1 min and a dose-response analysis

Age, sex, education level, income, BMI, binge drinking, smoking status, energy intake by 24-h dietary recall, self-reported general health condition, high blood pressure, high cholesterol, type 2 diabetes, history of heart attack, stroke, and cancer.

Reallocating 1 min of SB to LPA or MPA demonstrated a J-shaped association with mortality, with the turning point at about

400 min and 15 min per day, respectively.

Reallocating time from SB to VPA decreased all-cause mortality in a linear manner.

Loprinzi et al. [65]

Adults (n = 5377) from the 2003–2006 National Health and Nutrition Examination Survey, USA; prospective cohort

SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed

Mortality

Mekary et al. [12]/30 min

Age, sex, race–ethnicity, BMI, smoking status and education

HR (95% CI)

SB → LPA: 0.87 (0.80, 0.95)

SB → MVPA: 0.19 (0.06, 0.60)

LPA → SB: 1.14 (1.04, 1.24)

LPA → MVPA: 0.22 (0.07, 0.69)

MVPA → SB: 5.03 (1.64, 15.40)

MVPA → LPA: 4.40 (1.42, 13.56)

Matthews et al. [66]

Less active (n = 69,606) and more active (n = 85,008) individuals from the NIH-AARP Diet and Health Study, USA; prospective cohort

Sleep, SB, exercise and non-exercise activities, LPA, MVPA – self report

All-cause and cardiovascular mortality

Mekary et al. [12]/60 min

Age, education, smoking history, sleep duration, overall health, BMI, overall sitting, each type of physical activity, and the sum of overall sitting and physical activity time

HR (95% CI)

All-cause mortality

Less active individuals

SB → exercise: 0.58 (0.54, 0.63)

SB → non-exercise: 0.70 (0.66, 0.74)

SB → household chores: 0.80 (0.74, 0.86)

SB → lawn and garden: 0.49 (0.43, 0.56)

SB → daily walking: 0.66 (0.57, 0.78)

SB → LPA: 0.81 (0.75, 0.88)

SB → MVPA: 0.58 (0.54, 0.62)

More active individuals

SB → exercise: 0.91 (0.88, 0.94)

SB → non-exercise: 1.00 (0.98, 1.02)

SB → household chores: 1.02 (0.99, 1.05)

SB → lawn and garden: 0.97 (0.93, 1.01)

SB → daily walking: 0.99 (0.94, 1.05)

SB → LPA: 1.04 (1.01, 1.08)

SB → MVPA: 0.96 (0.94, 0.98)

The time reallocations for cardiovascular mortality were weaker and non-significant among less active men for household chores, daily walking, and LPA compared to women. An increase in the risk was noted when reallocating SB with household and LPA in more active men. A significant inverse association for replacing SB with lawn and garden activities in more active men was noted (the same was not observed among women).

Matthews et al. [67]

Adults (n = 4840) from the 2003–2006 National Health and Nutrition Examination Survey, USA; prospective cohort

SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed

Mortality risk

Mekary et al. [12]/60 min

Age, sex, race-ethnicity, alcohol consumption, smoking status, BMI, self-reported diabetes, coronary artery disease, stroke, cancer, and mobility limitation.

HR (95% CI)

Overall

SB → LPA: 0.82 (0.73, 0.92)

SB → MVPA: 0.58 (0.44, 0.77)

Less active individuals

SB → LPA: 0.80 (0.69, 0.92)

SB → MVPA: 0.37 (0.26, 0.54)

More active individuals

SB → LPA: 1.29 (0.95, 1.74)

SB → MVPA: 0.92 (0.60, 1.43)

Schmid et al. [71]

Adults (n = 3702) from the National Health and Nutrition Examination Survey 2003–2004 and 2005–2006 cycles, USA; prospective cohort

SB, LPA, MVPA – accelerometers (location is not presented); sleep – not assessed

All-cause mortality, CVD mortality, cancer mortality

Mekary et al. [12]/30 min

Age, sex, total accelerometer wear time (model 1). Model 2 is additionally adjusted for education, ethnicity, height, smoking, alcohol consumption, total dietary fat intake, total dietary fibre intake, mobility

limitations, history of diabetes, history of coronary heart disease, history of congestive heart failure, history of stroke, history of cancer. Model 3 is the same as model 2 plus waist circumference.

HR (95% CI)

All-Cause Mortality

Model 1

SB → LPA: 0.85 (0.81, 0.88)

SB → MVPA: 0.38 (0.22, 0.63)

SB → LPA and MVPA: 0.82 (0.79, 0.85)

LPA → MVPA: 0.45 (0.26, 0.75)

Model 2

SB → LPA: 0.86 (0.83, 0.90)

SB → MVPA: 0.50 (0.31, 0.80)

SB → LPA and MVPA: 0.85 (0.81, 0.88)

LPA → MVPA: 0.58 (0.36, 0.93)

Model 3

SB → LPA: 0.88 (0.84, 0.92)

SB → MVPA: 0.51 (0.32, 0.83)

SB → LPA and MVPA: 0.86 (0.82, 0.90)

LPA → MVPA: 0.58 (0.36, 0.95)

CVD Mortality

Model 1

SB → LPA: 0.84 (0.77, 0.90)

SB → MVPA: 0.25 (0.09, 0.71)

SB → LPA and MVPA: 0.80 (0.74, 0.86)

LPA → MVPA: 0.30 (0.11, 0.86)

Model 2

SB → LPA: 0.86 (0.79, 0.93)

SB → MVPA: 0.35 (0.14, 0.92)

SB → LPA and MVPA: 0.83 (0.77, 0.90)

LPA → MVPA: 0.41 (0.16, 1.08)

Model 3

SB → LPA: 0.88 (0.81, 0.95)

SB → MVPA: 0.36 (0.13, 0.95)

SB → LPA and MVPA: 0.85 (0.78, 0.92)

LPA → MVPA: 0.41 (0.15, 1.11)

Cancer mortality

Model 1

SB → LPA: 0.91 (0.85, 0.98)

SB → MVPA: 0.53 (0.22, 1.31)

SB → LPA and MVPA: 0.88 (0.82, 0.96)

LPA → MVPA: 0.58 (0.24, 1.44)

Model 2

SB → LPA: 0.92 (0.85, 0.99)

SB → MVPA: 0.69 (0.32, 1.50)

SB → LPA and MVPA: 0.90 (0.83, 0.98)

LPA → MVPA: 0.75 (0.34, 1.63)

Model 3

SB → LPA: 0.93 (0.86, 1.01)

SB → MVPA: 0.79 (0.39, 1.62)

SB → LPA and MVPA: 0.92 (0.85, 1.00)

LPA → MVPA: 0.85 (0.41, 1.73)

Stamatakis et al. [72]

Adults (n = 201,129) from the 45 and Up study from New South Wales, Australia; prospective cohort

Sleep, SB, LPA, MVPA – self report

All-cause mortality

Mekary et al. [12]/60 min

Age, sex, educational level, marital status, residence, BMI, smoking status, self-rated health, receiving help with daily tasks for a long-term illness or disability, prevalent disease at baseline, psychological distress, mutually adjusted for all activity classes, and total time in all activity classes.

HR (95% CI)

Sleeping (≤7 h) → screen-time: 1.01 (0.98, 1.05)

Sleeping (≤7 h) → sitting: 1.03 (0.99, 1.07)

Sleeping (≤7 h) → standing: 0.98 (0.94, 1.02)

Sleeping (≤7 h) → walking: 0.93 (0.84, 1.03)

Sleeping (≤7 h) → MVPA: 0.90 (0.85, 0.96)

Sleeping (≤7 h) → total activity: 1.01 (0.98, 1.04)

Sleeping (> 7 h) → screen-time: 0.95 (0.93, 0.97)

Sleeping (> 7 h) → sitting: 0.96 (0.94, 0.98)

Sleeping (> 7 h) → standing: 0.92 (0.9, 0.94)

Sleeping (> 7 h) → walking: 0.80 (0.75, 0.86)

Sleeping (> 7 h) → MVPA: 0.84 (0.81, 0.87)

Sleeping (> 7 h) → total activity: 1.06 (1.04, 1.07)

Screen-time → sleeping (≤7 h): 0.95 (0.91, 0.99)

Screen-time → sleeping (> 7 h): 1.06 (1.04, 1.09)

Screen-time → sitting: 1.01 (1.00, 1.03)

Screen-time → standing: 0.97 (0.95, 0.98)

Screen-time → walking: 0.87 (0.82, 0.92)

Screen-time → MVPA: 0.89 (0.86, 0.91)

Screen-time → total activity: 1.01 (1.00, 1.02)

Sitting → sleeping (≤7 h): 0.94 (0.90, 0.98)

Sitting → sleeping (> 7 h): 1.05 (1.03, 1.07)

Sitting → screen-time: 0.99 (0.97, 1.00)

Sitting → standing: 0.95 (0.94, 0.96)

Sitting → walking: 0.86 (0.81, 0.90)

Sitting → MVPA: 0.88 (0.85, 0.90)

Sitting → total activity: 1.02 (1.01, 1.03)

Standing → sleeping (≤7 h): 0.99 (0.95, 1.03)

Standing → sleeping (> 7 h): 1.10 (1.08, 1.13)

Standing → screen-time: 1.04 (1.02, 1.05)

Standing → sitting: 1.05 (1.04, 1.06)

Standing → walking: 0.90 (0.85, 0.95)

Standing → MVPA: 0.92 (0.89, 0.95)

Standing → total activity: 0.98 (0.97, 0.99)

Walking → sleeping (≤7 h): 1.10 (1.03, 1.18)

Walking → sleeping (> 7 h): 1.17 (1.12, 1.21)

Walking → screen-time: 1.15 (1.09, 1.22)

Walking → sitting: 1.17 (1.11, 1.23)

Walking → standing: 1.11 (1.05, 1.18)

Walking → MVPA: 1.02 (0.96, 1.09)

Walking → total activity: 0.88 (0.83, 0.93)

MVPA → sleeping (≤7 h): 1.07 (1.02, 1.13)

MVPA → sleeping (> 7 h): 1.18 (1.14, 1.22)

MVPA → screen-time: 1.13 (1.09, 1.16)

MVPA → sitting: 1.14 (1.11, 1.18)

MVPA → standing: 1.09 (1.06, 1.12)

MVPA → walking: 0.98 (0.92, 1.04)

MVPA → total activity: 0.90 (0.87, 0.92)

Wijndaele et al. [39]

Middle-aged adults (n = 423,659) from the UK Biobank cohort study, UK; prospective cohort

SB (leisure screen time, TV viewing, computer usage) and leisure/home activities (walking for pleasure, light and heavy do-it-yourself), structured exercise, sleep – self reported

Mortality risk

Mekary et al. [12]/30 min

Townsend deprivation index, alcohol intake, smoking status, salt adding behaviour, oily fish consumption, fruit and vegetable intake, processed and sleep duration, chronic disease status, parental history of cardiovascular disease or diabetes

HR (95% CI)

Screen time → leisure/home activities: 0.95 (0.94, 0.97)

Screen time → structured exercise: 0.87 (0.84, 0.90)

Screen time → walking for pleasure: 0.95 (0.92, 0.98)

Screen time → light do-it-yourself: 0.97 (0.94, 1.00)

Screen time → heavy do-it-yourself: 0.93 (0.90, 0.96)

Screen time → strenuous sports: 0.87 (0.79, 0.95)

Screen time → other exercises: 0.88 (084, 0.91)

TV viewing → leisure/home activities: 0.94 (0.93, 0.96)

TV viewing → structured exercise: 0.87 (0.84, 0.90)

TV viewing → walking for pleasure: 0.94 (0.92, 0.97)

TV viewing → light do-it-yourself: 0.96 (0.94, 0.99)

TV viewing → heavy do-it-yourself: 0.91 (0.89, 0.95)

TV viewing → strenuous sports: 0.86 (0.79, 0.95)

TV viewing → other exercises: 0.87 (0.83, 0.91)

Men

Computer usage → leisure/home activities: 0.98 (0.96, 1.00)

Computer usage → structured exercise: 0.89 (0.85, 0.93)

Computer usage → walking for pleasure: 0.98 (0.95, 1.01)

Computer usage → light do-it-yourself: 0.99 (0.96, 1.02)

Computer usage → heavy do-it-yourself: 0.97 (0.93, 1.00)

Computer usage → strenuous sports: 0.90 (0.81, 0.99)

Computer usage → other exercises: 0.88 (0.84, 0.93)

Women

Computer usage → leisure/home activities: 0.94 (0.91, 0.97)

Computer usage → structured exercise: 0.90 (0.84, 0.96)

Computer usage → walking for pleasure: 0.93 (0.89, 0.98)

Computer usage → light do-it-yourself: 0.99 (0.94, 1.04)

Computer usage → heavy do-it-yourself: 0.84 (0.76, 0.94)

Computer usage → strenuous sports: 0.88 (0.73, 1.06)

Computer usage → other exercises: 0.90 (0.84, 0.97)