HealthDay News — Combining high levels of physical activity and low levels of leisure time sitting may be necessary to reduce the risk of obesity, according to researchers.

“Physical activity and sedentariness are two common lifestyle-related behaviors associated with both obesity and metabolic health, as well as with chronic diseases such as type 2 diabetes and cardiovascular disease, and with all-cause mortality,” wrote Joshua A. Bell, of University College London, and colleagues in Diabetologia.

To assess the effects of moderate-to-vigorous physical activity and leisure time sitting on risk of obesity and clustering of two or more of five metabolic risk factors — low high-density lipoprotein cholesterol level, high triacylglycerol level, hypertension, hyperglycemia, and insulin resistance — the investigators analyzed data from 3,670 patients. Overall, 73% of patients where men and mean patient age was 56 years.

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Physical activity, but not leisure time sitting, was associated with incident obesity, according to the researchers. At five years of follow-up, patients reporting both high levels of physical activity and low levels of leisure time sitting had the lowest risk of incident obesity (odds ratio, 0.26; 95% CI: 0.11-0.64). However, weaker effects were observed after 10 years.

At five years, patients with intermediate levels of both physical activity and leisure time sitting, compared with those with low levels of physical activity and high levels of leisure time sitting, had lower risk of incident clustering of metabolic risk factors (OR, 0.53; 95% CI: 0.36-0.78), with similar odds after 10 years.

“High levels of physical activity were associated with a slightly reduced risk of becoming obese after 10 years of follow-up; however, the combined effect of high physical activity and low leisure time sitting after 5 years was much larger, suggesting a substantially reduced risk of developing obesity for highly active individuals who also engage in low amounts of sitting in their leisure time,” concluded the researchers.


  1. Bell J et al. Diabetologia. 2014; doi: 10.1007/s00125-014-3323-8