Associations between Context-Specific Sedentary Behaviors and Cardiometabolic Biomarkers: Implications for Nursing

Objective This study aimed to characterize associations between three context-specific sedentary behaviors and cardiometabolic biomarkers to support individualized nursing assessment and intervention. Methods We included participants with biomarkers of interest measured from 3 large prospective cohorts: the Nurses’ Health Study (NHS, 1989-1990), the Health Professionals Follow-up Study (HPFS, 1993-1995), and NHS-II (1996-1999). We included 25,027 participants with available data on at least one of 15 biomarkers (e.g., C-peptide, HDL-C, CRP). Using the sedentary behavior items from the self-administered questionnaires employed in these three cohorts, which assess behaviors over the past year, we evaluated the three sedentary behaviors most proximal to the time of blood collection: sitting at home watching TV, sitting at work/away from home/while driving, and other sitting at home (e.g., reading, mealtimes, at desk). We ran generalized linear models using 25,027 participants with available data on one or more of 15 biomarkers. We adjusted models for potential confounding variables. Results Prolonged sitting at home watching TV showed the strongest associations with an adverse cardiometabolic profile. Sitting at home watching TV≥14 h/w (≥2 h/d) emerged as a critical threshold for significantly elevated cardiometabolic risk. For every 14 h/w increment in sitting at home watching TV, the percent differences in biomarker concentrations were 3.4% higher for C-peptide, 1.2 % lower for HDL-C, 2.9 % higher for TG, 6.3 % higher for CRP, 2.5 % higher for IL-6, 2.1 % higher for TNF-R1, 1.2 % higher for TNF-R2, 2.0 % lower for adiponectin, 9.4 % higher for leptin, 4.1 % higher for the TG/HDL-C ratio, and 11.8 % higher for the leptin/adiponectin ratio (all P < 0.005). After further adjustment for BMI, these associations were attenuated; however, leptin and the leptin/adiponectin ratio (both P < 0.001), HbA1c ( P < 0.01), C-peptide, TNF-R1, and TNF-R2 (all P < 0.05) remained statistically significant. Sitting at work/away from home/while driving and other sitting-at-home activities were not appreciably associated with biomarker concentrations. Healthy sleepers (7–8 h/d) engaging in sitting at home watching TV >7 h/w showed 5.4 % higher leptin levels ( P < 0.001), while long sleepers (>8 h/d) with sitting at home watching TV >7h/week showed 5.8 % higher TNF-R2 levels ( P <0.001), compared to healthy sleepers with sitting at home watching TV ≤7h/week. Conclusions This study shows that cardiometabolic biomarkers can quantify the health hazards of sedentary behaviors, providing objective tools for nursing research on behavioral interventions and overcoming the limitations of assessments that rely solely on subjective questionnaires. Furthermore, this study offers objective quantitative evidence for clinical nursing practice. When delivering health education for patients with chronic diseases, nurses should guide patients to limit weekly TV watching to less than seven hours and avoid excessive TV viewing combined with oversleeping to maintain cardiometabolic health.