Introduction:
Sedentary behavior (SB) has been associated with an increased risk of cardiovascular disease (CVD) in high-income countries. However, the burden and impact of SB in low- and middle-income countries is not well known. This study examined self-reported sedentary behavior and the association with CVD risk in Grenada, a middle-income country.
Methods:
A modified WHO STEPS survey was administered to a random sample of the Grenadian adult population, and sedentary behavior was assessed. Participants were asked to quantify the amount of time per day spent sitting (at home or work), reclining (excluding during sleep), or traveling in a vehicle. SB was assessed in hourly intervals and also grouped into two categories: 3 hours or less (approximately two thirds of the sample) and greater than 3 hours (approximately one third). Frequency of SB was compared across gender (age-standardized), age, and education groups. The relationship between SB and log-transformed 10-year CVD risk (Framingham) was evaluated using multivariable linear regression. Statistical analyses were performed using STATA v. 10.
Results:
Of 2622 participants, 32.4% reported greater than 3 hours per day of SB. SB was more common among men, among the youngest (age 18-29) and oldest (age 70+) individuals, and among those with higher education (
Table
). In univariate analysis, SB was adversely associated with 10-year CVD risk (p<0.05). However, after controlling for gender, age and education, SB was not significantly associated with 10-year CVD risk.
Conclusions:
Sedentary behavior in Grenada is more common among men, extremes of age, and higher education levels. Increased SB is not independently associated with 10-year CVD risk when controlling for gender, age and education. This is in contrast to findings in high-income countries. These results call for further exploration of the patterns of sedentary behavior, an emerging health issue in low- and middle-income countries, and its effect on CVD risk.
Table
Frequency of reported sedentary behavior (figures are %; all p-values within groups<0.05)
N
Greater than 3 hours per day
Gender
Men
1129
35.2
*
Women
1493
30.3
*
Age
(years
)
≤18-29
634
39.1
30-39
428
30.6
40-49
580
23.6
50-59
448
28.1
60-69
249
28.1
≥70
283
48.4
Education
No schooling to Primary
1532
29.0
Secondary School
639
34.7
Post Graduate
419
39.9
*
Age-standardized rates
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