CVD risk from prolonged occupational sitting attenuated by additional physical activity – Evidence from a prospective cohort of 481,688 Asian adults

Abstract BackgroundFor the first time, the 2020 WHO guidelines on physical activity recommend reducing sedentary behaviors due to their health consequences. Less is known on the effect of prolonged occupational sitting, especially in the context of low physical activity engagement.This study aims at quantifying cardiovascular risk associated with prolonged occupational sitting and determining the additional amount of physical activity that may be needed to attenuate it.MethodsA cohort comprising 481,688 participants in a health surveillance program in Taiwan was followed between 1996 and 2017, collecting data on occupational sitting time, leisure-time physical activity (LTPA) habits, lifestyle, and metabolic parameters. The all-cause and expanded cardiovascular disease (CVD + diabetes mellitus + kidney disease) mortality associated with three occupational sitting volumes (mostly sitting, alternating sitting and non-sitting, mostly non-sitting) was analyzed applying multivariate Cox regression models to calculate the hazard ratios (HRs) for all participants and by subgroups, including five levels of LTPA. Deaths in the first two years of follow-up were excluded to avoid reverse causality.ResultsThe study recorded 26,257 deaths during a mean follow-up period of 12.85 years. Individuals mostly sitting at work had a higher mortality risk than those mostly non-sitting, both from all causes (HR: 1.16, 95% CI: 1.11-1.20) and from expanded CVD (HR:1.46, 95% CI:1.35-1.58), after adjusting for gender, age, education, smoking, drinking, and body mass index. Individuals alternating sitting and non-sitting at work did not experience increased risk for all-cause mortality, compared to individuals mostly non-sitting at work (HR: 1.01, 95% CI: 0.97-1.05), but did experience higher risk of deaths due to expanded CVD (HR: 1.13, 95% CI: 1.04-1.23). Individuals engaged in low (15-29 min/day) or no (<15 min/day) LTPA, who mostly sit at work, would need to increase their LTPA by 15 and 30 minutes respectively to reduce their risk of mortality to that of similarly inactive individuals who mostly do not sit at work.ConclusionsAs part of modern lifestyles, prolonged occupational sitting is considered normal and has not received due attention, even though its deleterious effect has been largely proved. Alternating sitting and non-sitting at work, as well as an extra 15 to 30 min/day of LTPA, can attenuate the harms of prolonged occupational sitting. Thus, emphasizing the associated harms and suggesting workplace system changes could help the society to de-normalize this common behavior, similarly to the process of de-normalizing smoking.

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Association between physical activity, occupational sitting time and mortality in a general population: An 18-year prospective survey in Tanushimaru, Japan

European Journal of Preventive Cardiology ◽

10.1177/2047487318810020 ◽

2018 ◽

Vol 27 (7) ◽

pp. 758-766 ◽

Cited By ~ 6

Author(s):

Akiko Sakaue ◽

Hisashi Adachi ◽

Mika Enomoto ◽

Ako Fukami ◽

Eita Kumagai ◽

...

Keyword(s):

Physical Activity ◽

General Population ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Sitting Time ◽

Inverse Association ◽

Physical Activity Questionnaire ◽

Occupational Sitting ◽

Activity Questionnaire

Aims It is well known that a decline in physical activity is associated with an increase of all-cause death including cardiovascular events and cancer. Few studies have examined the association between occupational sitting time and mortality. Therefore, we investigated this issue in a general population. Methods Physical activity and occupational sitting time were measured using the Baecke physical activity questionnaire in 1999. The questionnaire generated indices in three physical activity categories: work, sport and leisure-time. A total physical activity index was calculated by adding these three indices. The Baecke physical activity questionnaire was able to evaluate occupational sitting time. Hazard ratios and 95% confidence intervals (CIs) were calculated using Cox's proportional hazard regression models. Results We enrolled a total of 1680 participants, who were followed up for 15.9 ± 3.8 years. The final follow-up rate was 93%. During the follow-up period, 397 subjects died. A significant inverse association ( p < 0.0001) was found between physical activity and mortality after adjustment for age and sex. Compared with lower levels of physical activity, the adjusted hazard ratio for mortality at higher levels of physical activity was 0.85 (95% CI: 0.78–0.92). Longer occupational sitting time was also significantly associated with higher mortality ( p < 0.01). The adjusted hazard ratio for mortality at longer occupational sitting time was 1.16 (95% CI: 1.05–1.27). These findings were observed in males, but not in females. Conclusions Our data demonstrated that higher levels of physical activity are associated with a reduced risk of cancer and cardiovascular death. Further, longer occupational sitting time is associated with increased mortality.

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Hours lying down per day, as a proxy for sedentary behaviour and risk of diabetes in young and middle-aged adults in Norway: an 11-year follow-up of the HUNT study

BMJ Open ◽

10.1136/bmjopen-2019-035010 ◽

2020 ◽

Vol 10 (3) ◽

pp. e035010

Author(s):

Ernest O Asante ◽

Yi-Qian Sun ◽

Tom Ivar Lund Nilsen ◽

Bjørn Olav Åsvold ◽

Elin Pettersen Sørgjerd ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behaviour ◽

Leisure Time Physical Activity ◽

Self Report ◽

Incident Diabetes ◽

Middle Aged ◽

Increased Risk ◽

Middle Aged Adults ◽

Lying Down

ObjectiveWe aimed to examine relationship between hours lying down per day, as a proxy for sedentary behaviour and risk of diabetes in young and middle-aged adults, and to assess if leisure-time physical activity and body mass index (BMI) modified this relationship.DesignA population-based prospective cohort study.SettingNord-Trøndelag, Norway.ParticipantsThe cohort included 17 058 diabetes-free adults, at an age of 20–55 years in 1995–1997, who were followed-up to 2006–2008.Primary outcome measuresIncident diabetes was defined by self-report of diabetes or non-fasting glucose levels greater than 11 mmol/L at the follow-up.MethodsMultivariable logistic regression models were used to obtain OR with 95% CI for risk of diabetes by the categories of hours lying down (≤7, 8 and ≥9 hours/day).Results362 individuals (2.1%) developed diabetes during an average of 11-year follow-up. Individuals who reported lying down ≥9 hours/day had an adjusted OR of 1.35 (95% CI 1.01 to 1.80) for incident diabetes compared with those lying down 8 hours/day. Lying down ≤7 hours/day was not associated with the risk of diabetes. In analysis stratified by physical activity, the ORs associated with lying down ≥9 hours/day were 1.41 (95% CI 1.05 to 1.90) and 0.90 (95% CI 0.23 to 3.55), respectively, among the less active and highly active individuals (pinteraction=0.048). There was little evidence that the association differed by BMI status (pinteraction=0.62).ConclusionsProlonged hours lying down per day was associated with an increased risk of diabetes in young and middle-aged adults. The positive association appeared to be modified by physical activity but not by BMI.

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Physical Activity Among Preadolescents Modifies the Long-Term Association Between Sedentary Time Spent Using Digital Media and the Increased Risk of Being Overweight

Journal of Physical Activity and Health ◽

10.1123/jpah.2021-0163 ◽

2021 ◽

pp. 1-8

Author(s):

Elina Engberg ◽

Marja H. Leppänen ◽

Catharina Sarkkola ◽

Heli Viljakainen

Keyword(s):

Physical Activity ◽

Digital Media ◽

Leisure Time ◽

Media Use ◽

Leisure Time Physical Activity ◽

Normal Weight ◽

Web Based ◽

Increased Risk

Background: This study aimed to examine whether sedentary digital media use in preadolescence increases the risk of being overweight 3 years later, and whether this association differs based on preadolescents’ leisure-time physical activity (LTPA) levels. Methods: The authors conducted a 3-year follow-up study among 4661 participants with a mean (SD) age of 11 (1) years at baseline and 14 (1) years at follow-up. A web-based questionnaire assessed sedentary digital media use and LTPA. The authors categorized baseline LTPA duration into 3 levels: 0 to 5 (low), 6 to 8 (moderate), and ≥9 (high) hours per week. In addition, the authors categorized adolescents as normal weight or overweight/obese at follow-up. Results: Greater amounts of sedentary digital media use at baseline associated with an increased risk of being overweight 3 years later even after adjusting for confounders. This only held for preadolescents with low baseline LTPA (OR = 1.14; 95% confidence interval, 1.05–1.24), but not among those with moderate (OR = 1.02; 0.91–1.15) or high (OR = 0.96; 0.85–1.08) LTPA. Conclusions: Preadolescent LTPA modified the long-term association between sedentary digital media use and being overweight; specifically, 6 hours per week or more of LTPA mitigated the increased risk of being overweight associated with higher amounts of digital media use.

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Abstract MP78: Progression of Valvular Calcification and Risk of Incident Stroke: The Multi-ethnic Study of Atherosclerosis (MESA)

Circulation ◽

10.1161/circ.141.suppl_1.mp78 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Oluwaseun Fashanu ◽

Anas Bizanti ◽

Ahmad Al-Abdouh ◽

Di Zhao ◽

Matthew J Budoff ◽

...

Keyword(s):

Ischemic Stroke ◽

Stroke Risk ◽

Cox Regression ◽

The United States ◽

Cvd Risk ◽

Valvular Calcification ◽

Hazard Ratios ◽

Increased Risk ◽

Annular Calcification

Introduction: Stroke is a leading cause of morbidity and mortality in the United States. Identification of individuals at risk for stroke is important for implementation of preventive therapies. Prevalent valvular calcification (VC) has been shown to be associated with stroke but less is known about associations of VC progression with stroke. Methods: Progression (interval increase >0 Agatston units/year) of aortic valvular calcification (AVC) and mitral annular calcification (MAC) was assessed by two cardiac CTs over a median of 2.4 years. We determined the risk of adjudicated total and ischemic stroke using Cox regression adjusted for cardiovascular disease (CVD) risk factors. Results: We studied 5,606 multiethnic participants (39.6% White, 26.9% Black, 21.4% Hispanic, 12.2% Chinese) free of baseline CVD enrolled in MESA. Baseline mean ± SD age was 62 ± 10 years; 53% were women; 12% had prevalent AVC and 9% prevalent MAC at the baseline visit; 83% had no progression of VC, 14%, progression at one site (AVC or MAC), and 3% progression at both sites (AVC and MAC) at follow-up. Over a median of 12 years, 214 total and 170 ischemic strokes occurred. The number of sites with VC progression (range 0-2) was not associated with total and ischemic stroke (all p>0.05). We found MAC progression to be associated with increased risk of total stroke [adjusted hazard ratios (95% CI) 1.59 (1.11 - 2.27)] and ischemic stroke [1.64 (1.10 - 2.43)] in the whole cohort (model 3) and after further adjustment for baseline coronary artery calcification (model 4) ( Table ). Results remained significant for total stroke risk after excluding participants with interim atrial fibrillation or coronary heart disease [1.60 (1.01 - 2.54)]. In women, AVC progression was associated with ischemic stroke [1.87 (1.04 - 3.36)] (p-for-interaction=0.03). Conclusion: Progression of MAC over 2.4 years is associated with increased risk of total and ischemic stroke, and in women, AVC progression with higher ischemic stroke risk.

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Accelerometer-derived sedentary time and physical activity and the incidence of depressive symptoms – The Maastricht Study

Psychological Medicine ◽

10.1017/s0033291720004924 ◽

2020 ◽

pp. 1-8

Author(s):

Magdalena J. Konopka ◽

Sebastian Köhler ◽

Coen D. A. Stehouwer ◽

Nicolaas C. Schaper ◽

Ronald M. A. Henry ◽

...

Keyword(s):

Physical Activity ◽

Depressive Symptoms ◽

Sex Education ◽

Sedentary Time ◽

Cox Regression ◽

Future Research ◽

Cox Regression Analysis ◽

Increased Risk ◽

Intensity Physical Activity

Abstract Background This study examined the associations between accelerometer-derived sedentary time (ST), lower intensity physical activity (LPA), higher intensity physical activity (HPA) and the incidence of depressive symptoms over 4 years of follow-up. Methods We included 2082 participants from The Maastricht Study (mean ± s.d. age 60.1 ± 8.0 years; 51.2% men) without depressive symptoms at baseline. ST, LPA and HPA were measured with the ActivPAL3 activity monitor. Depressive symptoms were measured annually over 4 years of follow-up with the 9-item Patient Health Questionnaire (PHQ-9). Cox regression analysis was performed to examine the associations between ST, LPA, HPA and incident depressive symptoms (PHQ-9 ⩾ 10). Analyses were adjusted for total waking time per day, age, sex, education level, type 2 diabetes mellitus, body mass index, total energy intake, smoking status and alcohol use. Results During 7812.81 person-years of follow-up, 203 (9.8%) participants developed incident depressive symptoms. No significant associations [Hazard Ratio (95% confidence interval)] were found between sex-specific tertiles of ST (lowest v. highest tertile) [1.13 (0.76–1.66], or HPA (highest v. lowest tertile) [1.14 (0.78–1.69)] and incident depressive symptoms. LPA (highest v. lowest tertile) was statistically significantly associated with incident depressive symptoms in women [1.98 (1.19–3.29)], but not in men (p-interaction <0.01). Conclusions We did not observe an association between ST or HPA and incident depressive symptoms. Lower levels of daily LPA were associated with an increased risk of incident depressive symptoms in women. Future research is needed to investigate accelerometer-derived measured physical activity and ST with incident depressive symptoms, preferably stratified by sex.

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Healthy behaviours and risk of all-cause mortality

European Journal of Public Health ◽

10.1093/eurpub/ckz185.469 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

J Lahti ◽

E Mauramo ◽

E Lahelma ◽

T Lallukka ◽

O Pietiläinen ◽

...

Keyword(s):

Mortality Risk ◽

Cox Regression ◽

Leisure Time Physical Activity ◽

Premature Mortality ◽

Middle Aged ◽

A Value ◽

Risk Of Mortality ◽

Increased Risk ◽

Healthy Behaviour

Abstract Introduction Healthy behaviours are associated with better health in general but less is known about the combined associations of multiple healthy behaviours with mortality risk. We aimed to examine the associations of combined healthy behaviours with mortality risk over a 15-year follow-up among middle-aged employees. Methods Survey data, collected in 2000–2002 among 40–60-year-old employees of the City of Helsinki, Finland, was linked with complete register data on mortality from Statistics Finland (response rate 67%, written informed consent for register linkages 74%). Healthy behaviours included high leisure-time physical activity, non-smoking, no binge drinking and healthy food habits. Each healthy behaviour were dichotomized and assigned a value of one for healthy and zero for unhealthy. The number of healthy behaviours were summed together (score range 0-4). Cox regression models were fitted, and the follow-up continued until the end of 2015 (n = 6336). Confounders included age, sex, marital status, socioeconomic position and self-rated health. Results Of the respondents, 7% reported four healthy behaviours, 27% three, 34% two, 22% one and 9% no healthy behaviours. A total of 281 deaths occurred during the follow-up. Each healthy behaviour was individually associated with a reduced mortality risk, non-smoking having the strongest and healthy diet the weakest association. The combined association showed that those without any of the healthy behaviours (HR 2.8, 95% CI 1.51-5.29) and those with only one healthy behaviour (HR 1.89, 95% CI 1.04-3.43) had a higher mortality risk than those with four healthy behaviours. Instead, those with at least two healthy behaviours were not at an increased risk of mortality. Conclusions A low number of healthy behaviours predicted mortality among middle-aged employees. Efforts should be made to promote multiple healthy behaviours among the middle-aged to enhance health and prevent premature mortality. Key messages Almost one third of the respondents had no or only one healthy behaviour. A low number of healthy behaviours was associated with an increased risk of mortality.

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Demographic, lifestyle and comorbid risk factors for all-cause mortality in a Danish cohort of middle-aged adults with incident asthma

BMJ Open ◽

10.1136/bmjopen-2021-049243 ◽

2021 ◽

Vol 11 (10) ◽

pp. e049243

Author(s):

Oliver Djurhuus Tupper ◽

Zorana Jovanovic Andersen ◽

Charlotte Suppli Ulrik

Keyword(s):

Physical Activity ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Secondary Outcome ◽

Long Term Study ◽

Increased Risk ◽

All Cause Mortality ◽

Incident Asthma ◽

First Time

ObjectiveWe aimed to identify factors associated with all-cause mortality in adults with incident asthma.Design and settingCross-sectional cohort study, in the metropolitan areas of Copenhagen and Aarhus, Denmark.ParticipantsAdults aged 50–64 years enrolled in the Danish Diet, Cancer, and Health cohort were followed up from baseline (1993–1997) in the National Patients Registry for first-time admissions for asthma and vital status. We defined incident asthma as at least one first-time hospital admission with asthma as the primary registered diagnosis between baseline and end of follow-up (2013) in participants without previously known asthma. Among the cohort comprising 57 053 individuals, we identified 785 adults (aged 50—64) with incident asthma, of whom 76 died during follow-up.Primary and secondary outcome measuresBaseline reported socioeconomic and lifestyle traits, and comorbidities associated with all-cause mortality.ResultsSelf-reported leisure-time physical activity was associated with a substantial reduction in risk with an HR of 0.53 (95% CI 0.33 to 0.85). Being male, single and having a diagnosis of hypertension or diabetes were associated with an increased risk of all-cause mortality with an HR of 1.83 (95% CI 1.14 to 2.38), 2.16 (95% CI 2.06 to 4.40), 2.47 (95% CI 1.54 to 3.95) and of 2.42 (95% CI 0.96 to 6.11), respectively.ConclusionsThis long-term study of adults with hospital contacts for incident asthma revealed that self-reported leisure-time physical activity is associated with an approximately 50% reduction in all-cause mortality. In contrast, both hypertension and diabetes were associated with a higher risk of mortality.

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Association between blood pressure categories and cardiovascular disease mortality in China

PLoS ONE ◽

10.1371/journal.pone.0255373 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255373

Author(s):

Jie Guo ◽

Jun Lv ◽

Yu Guo ◽

Zheng Bian ◽

Bang Zheng ◽

...

Keyword(s):

Blood Pressure ◽

Cox Regression ◽

Cvd Risk ◽

Hazard Ratios ◽

Disease Mortality ◽

Increased Risk ◽

Diastolic Hypertension ◽

High Prevalence ◽

Cvd Mortality

Background Blood pressure (BP) categories are useful to simplify preventions in public health, and diagnostic and treatment approaches in clinical practice. Updated evidence about the associations of BP categories with cardiovascular diseases (CVDs) and its subtypes is warranted. Methods and findings About 0.5 million adults aged 30 to 79 years were recruited from 10 areas in China during 2004–2008. The present study included 430 977 participants without antihypertension treatment, cancer, or CVD at baseline. BP was measured at least twice in a single visit at baseline and CVD deaths during follow-up were collected via registries and the national health insurance databases. Multivariable Cox regression was used to estimate the associations between BP categories and CVD mortality. Overall, 16.3% had prehypertension-low, 25.1% had prehypertension-high, 14.1% had isolated systolic hypertension (ISH), 1.9% had isolated diastolic hypertension (IDH), and 9.1% had systolic-diastolic hypertension (SDH). During a median 10-year follow-up, 9660 CVD deaths were documented. Compared with normal, the hazard ratios (95% CI) of prehypertension-low, prehypertension-high, ISH, IDH, SDH for CVD were 1.10 (1.01–1.19), 1.32 (1.23–1.42), 2.04 (1.91–2.19), 2.20 (1.85–2.61), and 3.81 (3.54–4.09), respectively. All hypertension subtypes were related to the increased risk of CVD subtypes, with a stronger association for hemorrhagic stroke than for ischemic heart disease. The associations were stronger in younger than older adults. Conclusions Prehypertension-high should be considered in CVD primary prevention given its high prevalence and increased CVD risk. All hypertension subtypes were independently associated with CVD and its subtypes mortality, though the strength of associations varied substantially.

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Association of Sedentary Time and Incident Heart Failure Hospitalization in Postmenopausal Women

Circulation Heart Failure ◽

10.1161/circheartfailure.120.007508 ◽

2020 ◽

Vol 13 (12) ◽

Author(s):

Michael J. LaMonte ◽

Joseph C. Larson ◽

JoAnn E. Manson ◽

John Bellettiere ◽

Cora E. Lewis ◽

...

Keyword(s):

Physical Activity ◽

Heart Failure ◽

Postmenopausal Women ◽

Cox Regression ◽

Coronary Revascularization ◽

Sitting Time ◽

Time Varying ◽

Hazard Ratios ◽

Increased Risk ◽

Race Ethnicity

Background: The 2018 US Physical Activity Guidelines recommend reducing sedentary behavior (SB) for cardiovascular health. SB’s role in heart failure (HF) is unclear. Methods: We studied 80 982 women in the Women’s Health Initiative Observational Study, aged 50 to 79 years, who were without known HF and reported ability to walk ≥1 block unassisted at baseline. Mean follow-up was 9 years for physician-adjudicated incident HF hospitalization (1402 cases). SB was assessed repeatedly by questionnaire. Time-varying total SB was categorized according to awake time spent sitting or lying down (≤6.5, 6.6–9.5, >9.5 h/d); sitting time (≤4.5, 4.6–8.5, >8.5 h/d) was also evaluated. Hazard ratios and 95% CI were estimated using Cox regression. Results: Controlling for age, race/ethnicity, education, income, smoking, alcohol, menopausal hormone therapy, and hysterectomy status, higher HF risk was observed across incremental tertiles of time-varying total SB (hazard ratios [95% CI], 1.00 [referent], 1.15 [1.01–1.31], 1.42 [1.25–1.61], trend P <0.001) and sitting time (1.00 [referent], 1.14 [1.01–1.28], 1.54 [1.34–1.78], trend P <0.001). The inverse trends remained significant after further controlling for comorbidities including time-varying myocardial infarction and coronary revascularization (hazard ratios: SB, 1.00, 1.11, 1.27; sitting, 1.00, 1.09, 1.37, trend P <0.001 each) and for baseline physical activity (hazard ratios: SB 1.00, 1.10, 1.24; sitting 1.00, 1.08, 1.33, trend P <0.001 each). Associations with SB exposures were not different according to categories of baseline age, race/ethnicity, body mass index, physical activity, physical functioning, diabetes, hypertension, or coronary heart disease. Conclusions: SB was associated with increased risk of incident HF hospitalization in postmenopausal women. Targeted efforts to reduce SB could enhance HF prevention in later life.

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Changes in Workers’ Sedentary and Physical Activity Behaviors in Response to the COVID-19 Pandemic and Their Relationships With Fatigue: Longitudinal Online Study (Preprint)

10.2196/preprints.26293 ◽

2020 ◽

Author(s):

Mohammad Javad Koohsari ◽

Tomoki Nakaya ◽

Gavin R McCormack ◽

Ai Shibata ◽

Kaori Ishii ◽

...

Keyword(s):

Physical Activity ◽

Public Transportation ◽

Online Survey ◽

Sitting Time ◽

Sedentary Behaviors ◽

Linear Regression Models ◽

Negative Effects ◽

Work Related ◽

Domain Specific

BACKGROUND Sedentary behaviors and physical activity are likely to be affected by the COVID-19 outbreak, and sedentary lifestyles can increase subjective fatigue. The nonpharmaceutical policies imposed as a result of the COVID-19 pandemic may also have adverse effects on fatigue. OBJECTIVE This study has two aims: to examine the changes in sedentary behaviors and physical activity of company workers in response to the COVID-19 pandemic in Japan and to examine relationships between changes in these sedentary behaviors and physical activity and changes in fatigue. METHODS Data from a nationwide prospective online survey conducted in 2019 and 2020 were used. On February 22, 2019, an email with a link to participate in the study was sent to 45,659 workers, aged 20 to 59 years, who were randomly selected from a database of approximately 1 million individuals. A total of 2466 and 1318 participants, who self-reported their occupation as company workers, answered the baseline and follow-up surveys, respectively. Surveys captured fatigue, workday and daily domain-specific sedentary behaviors and physical activity, and total sedentary behaviors and physical activity. We used multivariable linear regression models to estimate associations of changes in sedentary behaviors and physical activity with changes in fatigue. RESULTS Increases in public transportation sitting during workdays, other leisure sitting time during workdays, and other leisure sitting time were associated with an increase in the motivation aspect of fatigue (b=0.29, 95% CI 0-0.57, P=.048; b=0.40, 95% CI 0.18-0.62, P<.001; and b=0.26, 95% CI 0.07-0.45, P=.007, respectively). Increases in work-related sitting time during workdays, total sitting time during workdays, and total work-related sitting time were significantly associated with an increase in the physical activity aspect of fatigue (b=0.06, 95% CI 0-0.12, P=.03; b=0.05, 95% CI 0.01-0.09, P=.02; and b=0.07, 95% CI 0-0.14, P=.04, respectively). The motivation and physical activity aspects of fatigue increased by 0.06 for each 1-hour increase in total sitting time between baseline and follow-up (b=0.06, 95% CI 0-0.11, P=.045; and b=0.06, 95% CI 0.01-0.10, P=.009, respectively). CONCLUSIONS Our findings demonstrated that sedentary and active behaviors among company workers in Japan were negatively affected during the COVID-19 outbreak. Increases in several domain-specific sedentary behaviors also contributed to unfavorable changes in workers’ fatigue. Social distancing and teleworking amid a pandemic may contribute to the sedentary lifestyle of company workers. Public health interventions are needed to mitigate the negative effects of the COVID-19 pandemic or future pandemics on sedentary and physical activity behaviors and fatigue among company workers.

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