Is the Time Right for Preventive Cardiology Guidelines on Sedentary Behaviours and Sitting Time?

In this review sedentary behaviour (SB) is considered beyond its simplistic definition of "sitting" and also includes sedentary activities. We explore the definition, physiological characteristics, prevalence, and guidelines of SB, contrasting it with physical activity (PA). The discussion encompasses: (1) the association between SB and mortality, with a specific focus on cardiovascular (CV) outcomes; (2) biological mechanisms that link SB to CV health, additionally differentiating between the effects of acute and chronic sitting; (3) sex and gender differences in SB; and (4) SB as an independent CV risk factor is explored. The review concludes with an examination of the potential beneficial effects of PA on mitigating the detrimental effects of SB and an analysis of evidence that supports the use of break-up strategies in preventive cardiology. This analysis sheds light on the significant deleterious consequences of SB on CV health. It highlights the potential of incorporating strategies to reduce and interrupt prolonged sitting alongside existing guidelines that promote PA. These findings suggest considering SB as a major CV risk factor, and emphasize the importance of targeting SB reduction and interruption as a valuable approach for preventing and managing CV disease. However, further research is needed to determine the long-term effectiveness of SB interventions, to inform the development of optimal guidelines for CV health management.