Studying at Cambridge

DAPA Measurement Toolkit

Sedentary behaviour


Behaviour is defined as sedentary if it satisfies all of the following criteria:

  • Requires little or no energy expenditure (≤ 1.5 METs)
  • Performed in a sitting or reclining posture
  • The individual is awake

Sedentary behaviours exist at the lower end of the energy expenditure continuum (Figure P.1.7), and can include:

  • Driving
  • Watching TV
  • Playing video games
  • Sitting in an office or school environment

Activities performed while seated or reclined that require physical work > 1.5 METs are not considered to be sedentary behaviours. These may include:

  • Rowing
  • Cycling
  • Pushing a manual wheelchair
  • Playing computer games requiring whole-body movement
  • Floor-based play in young children

In contrast, some standing activities may be ≤1.5 MET [10]. These are not classified as sedentary behaviours as they lack the sitting/reclining postural element.

Figure P.1.7 The continuum of human movement and energy expenditure.

Evidence suggests that sedentary behaviour is a strong independent risk factor for all-cause mortality, especially when it is prolonged and uninterrupted [4, 9]

It is associated with greater risk of:

  • Cardiovascular disease [2, 7, 8]
  • Cancer [2, 12]
  • Type 2 diabetes [2, 8]
  • Intermediate cardio-metabolic risk [13]

Sedentary behaviour is not equivalent to inactivity or low overall levels of physical activity (i.e. not meeting physical activity guidelines) [11]. Physical activity and sedentary behaviour are often uncorrelated at group level [1], and high levels of daily sedentary behaviour and moderate-to-vigorous physical activity can co-exist in the same individual [5, 6] (Figure P.1.8, below). Such a person could plausibly meet current physical activity guidelines and yet still incur a higher risk of sedentary behaviour-related health risks.

Figure P.1.8 Four different and plausible daily activity profiles. Profile D illustrates the potential for high levels of sedentary behaviour and moderate-to-vigorous physical activity (MVPA) to co-exist.


  1. Biddle SJ, Gorely T, Marshall SJ, Murdey I, Cameron N. Physical activity and sedentary behaviours in youth: issues and controversies. The journal of the Royal Society for the Promotion of Health. 2004;124(1):29-33.
  2. Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of internal medicine. 2015;162(2):123-32.
  3. British Heart Foundation National Centre for Physical Activity and Health. Evidence Briefing: Sedentary Behaviour2012. Available from:
  4. Chau JY, Grunseit AC, Chey T, Stamatakis E, Brown WJ, Matthews CE, et al. Daily Sitting Time and All-Cause Mortality: A Meta-Analysis. Plos One. 2013;8(11):e80000.
  5. Craft LL, Zderic TW, Gapstur SM, Vaniterson EH, Thomas DM, Siddique J, et al. Evidence that women meeting physical activity guidelines do not sit less: an observational inclinometry study. The international journal of behavioral nutrition and physical activity. 2012;9:122.
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  7. Ford ES, Caspersen CJ. Sedentary behaviour and cardiovascular disease: a review of prospective studies. International journal of epidemiology. 2012;41(5):1338-53.
  8. Grontved A, Hu FB. Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis. JAMA. 2011;305(23):2448-55.
  9. Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Medicine and science in sports and exercise. 2009;41(5):998-1005.
  10. Mansoubi M, Pearson N, Clemes SA, Biddle SJ, Bodicoat DH, Tolfrey K, et al. Energy expenditure during common sitting and standing tasks: examining the 1.5 MET definition of sedentary behaviour. BMC public health. 2015;15:516.
  11. Sedentary Behaviour Research Network. Letter to the editor: standardized use of the terms "sedentary" and "sedentary behaviours". Appl Physiol Nutr Metab. 2012;37(3):540-2.
  12. Schmid D, Leitzmann MF. Television viewing and time spent sedentary in relation to cancer risk: a meta-analysis. Journal of the National Cancer Institute. 2014;106(7).
  13. Wijndaele K, Orrow G, Ekelund U, Sharp SJ, Brage S, Griffin SJ, et al. Increasing objectively measured sedentary time increases clustered cardiometabolic risk: a 6 year analysis of the ProActive study. Diabetologia. 2014;57(2):305-12.