BACKGROUND: Cardiorespiratory fitness (CRF) is an important indicator of current and future health. While the impact of habitual physical activity on CRF is well established, the role of sedentary behaviour (SB) remains less understood. OBJECTIVE: We aimed to determine the effect of SB on CRF. METHODS: Searches were conducted in MEDLINE, Embase, PsycINFO, CINAHL and SPORTDiscus from inception to August 2022. Randomised controlled trials, quasi-experimental studies and cohort studies that assessed the relationship between SB and CRF were eligible. Narrative syntheses and meta-analyses summarised the evidence, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) certainty was based on evidence from randomised controlled trials. RESULTS: This review included 18 studies that focused on youth (four randomised controlled trials, three quasi-experimental studies, 11 cohort studies) and 24 on adult populations (15 randomised controlled trials, five quasi-experimental studies, four cohort studies). In youth and adults, evidence from randomised controlled trials suggests mixed effects of SB on CRF, but with the potential for interventions to improve CRF. Quasi-experimental and cohort studies also support similar conclusions. Certainty of evidence was very low for both age groups. A meta-analysis of adult randomised controlled trials found that interventions targeting reducing SB, or increasing physical activity and reducing SB, had a significant effect on post-peak oxygen consumption (mean difference = 3.16 mL.kg-1.min-1, 95% confidence interval: 1.76, 4.57). CONCLUSIONS: Evidence from randomised controlled trials indicates mixed associations between SB and CRF, with the potential for SB to influence CRF, as supported by meta-analytical findings. Further well-designed trials are warranted to confirm the relationship between SB and CRF, explore the effects of SB independent from higher intensity activity, and investigate the existence of such relationships in paediatric populations. CLINICAL TRIAL REGISTRATION: PROSPERO CRD42022356218.

Alliance for Research in Exercise Nutrition and Activity Allied Health and Human Performance University of South Australia Adelaide SA Australia

Baker Heart and Diabetes Institute Melbourne VIC Australia

Centre for Surveillance and Applied Research Public Health Agency of Canada 785 Carling Avenue Ottawa ON K1A 0K9 Canada

Department Applied Human Sciences University of Prince Edward Island Charlottetown PEI Canada

Department of Physical Education and Sport Faculty of Science Humanities and Education Technical University of Liberec Liberec Czech Republic

Diabetes Research Centre College of Life Sciences University of Leicester Leicester UK

Exercise Physiology and Cardiovascular Health Lab University of Ottawa Heart Institute Ottawa ON Canada

Health Canada Library Ottawa ON Canada

Institute for Physical Activity and Nutrition School of Exercise and Nutrition Sciences Deakin University Geelong VIC Australia

Institute of Active Lifestyle Faculty of Physical Culture Palacký University Olomouc Olomouc Czech Republic

MRC Epidemiology Unit Institute of Metabolic Science University of Cambridge Cambridge Biomedical Campus Cambridge UK

School of Epidemiology and Public Health Faculty of Medicine University of Ottawa Ottawa ON Canada

School of Human Kinetics Faculty of Health Sciences University of Ottawa Ottawa ON Canada

Telfer School of Management University of Ottawa Ottawa ON Canada

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Sports Med. 2024 Apr;54(4):1015-1020. doi: 10.1007/s40279-024-01995-5. PubMed

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