# Sex differences in the impact of sedentary time on early-onset metabolic multimorbidity: evidence from a study of over 20,000 young adults

## TL;DR

This study finds that sitting for long periods is linked to a higher risk of multiple metabolic diseases in young men, but not in women, suggesting the need for gender-specific health interventions.

## Contribution

The study reveals a sex-specific association between sedentary time and early-onset metabolic multimorbidity, highlighting the need for targeted interventions for men.

## Key findings

- Men who sat for ≥6 hours/day had 22–26% higher odds of metabolic multimorbidity compared to those sitting <4 hours/day.
- No significant link was found between sedentary time and metabolic diseases in women.
- Education level, smoking, and physical activity modified the association in men, indicating gender-specific influences.

## Abstract

This study examines how sitting for a long time affects the prevalence of multiple metabolic diseases early in life, focusing on differences between men and women. Researchers analyzed data from over 21,000 young adults aged 18 to 45, finding that men who sat for more than 6 h a day showed a higher prevalence of metabolic diseases like obesity, high blood pressure, and diabetes. Specifically, sitting 6–8 h daily was associated with a 22% higher prevalence of these conditions, and those sitting over 8 h showed a 26% higher prevalence. However, no such link was found in women. The study highlights that while women reported more sedentary time, men exhibited a stronger association between sitting duration and metabolic disease prevalence. Factors like education level, smoking, and physical activity influenced these associations differently for men and women. The findings suggest that reducing sedentary behavior could help lower the prevalence of metabolic diseases, especially in men. This research underscores the importance of considering gender differences in health interventions. It also points out the need for more studies to understand why men and women respond differently to sedentary lifestyles. Overall, the study emphasizes the need for targeted strategies to combat the health risks associated with longer sitting time, particularly among young men.

The online version contains supplementary material available at 10.1186/s13293-026-00831-x.

Both sedentary lifestyles and metabolic multimorbidity are experiencing a rising global prevalence, representing growing public health concerns. Although the detrimental effects of sedentary behavior on metabolic diseases are well-documented, the association between sedentary time and early-onset metabolic multimorbidity, especially potential sex-specific differences in this association, remains unexplored. This study aimed to investigate the sex-specific effects of sedentary time on the prevalence of early-onset metabolic multimorbidity.

We recruited 21,444 young adults (18–45 years; 50.6% women) and assessed their sedentary time using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Metabolic multimorbidity was defined as the coexistence of at least two of the following conditions: obesity, hypertension, dyslipidemia, diabetes, and non-alcoholic fatty liver disease. Logistic regression models were used to evaluate the sex-specific association between sedentary time and metabolic multimorbidity. Subgroup analyses by sociodemographic characteristics and lifestyle factors were performed to identify potential interactions and susceptible subpopulations. Sensitivity analysis was conducted to assess the robustness of the results.

The overall prevalence of metabolic multimorbidity was 25.35%, with a significantly higher prevalence in males than in females (40.72% vs. 10.35%), despite a higher proportion of females reporting longer sedentary time. In males, sedentary time exhibited a linear positive association with the increased odds of metabolic multimorbidity, whereas no such association was observed in females. Males reporting 6-<8 and ≥ 8 h/day sedentary time had 22% (95% CI 1.01–1.47) and 26% (95% CI 1.05–1.50) higher odds of metabolic multimorbidity, respectively, compared to those reporting < 4 h/day sedentary time (P
for trend = 0.019). Education level, smoking status and physical activity level were found to modify the association between sedentary time and metabolic multimorbidity.

Longer sedentary time is associated with increased odds of early-onset metabolic multimorbidity in men, but this association is not observed in women. These findings suggest that targeted, sex-specific interventions may reduce metabolic risk and improve long-term outcomes, highlighting the need to consider sex differences in both prevention strategies and expected health benefits.

The online version contains supplementary material available at 10.1186/s13293-026-00831-x.

Men, but not women, exhibit a significant association between longer sedentary time and an elevated prevalence of metabolic multimorbidity.Men who are sedentary for ≥ 6 h/day experience a 22–26% higher odds of metabolic multimorbidity compared to those sedentary for < 4 h/day.No significant link was found between sedentary time and metabolic diseases in women.Education level, smoking status, and physical activity levels modify the association between sedentary time and metabolic multimorbidity in men, indicating gender-specific influences.The study underscores the necessity for tailored interventions to mitigate sedentary behavior and enhance metabolic health, particularly among men.

Men, but not women, exhibit a significant association between longer sedentary time and an elevated prevalence of metabolic multimorbidity.

Men who are sedentary for ≥ 6 h/day experience a 22–26% higher odds of metabolic multimorbidity compared to those sedentary for < 4 h/day.

No significant link was found between sedentary time and metabolic diseases in women.

Education level, smoking status, and physical activity levels modify the association between sedentary time and metabolic multimorbidity in men, indicating gender-specific influences.

The study underscores the necessity for tailored interventions to mitigate sedentary behavior and enhance metabolic health, particularly among men.

The online version contains supplementary material available at 10.1186/s13293-026-00831-x.