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

CVD risk from prolonged occupational sitting attenuated by additional physical activity – Evidence from a prospective cohort of 481,688 Asian adults | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article CVD risk from prolonged occupational sitting attenuated by additional physical activity – Evidence from a prospective cohort of 481,688 Asian adults Wayne Gao, Mattia Sanna, Yea-Hung Chen, Min-Kuang Tsai, Po-Jung Lu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1134870/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background For 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. Methods A 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. Results The 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. Conclusions As 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. sedentary behavior prolonged occupational sitting physical activity cardiovascular mortality all-cause mortality Figures Figure 1 Condensed Abstract Competency in medical knowledge Individuals who mostly sit at work face increased mortality risk, compared to individuals who mostly do not sit at work. Alternating sitting and non-sitting at work or engaging in an additional 15 to 30 mins of leisure-time physical activity can reduce workers’ mortality risk to that of individuals who mostly do not sit at work. Translational outlook By de-normalizing prolonged occupational sitting, with behavioral and system change efforts similar to those made to de-normalize smoking, we can achieve a paradigm shift and hopefully reverse the current perception of sedentary lifestyles, both at work and during leisure time. Introduction Modern lifestyles have become increasingly sedentary, 1 and prolonged sitting is currently so pervasive that most people perceive it as part of normal life, 2 despite the fact that, with some exceptions, 3 the scientific literature agrees on its deleterious effects. For the first time in 2020, the WHO guidelines on physical activity recommend reducing sedentary behaviors due to its health consequences, 4 which accords with similar recent physical activities guidelines published in the USA in 2018, 5 and UK in 2019, 6 that also discourage prolonged sitting. However, this guidance can be difficult to adhere to, particularly in workplace settings where not sitting is not well supported. Few studies have specifically examined prolonged occupational sitting. However, several studies have found increased mortality among prolonged sitters from all causes, 7 – 11 as well as from cardiovascular disease (CVD), 12 cancer, 13 , 14 and diabetes. 15 , 16 For example, a cohort study of more than 200,00 individuals in Australia found a dose-response relationship between prolonged sitting and all-cause mortality, with increased risk among individuals with more hours per day of prolonged sitting. 8 Similarly, a meta-analysis of six studies found increased risk for all-cause mortality with increased prolonged sitting. 9 On the other hand, associations between prolonged sitting and health outcomes have not been consistently demonstrated. Prospective studies have generally found that prolonged sitting increases the risk of diabetes mellitus, for example, but not cancer. 17 Similarly, an analysis found that associations between prolonged sitting and health outcomes are dependent on gender. 18 It is not necessarily clear, overall, if the adverse health effects associated with prolonged sitting necessarily translate to occupational settings. In addition, the health risks of prolonged sitting have been shown to be independent of leisure-time physical inactivity. 19 , 20 Working long hours shares some similarities with prolonged sitting in terms of health impacts. For instance, some studies have found similar dose-response relationships between working long hours and increased incidence in coronary heart disease and stroke. 21 , 22 Thus, one would expect similar, if not worse health consequences for prolonged occupational sitting; nonetheless, the evidences of harms associated with working long hours in a sitting position are less consistent. 17 , 23 Another important issue is the amount of leisure-time physical activity (LTPA) needed to offset or attenuate the health repercussions of prolonged occupational sitting. For example, A meta-analysis by Ekelund and colleagues concluded that the risk of prolonged sitting could be eliminated with 60-75 min/day of exercise, 20 approximately 4–5 times more than the current WHO recommendation. 24 It is unclear, however, whether this level of offset can be reasonably achieved or whether the findings would hold using different approaches. In this study, we aim to (1) understand the health risks of prolonged sitting on all-cause and CVD mortality, and (2) quantify the amount of LTPA needed to mitigate the risks for individuals mostly sitting at work to the level of those alternating sitting and non-sitting or mostly non-sitting at work. Methods Study Population and General Data Collection Our cohort included 481,688 individuals aged 20 years and older who participated in an annual to bi-annual standard medical screening program in Taiwan run by a private firm, MJ Health Management Institution, between 1996 and 2017. Most of the participants were outwardly healthy, and followed for a mean period of 12.85 years (standard deviation = 5.67 years), which equates to 6,186,949 person-years at follow-up. At each visit, participants completed a self-administered questionnaire on their medical history and lifestyle risk factors, and specimens for biological tests were collected. Previous studies have described in more detail the entire program, as well as the data collection methods. 25 , 26 Measurement of Prolonged Occupational Sitting, Physical Activity, and Adverse Health Outcomes The occupational sitting status of each participant was categorized into three groups: mostly sitting, alternating sitting and non-sitting, mostly non-sitting; based on the answer to the following question included in the above-mentioned questionnaire: “What is your level of activity at work?”. The response options included: “mostly sitting”, “mostly sitting and standing performing repetitive motions in the course of work”, “standing and walking around most of the time”. The LTPA status was determined through two multiple-choice questions. The first asked the participants to classify all their weekly LTPAs in the last month into four intensity categories: light (e.g., walking), moderate (e.g., brisk walking), medium vigorous (e.g., jogging), or highly vigorous (e.g., running). The second required the participants to indicate the weekly duration of each LTPA in the last month. Further details can be found in Wen et al (2011). 25 Based on their answers, participants were classified into five LTPA groups by metabolic equivalent of task (MET)-hour/week: inactive (<3.75 MET-hour/week or <15 min/day), low –i.e. engaged in low LTPA- (3.75-7.49 MET-hour/week or 15-29 min/day), medium (7.50-16.49 MET-hour/week or 30-59 min/day), high (16.5-25.49 MET-hour/week or 60-89 min/day), and very high (≧25.5 MET-hour/week or ≧90 min/day). The codification proposed by Ainsworth and colleagues was adopted. 27 Deaths were ascertained by linking each participant’s identification number to the Taiwan National Death Registry, excluding the first two years of the follow-up period to avoid reverse causality (i.e., sicknesses or poor health causing a sedentary lifestyle). Along with all-cause mortality, we focused on the so-called expanded CVD (CVD + diabetes + kidney disease) mortality, to account for the tendency of physicians in Taiwan to enter diabetes as the underlying cause of death in the death certificates. 28 – 31 Statistical Analysis First, we fit Cox proportional hazards models to obtain hazard ratios for all-cause and expanded-CVD mortality relative to a reference of mostly non-sitting. Then, we repeated this analysis by separately stratifying to men, women, individuals aged < 60 years, individuals aged ≥ 60 years, smokers, never-smokers, individuals with body mass index (BMI) ≥ 25, individuals with BMI ≥ 30, hypertensive, and diabetics. Finally, we fit a Cox model between occupational sitting status and LTPA to obtain hazard ratios of sitting-LTPA groups relative to the reference of mostly sitting and no LTPA. We also used the model to identify the amount of exercise needed to offset the risk from sitting. The models were adjusted for gender, age, education, smoking, drinking, and BMI. P-values of less than 0.05 were considered as significant. The statistical analysis was performed using SAS version 9.4. Results A majority (60.2%, 290,075) of participants (Table 1) were in the mostly sitting group, while 10.7% (51,403) were in the non-sitting group and 29.1% (140,210) in the alternating sitting and non-sitting group. Physical activity varied across sitting groups, with 47.5% of the mostly sitting group describing themselves as physically inactive, compared to 51.7% in the alternating sitting and non-sitting group, and 57.2% in the mostly non-sitting group. People in the mostly sitting group tended to be younger and more educated (college or higher: 49.4% vs. 23.3% in the alternating sitting and non-sitting group and 18.0% in the mostly non-sitting group), had fewer lifestyle risks like smoking (17.7% vs. 25.0% and 33.9%) or drinking (6.3% vs. 9.2% and 14.8%), and were less likely to be overweight or obese (BMI ≥ 25 kg/m 2 : 25.6% vs. 28.1% and 30.2%) or hypertensive (systolic blood pressure ≥ 140mmHg: 16.3% vs. 18.1% and 20.4%). During the entire follow-up period of 12.85 years (Table 2) the study recorded 26,257 deaths, 57.3% of which occurred among individuals mostly sitting at work (15,045). The number of deaths attributable to expanded CVD was 7,563, with 61.7% of these occurring in the mostly sitting group (61.7%). After adjusting for gender, age, education, smoking, drinking, and BMI, individuals mostly sitting at work had a higher risk of dying by all causes (HR: 1.16, 95% CI: 1.11-1.20) and expanded CVD (HR: 1.46, 95% CI: 1.35-1.58), compared with the mostly non-sitting group. Significantly higher risks were estimated in the alternating sitting and non-sitting group only for expanded CVD (HR: 1.13, 95% CI: 1.04-1.23). In all the subgroup analyses, individuals mostly sitting at work exhibited higher all-cause mortality risk, compared to mostly non-sitting at work counterparts. We observed significant increased risk among men (HR: 1.13, 95% CI: 1.08-1.19) and among women (HR: 1.21, 95% CI: 1.12-1.31), among people younger than 60 (HR: 1.21, 95% CI: 1.14-1.28) and among people older than 60 (HR: 1.57, 95% CI: 1.49-1.66), among smokers (HR: 1.14, 95% CI: 1.08-1.20) and among never smokers (HR: 1.17, 95% CI: 1.11-1.24), and among people with chronic conditions. No significant differences were observed between the alternating sitting and non-sitting group and the mostly non-sitting group (Table 2). A similar pattern was found for expanded CVD mortality, as mostly sitting at work was associated with significantly higher mortality risk among men (HR: 1.42, 95% CI: 1.29-1.55), women (HR: 1.42, 95% CI: 1.22-1.66), individuals aged < 60 years (HR: 1.67, 95% CI: 1.47-1.90), individuals aged ≥ 60 years (HR: 1.94, 95% CI: 1.76-2.15), smokers (HR: 1.43, 95% CI: 1.28-1.59), never-smokers (HR: 1.47, 95% CI: 1.31-1.65), and, as before, among people with chronic conditions. In this case, some significant differences were also detected in the alternating sitting and non-sitting group, with higher mortality risks among men (HR: 1.14, 95% CI: 1.03-1.26), individuals aged < 60 years (HR: 1.21, 95% CI: 1.06-1.38), individuals aged ≥ 60 years (HR: 1.14, 95% CI: 1.02-1.27), never-smokers (HR: 1.15, 95% CI: 1.02-1.30), and overweight individuals (HR: 1.17, 95% CI: 1.02-1.34) (Table 2). Finally, as displayed in Figure 1, the all-cause mortality risk in the three occupational sitting groups was analyzed across the five levels of LTPA, using the model with the inactive/mostly sitting group as the reference. At each LTPA level from “inactive” to “high”, individuals mostly sitting at work show significantly higher risks than those alternating sitting and non-sitting, as well as than those mostly non-sitting, while the HRs estimated for these latter two groups are quite similar. At very high LTPA, no substantial differences can be observed between mostly sitting (HR: 0.65, 95% CI: 0.59-0.71), alternating sitting and non-sitting (HR: 0.64, 95% CI: 0.57-0.72), and mostly non-sitting (HR: 0.75, 95% CI: 0.66-0.85). Individuals mostly sitting at work who engaged in low LTPA are less at risk than the reference group (HR: 0.92, 95% CI: 0.87-0.96), but more at risk than individuals alternating sitting and non-sitting engaged in the same LTPA level (HR: 0.79, 95% CI: 0.75-0.84) and more at risk than individuals mostly non-sitting engaged in no (HR: 0.83, 95% CI: 0.78-0.87) and low (HR: 0.82, 95% CI: 0.74-0.90) LTPA. Only at medium LTPA, the risk for individuals mostly sitting at work becomes similar (HR=0.86, 95%CI, 0.82-0.90) to that of individuals alternating sitting and non-sitting and to that of individuals mostly non-sitting at no and low LTPA. At medium, high, and very high LTPA the HRs estimated for the alternating sitting and non-sitting group are quite like those estimated for the mostly non-sitting group, ranging between 0.65 and 0.75. To reach the same risk, individuals mostly sitting at work need to engage in very high LTPA. Discussion We found that individuals who mostly sit at work had higher mortality risks than those who mostly do not sit at work. This finding held across numerous subpopulations considered in the analysis, including those defined by gender, age, smoking, BMI, and pre-existing health conditions. For example, the risk for all-cause mortality was higher among smokers who mostly sat at work than among smokers who mostly did not sit at work. Our study finds that alternating sitting and non-sitting or increasing LTPA can alleviate harms associated with prolonged occupational sitting. For example, individuals who alternated sitting and non-sitting at work had a 13% reduction in risk for all-cause mortality compared to individuals who mostly sat at work. In addition, we found that the risk for all-cause mortality among individuals who mostly sat at work but had high LTPA was comparable to the risk among individuals who mostly did not sit at work but had low LTPA. Few studies have specifically examined risks associated with prolonged occupational sitting. 17 , 23 However, our findings are in line with several other studies showing increased risk for mortality among individuals who experienced prolonged sitting in general. 7 , 20 , 32 The 1.15 hazard ratio for all-cause mortality, comparing 8-11 hours of prolonged sitting to less than 4 hours of prolonged sitting, reported in a recent cohort study by Eklund and colleagues, 20 is remarkably similar to our observed hazard ratio of 1.16 comparing individuals who mostly sit at work to individuals who mostly do not sit at work. Further, despite meaningful differences in approach, our study is consistent with the above-mentioned meta-analysis in suggesting that detrimental effects of prolonged sitting can be offset by physical activity. Overall, our findings from a large prospective cohort help to strengthen the increasingly accumulating evidence on the association between sedentary lifestyle and health risks. Prior studies have showed harms associated with total siting times, 8 , 10 , 11 TV watching times, 13 , 33 and leisure time mainly spent sitting. 12 As previously noted, evidence on the health risks associated with occupational sitting does exist but is less evident as the heterogeneity of study designs and measures makes it difficult to draw definitive conclusions. 10 , 17 Several explanations have been proposed to explain the harms of prolonged sitting, including a lack of exercise of the large muscles in the lower limbs and trunk with increased blood flow to lower extremities, as well as the presence of a biomarker for low-grade inflammation, 34 , 35 that can lead to reduced insulin action, 36 diabetes, obesity, metabolic syndrome, 37 and reduced kidney function. 38 , 39 Since individuals working long hours often share many characteristics with those who have a sedentary life style, not surprisingly a similar amplification of CVD risks has been reported in a number of studies. 15 , 21 , 22 , 40 Our findings have several implications in terms of possible interventions for reducing the risks associated with prolonged occupational sitting. First, the attenuated risk among individuals who alternate sitting and non-sitting at work suggests that in addition to increasing LTPA volume, negative health consequences can also be reduced by taking breaks, which might be prompted by mobile phones, wearable devices, 41 or employer-designed break times. The former option has been formally explored with prospective experimental studies that have provided considerable evidence of positive effects of breaking up prolonged sitting time on metabolic outcomes. 42 Practical solutions such as standing tables and activity-permissive workstations can also reduce occupational sedentary time effectively, without compromising work performance. 43 Second, while the health risks of prolonged occupational sitting could be detrimental for those who are also physically inactive, it is reassuring to find that those risks could be offset by only 30 min/day of exercise. Time for such exercise could be facilitated by employers with, for example, designated areas for engaging in LTPA or optional group activities. Strengths and Limitations This study has a number of strengths. First, it is based on a large single cohort, with prolonged occupational sitting and amount of physical activity defined consistently for the entire cohort, which is in contrast to the heterogeneity often encountered in pooled studies. 19 , 20 Second, the metric used to express the volume of physical activity, namely MET-h/week, is difficult to collect but has been shown to be valid in a highly cited publication. 25 Third, study subjects had a complete medical examination including biological data, which made possible to adjust for possible confounders. Fourth, we were able to link the data to the national death registry and excluded individuals who died within the first two years of entry into the cohort to eliminate those with pre-existing health conditions, thus minimizing the potential for reverse causation. The present study has also some important limitations. First, prolonged occupational sitting and physical activity were both self-reported, so data could be biased. Participants tend to provide what they perceive to be desired answers, indicating they exercise more and sit less than what would be measured by an objective method. 44 However, the participants were asked as many as 100 questions during their check-ups, making over- or under-reporting less likely. Second, the fact that the participants paid out of pocket for their health check-ups may have attracted individuals with higher socio-economic status (SES). However, the risks were calculated based on internal comparison of subgroups, thus minimizing the effect of SES. Third, while we have three categories of prolonged occupational sittings to demonstrate a dose-response effect, a precise quantification of the number of hours spent sitting at work every day was not available. Conclusion The risks associated with prolonged occupational sitting are serious and can be minimized via alternating sitting and non-sitting or by additional physical activity. While comparisons between prolonged sitting and smoking are controversial, 45 we argue that the comparison is useful to at least emphasize the normalization of the risk behavior and the opportunities for change, at individual and system levels. In occupational settings, the opportunities for system change to reduce risks are numerous and include allowance for more frequent breaks, provision of standing desks, or designated workplace areas for physical activity. Declarations Funding Wayne Gao and Mattia Sanna received intracollegiate research funding: TMU110-AE1-B06 and TMU109-AE1-B17 from Taipei Medical University. This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW109-TDU-B-212-114004), MOST Clinical Trial Consortium for Stroke (MOST 109-2321-B-039-002), China Medical University Hospital (DMR-109-231), Tseng-Lien Lin Foundation, Taichung, Taiwan Conflict of interest None declared. References Matthews CE, Keadle SK, Troiano RP, et al. Accelerometer-measured dose-response for physical activity, sedentary time, and mortality in US adults. The American Journal of Clinical Nutrition. 2016;104(5):1424–1432. doi: 10.3945/ajcn.116.135129 Flint SW, Crank H, Tew G, Till S. "It's not an Obvious Issue, Is It?" Office-Based Employees' Perceptions of Prolonged Sitting at Work. 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PLoS One. 2018;13(4):e0195306. doi: 10.1371/journal.pone.0195306 Pandey A, Salahuddin U, Garg S, et al. Continuous Dose-Response Association Between Sedentary Time and Risk for Cardiovascular Disease: A Meta-analysis. JAMA Cardiology. 2016;1(5):575–583. doi: 10.1001/jamacardio.2016.1567 Wen CP, Wai JPM, Chen CH, Gao W. Can weight loss be accelerated if we exercise smarter with wearable devices by subscribing to Personal Activity Intelligence (PAI)? The Lancet Regional Health – Europe. 2021;5:100133. doi: 10.1016/j.lanepe.2021.100133 Benatti Braga F, Ried-Larsen M. The Effects of Breaking up Prolonged Sitting Time: A Review of Experimental Studies. Medicine & Science in Sports & Exercise. 2015;47(10):2053–2061. doi: 10.1249/MSS.0000000000000654 Neuhaus M, Eakin EG, Straker L, et al. Reducing occupational sedentary time: a systematic review and meta-analysis of evidence on activity-permissive workstations. Obesity Reviews. 2014;15(10):822–838. doi: 10.1111/obr.12201 Lagersted-Olsen J, Korshøj M, Skotte J, Carneiro IG, Søgaard K, Holtermann A. Comparison of Objectively Measured and Self-reported Time Spent Sitting. International Journal of Sports Medicine. 2014;35(06):534–540. doi: 10.1055/s-0033-1358467 Chau JY, Reyes-Marcelino G, Burnett ACR, Bauman AE, Freeman B. Hyping health effects: a news analysis of the 'new smoking' and the role of sitting. British Journal of Sports Medicine. 2019;53(16):1039–1040. doi: 10.1136/bjsports-2018-099432 Tables Table 1 Distribution of socio-demographic characteristics, smoking and drinking, LTPA, and metabolic indicators by occupational sitting status. Total Mostly sitting Alternating sitting and non-sitting Mostly non-sitting N (%) N (%) N (%) N (%) Age 20-39 286,867 (59.6) 178,913 (61.7) 82,060 (58.5) 25,894 (50.4) 40-59 147,257 (30.6) 83,620 (28.8) 44,482 (31.7) 19,155 (37.3) 60 or above 47,564 (9.9) 27,542 (9.5) 13,668 (9.7) 6,354 (12.4) Sex Men 225,611 (46.8) 128,404 (44.3) 64,141 (45.7) 33,066 (64.3) Women 256,077 (53.2) 161,671 (55.7) 76,069 (54.3) 18,337 (35.7) Education Middle school or lower 93,260 (19.6) 37,911 (13.2) 36,038 (26.1) 19,311 (38.3) High school 99,827 (21.0) 46,309 (16.2) 39,500 (28.6) 14,018 (27.8) Junior college 99,166 (20.9) 60,726 (21.2) 30,435 (22.0) 8,005 (15.9) College or higher 182,806 (38.5) 141,500 (49.4) 32,236 (23.3) 9,070 (18.0) Smoking status Never-smoker 338,745 (72.4) 216,833 (76.6) 93,362 (69.1) 28,550 (57.6) Ex-smoker 28,306 (6.1) 16,071 (5.7) 8,038 (5.9) 4,197 (8.5) Current smoker 100,611 (21.5) 50,019 (17.7) 33,775 (25.0) 16,817 (33.9) Drinking status Non-drinker 373,541 (81.2) 235,079 (84.2) 104,659 (78.8) 33,803 (69.9) Moderate drinker 49,679 (10.8) 26,338 (9.4) 15,934 (12.0) 7,407 (15.3) Regular drinker 37,080 (8.1) 17,625 (6.3) 12,287 (9.2) 7,168 (14.8) Leisure-time physical activity Inactive 235,021 (49.8) 135,378 (47.5) 71,025 (51.7) 28,618 (57.2) Low 125,734 (26.6) 81,556 (28.6) 34,367 (25.0) 9,811 (19.6) Medium 70,196 (14.9) 44,312 (15.6) 19,787 (14.4) 6,097 (12.2) High 26,120 (5.5) 15,552 (5.5) 7,643 (5.6) 2,925 (5.8) Very high 15,000 (3.2) 7,965 (2.8) 4,433 (3.2) 2,602 (5.2) Body mass index <18.5 43,080 (8.9) 27,930 (9.6) 11,659 (8.3) 3,491 (6.8) 18.5-24.9 309,346 (64.2) 187,863 (64.8) 89,111 (63.6) 32,372 (63.0) 25-29.9 108,616 (22.6) 62,252 (21.5) 33,214 (23.7) 13,150 (25.6) 30 or above 20,463 (4.2) 11,891 (4.1) 6,193 (4.4) 2,379 (4.6) Systolic blood pressure =140 mmHg or on medication 83,345 (17.3) 47,420 (16.3) 25,414 (18.1) 10,511 (20.4) Fasting blood sugar level =126 mg/dL or on medication 23,207 (4.8) 13,802 (4.8) 6,666 (4.8) 2,739 (5.3) Total cholesterol =240 mg/dL or on medication 54,487 (11.3) 32,258 (11.1) 16,114 (11.5) 6,115 (11.9) Table 2 Overall and by subgroup Cox regression analysis output. Population All-cause Expanded CVD Deaths HR [95% CI] Deaths HR [95% CI] All participants Mostly sitting 15,045 1.16 [1.11, 1.20] 4,646 1.46 [1.35, 1.58] Alternating sitting and non-sitting 7,257 1.01 [0.97, 1.05] 1,928 1.13 [1.04, 1.23] Mostly non-sitting 3,955 Ref. 962 Ref. Men Mostly sitting 8,077 1.13 [1.08, 1.19] 2,426 1.42 [1.29, 1.55] Alternating sitting and non-sitting 3,658 1.01 [0.96, 1.06] 946 1.14 [1.03, 1.26] Mostly non-sitting 3,084 Ref. 726 Ref. Women Mostly sitting 6,968 1.21 [1.12, 1.31] 2,220 1.42 [1.22, 1.66] Alternating sitting and non-sitting 3,599 1.03 [0.95, 1.12] 982 1.06 [0.91, 1.25] Mostly non-sitting 871 Ref. 236 Ref. Age<60 Mostly sitting 5,563 1.21 [1.14, 1.28] 1,288 1.67 [1.47, 1.90] Alternating sitting and non-sitting 3,665 1.01 [0.95, 1.07] 787 1.21 [1.06, 1.38] Mostly non-sitting 1,962 Ref. 409 Ref. Age≥60 Mostly sitting 9,482 1.57 [1.49, 1.66] 3,358 1.94 [1.76, 2.15] Alternating sitting and non-sitting 3,592 1.06 [1.00, 1.12] 1,141 1.14 [1.02, 1.27] Mostly non-sitting 1,993 Ref. 553 Ref. Smokers Mostly sitting 5,561 1.14 [1.08, 1.20] 1,675 1.43 [1.28, 1.59] Alternating sitting and non-sitting 2,671 1.01 [0.95, 1.07] 653 1.09 [0.97, 1.23] Mostly non-sitting 2,190 Ref. 503 Ref. Never-smokers Mostly sitting 8,737 1.17 [1.11, 1.24] 2,722 1.47 [1.31, 1.65] Alternating sitting and non-sitting 4,180 1.02 [0.96, 1.08] 1,165 1.15 [1.02, 1.30] Mostly non-sitting 1,560 Ref. 391 Ref. BMI≥25 Mostly sitting 5,835 1.13 [1.06, 1.21] 2,061 1.50 [1.32, 1.71] Alternating sitting and non-sitting 2,805 0.98 [0.91, 1.05] 867 1.17 [1.02, 1.34] Mostly non-sitting 1,350 Ref. 363 Ref. BMI≥30 Mostly sitting 995 1.20 [1.01, 1.42] 376 1.47 [1.07, 2.00] Alternating sitting and non-sitting 436 0.96 [0.80, 1.16] 147 1.08 [0.77, 1.51] Mostly non-sitting 184 Ref. 57 Ref. Hypertensives Mostly sitting 8,418 1.21 [1.14, 1.28] 3,253 1.42 [1.28, 1.57] Alternating sitting and non-sitting 3,599 1.01 [0.95, 1.08] 1,275 1.08 [0.97, 1.20] Mostly non-sitting 1,749 Ref. 567 Ref. Diabetics Mostly sitting 3,531 1.20 [1.09, 1.32] 1,693 1.47 [1.27, 1.71] Alternating sitting and non-sitting 1,298 0.97 [0.88, 1.08] 539 1.04 [0.88, 1.23] Mostly non-sitting 608 Ref. 233 Ref. Additional Declarations There is NO Competing Interest. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1134870","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":74760855,"identity":"ce03261f-b703-4bf4-ab15-ae575e452ac8","order_by":0,"name":"Wayne Gao","email":"","orcid":"https://orcid.org/0000-0002-6083-5849","institution":"Taipei Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Wayne","middleName":"","lastName":"Gao","suffix":""},{"id":74760856,"identity":"81ac65a9-b43c-4834-bc14-76e99a4092fe","order_by":1,"name":"Mattia Sanna","email":"","orcid":"https://orcid.org/0000-0001-7262-0856","institution":"Taipei Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mattia","middleName":"","lastName":"Sanna","suffix":""},{"id":74760857,"identity":"b888e2e8-2b26-4664-8239-43e0dff8641b","order_by":2,"name":"Yea-Hung Chen","email":"","orcid":"","institution":"University of California","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yea-Hung","middleName":"","lastName":"Chen","suffix":""},{"id":74760858,"identity":"14a9ced4-3b74-4a5a-96ea-45e119f464b8","order_by":3,"name":"Min-Kuang Tsai","email":"","orcid":"","institution":"National Health Research Institutes","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Min-Kuang","middleName":"","lastName":"Tsai","suffix":""},{"id":74760859,"identity":"94133792-ec5c-4da5-a64e-9e76a6f07da5","order_by":4,"name":"Po-Jung Lu","email":"","orcid":"","institution":"China Medical University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Po-Jung","middleName":"","lastName":"Lu","suffix":""},{"id":74760860,"identity":"6ce0f903-9e2c-4c41-a304-798c61613ba2","order_by":5,"name":"Chi-Pang Wen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA10lEQVRIiWNgGAWjYBADxn4GHgaGBJK0zGyAa2EmUsuGAzwwNgEt/DOSjz38UmEju/l277EPDxhs8uUd+I9J4NMicSMt3VjmTJrxtjvnkmckMKRZbjzAzIZXi4F0jpm0ZNvhxG03coyBfjlsYNjAzHYDv5b8b2Atm2cQryWHTfIjUMsGCagWeQYCWiTuPzOTZgD6ZQbYYQZpBgbMzOY/8Gnh7zn8TPIHMMT6gQ5jBDIM5NsbHxvg0wICzPAYYQCqNThMSD0QMKK4Q76BCC2jYBSMglEwogAAv2BE4Oksqj8AAAAASUVORK5CYII=","orcid":"","institution":"National Health Research Institutes","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Chi-Pang","middleName":"","lastName":"Wen","suffix":""}],"badges":[],"createdAt":"2021-12-02 13:21:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1134870/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1134870/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":17070962,"identity":"445d1854-e510-474d-915a-9314535a63f5","added_by":"auto","created_at":"2022-01-06 19:43:28","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":44060,"visible":true,"origin":"","legend":"\u003cp\u003eCox regression analysis output by occupational sitting status and LTPA.\u003c/p\u003e","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-1134870/v1/cede9f95ae21f4eb07028168.png"},{"id":38768062,"identity":"c642c5c0-70d4-4896-9f0b-500ed1594d86","added_by":"auto","created_at":"2023-06-19 13:51:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":574318,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1134870/v1/9ee505bf-eee9-44b0-bc28-422bfd05e4de.pdf"}],"financialInterests":"There is \u003cb\u003eNO\u003c/b\u003e Competing Interest.","formattedTitle":"CVD risk from prolonged occupational sitting attenuated by additional physical activity – Evidence from a prospective cohort of 481,688 Asian adults","fulltext":[{"header":"Condensed Abstract","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eCompetency in medical knowledge\u003c/h2\u003e \u003cp\u003eIndividuals who mostly sit at work face increased mortality risk, compared to individuals who mostly do not sit at work. Alternating sitting and non-sitting at work or engaging in an additional 15 to 30 mins of leisure-time physical activity can reduce workers\u0026rsquo; mortality risk to that of individuals who mostly do not sit at work.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eTranslational outlook\u003c/h2\u003e \u003cp\u003eBy de-normalizing prolonged occupational sitting, with behavioral and system change efforts similar to those made to de-normalize smoking, we can achieve a paradigm shift and hopefully reverse the current perception of sedentary lifestyles, both at work and during leisure time.\u003c/p\u003e \u003c/div\u003e"},{"header":"Introduction","content":"\u003cp\u003eModern lifestyles have become increasingly sedentary,\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e and prolonged sitting is currently so pervasive that most people perceive it as part of normal life,\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e despite the fact that, with some exceptions,\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e the scientific literature agrees on its deleterious effects. For the first time in 2020, the WHO guidelines on physical activity recommend reducing sedentary behaviors due to its health consequences,\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e which accords with similar recent physical activities guidelines published in the USA in 2018,\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e and UK in 2019,\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e that also discourage prolonged sitting. However, this guidance can be difficult to adhere to, particularly in workplace settings where not sitting is not well supported.\u003c/p\u003e \u003cp\u003eFew studies have specifically examined prolonged occupational sitting. However, several studies have found increased mortality among prolonged sitters from all causes,\u003csup\u003e\u003cspan additionalcitationids=\"CR8 CR9 CR10\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e as well as from cardiovascular disease (CVD),\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e cancer,\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e and diabetes.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e For example, a cohort study of more than 200,00 individuals in Australia found a dose-response relationship between prolonged sitting and all-cause mortality, with increased risk among individuals with more hours per day of prolonged sitting.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e Similarly, a meta-analysis of six studies found increased risk for all-cause mortality with increased prolonged sitting.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e On the other hand, associations between prolonged sitting and health outcomes have not been consistently demonstrated. Prospective studies have generally found that prolonged sitting increases the risk of diabetes mellitus, for example, but not cancer.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e Similarly, an analysis found that associations between prolonged sitting and health outcomes are dependent on gender.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e It is not necessarily clear, overall, if the adverse health effects associated with prolonged sitting necessarily translate to occupational settings. In addition, the health risks of prolonged sitting have been shown to be independent of leisure-time physical inactivity.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e Working long hours shares some similarities with prolonged sitting in terms of health impacts. For instance, some studies have found similar dose-response relationships between working long hours and increased incidence in coronary heart disease and stroke.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e Thus, one would expect similar, if not worse health consequences for prolonged occupational sitting; nonetheless, the evidences of harms associated with working long hours in a sitting position are less consistent.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAnother important issue is the amount of leisure-time physical activity (LTPA) needed to offset or attenuate the health repercussions of prolonged occupational sitting. For example, A meta-analysis by Ekelund and colleagues concluded that the risk of prolonged sitting could be eliminated with 60-75 min/day of exercise,\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e approximately 4\u0026ndash;5 times more than the current WHO recommendation.\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e It is unclear, however, whether this level of offset can be reasonably achieved or whether the findings would hold using different approaches.\u003c/p\u003e \u003cp\u003eIn this study, we aim to (1) understand the health risks of prolonged sitting on all-cause and CVD mortality, and (2) quantify the amount of LTPA needed to mitigate the risks for individuals mostly sitting at work to the level of those alternating sitting and non-sitting or mostly non-sitting at work.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStudy Population and General Data Collection\u003c/h2\u003e \u003cp\u003eOur cohort included 481,688 individuals aged 20 years and older who participated in an annual to bi-annual standard medical screening program in Taiwan run by a private firm, MJ Health Management Institution, between 1996 and 2017. Most of the participants were outwardly healthy, and followed for a mean period of 12.85 years (standard deviation = 5.67 years), which equates to 6,186,949 person-years at follow-up.\u003c/p\u003e \u003cp\u003eAt each visit, participants completed a self-administered questionnaire on their medical history and lifestyle risk factors, and specimens for biological tests were collected. Previous studies have described in more detail the entire program, as well as the data collection methods. \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eMeasurement of Prolonged Occupational Sitting, Physical Activity, and Adverse Health Outcomes\u003c/h2\u003e \u003cp\u003eThe occupational sitting status of each participant was categorized into three groups: mostly sitting, alternating sitting and non-sitting, mostly non-sitting; based on the answer to the following question included in the above-mentioned questionnaire: \u0026ldquo;What is your level of activity at work?\u0026rdquo;. The response options included: \u0026ldquo;mostly sitting\u0026rdquo;, \u0026ldquo;mostly sitting and standing performing repetitive motions in the course of work\u0026rdquo;, \u0026ldquo;standing and walking around most of the time\u0026rdquo;.\u003c/p\u003e \u003cp\u003eThe LTPA status was determined through two multiple-choice questions. The first asked the participants to classify all their weekly LTPAs in the last month into four intensity categories: light (e.g., walking), moderate (e.g., brisk walking), medium vigorous (e.g., jogging), or highly vigorous (e.g., running). The second required the participants to indicate the weekly duration of each LTPA in the last month. Further details can be found in Wen et al (2011).\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e Based on their answers, participants were classified into five LTPA groups by metabolic equivalent of task (MET)-hour/week: inactive (\u0026lt;3.75 MET-hour/week or \u0026lt;15 min/day), low \u0026ndash;i.e. engaged in low LTPA- (3.75-7.49 MET-hour/week or 15-29 min/day), medium (7.50-16.49 MET-hour/week or 30-59 min/day), high (16.5-25.49 MET-hour/week or 60-89 min/day), and very high (≧25.5 MET-hour/week or ≧90 min/day). The codification proposed by Ainsworth and colleagues was adopted.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eDeaths were ascertained by linking each participant\u0026rsquo;s identification number to the Taiwan National Death Registry, excluding the first two years of the follow-up period to avoid reverse causality (i.e., sicknesses or poor health causing a sedentary lifestyle). Along with all-cause mortality, we focused on the so-called expanded CVD (CVD + diabetes + kidney disease) mortality, to account for the tendency of physicians in Taiwan to enter diabetes as the underlying cause of death in the death certificates.\u003csup\u003e\u003cspan additionalcitationids=\"CR29 CR30\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eFirst, we fit Cox proportional hazards models to obtain hazard ratios for all-cause and expanded-CVD mortality relative to a reference of mostly non-sitting. Then, we repeated this analysis by separately stratifying to men, women, individuals aged \u0026lt; 60 years, individuals aged \u0026ge; 60 years, smokers, never-smokers, individuals with body mass index (BMI) \u0026ge; 25, individuals with BMI \u0026ge; 30, hypertensive, and diabetics. Finally, we fit a Cox model between occupational sitting status and LTPA to obtain hazard ratios of sitting-LTPA groups relative to the reference of mostly sitting and no LTPA. We also used the model to identify the amount of exercise needed to offset the risk from sitting. The models were adjusted for gender, age, education, smoking, drinking, and BMI. P-values of less than 0.05 were considered as significant.\u003c/p\u003e \u003cp\u003eThe statistical analysis was performed using SAS version 9.4.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA majority (60.2%, 290,075) of participants (Table 1) were in the mostly sitting group, while 10.7% (51,403) were in the non-sitting group and 29.1% (140,210) in the alternating sitting and non-sitting group. Physical activity varied across sitting groups, with 47.5% of the mostly sitting group describing themselves as physically inactive, compared to 51.7% in the alternating sitting and non-sitting group, and 57.2% in the mostly non-sitting group. People in the mostly sitting group tended to be younger and more educated (college or higher: 49.4% vs. 23.3% in the alternating sitting and non-sitting group and 18.0% in the mostly non-sitting group), had fewer lifestyle risks like smoking (17.7% vs. 25.0% and 33.9%) or drinking (6.3% vs. 9.2% and 14.8%), and were less likely to be overweight or obese (BMI \u0026ge; 25 kg/m\u003csup\u003e2\u003c/sup\u003e: 25.6% vs. 28.1% and 30.2%) or hypertensive (systolic blood pressure \u0026ge; 140mmHg: 16.3% vs. 18.1% and 20.4%).\u003c/p\u003e\n\u003cp\u003eDuring the entire follow-up period of 12.85 years (Table 2) the study recorded 26,257 deaths, 57.3% of which occurred among individuals mostly sitting at work (15,045). The number of deaths attributable to expanded CVD was 7,563, with 61.7% of these occurring in the mostly sitting group (61.7%). After adjusting for gender, age, education, smoking, drinking, and BMI, individuals mostly sitting at work had a higher risk of dying by all causes (HR: 1.16, 95% CI: 1.11-1.20) and expanded CVD (HR: 1.46, 95% CI: 1.35-1.58), compared with the mostly non-sitting group. Significantly higher risks were estimated in the alternating sitting and non-sitting group only for expanded CVD (HR: 1.13, 95% CI: 1.04-1.23).\u003c/p\u003e\n\u003cp\u003eIn all the subgroup analyses, individuals mostly sitting at work exhibited higher all-cause mortality risk, compared to mostly non-sitting at work counterparts. We observed significant increased risk among men (HR: 1.13, 95% CI: 1.08-1.19) and among women (HR: 1.21, 95% CI: 1.12-1.31), among people younger than 60 (HR: 1.21, 95% CI: 1.14-1.28) and among people older than 60 (HR: 1.57, 95% CI: 1.49-1.66), among smokers (HR: 1.14, 95% CI: 1.08-1.20) and among never smokers (HR: 1.17, 95% CI: 1.11-1.24), and among people with chronic conditions. No significant differences were observed between the alternating sitting and non-sitting group and the mostly non-sitting group (Table 2).\u003c/p\u003e\n\u003cp\u003eA similar pattern was found for expanded CVD mortality, as mostly sitting at work was associated with significantly higher mortality risk among men (HR: 1.42, 95% CI: 1.29-1.55), women (HR: 1.42, 95% CI: 1.22-1.66), individuals aged \u0026lt; 60 years (HR: 1.67, 95% CI: 1.47-1.90), individuals aged \u0026ge; 60 years (HR: 1.94, 95% CI: 1.76-2.15), smokers (HR: 1.43, 95% CI: 1.28-1.59), never-smokers (HR: 1.47, 95% CI: 1.31-1.65), and, as before, among people with chronic conditions. In this case, some significant differences were also detected in the alternating sitting and non-sitting group, with higher mortality risks among men (HR: 1.14, 95% CI: 1.03-1.26), individuals aged \u0026lt; 60 years (HR: 1.21, 95% CI: 1.06-1.38), individuals aged \u0026ge; 60 years (HR: 1.14, 95% CI: 1.02-1.27), never-smokers (HR: 1.15, 95% CI: 1.02-1.30), and overweight individuals (HR: 1.17, 95% CI: 1.02-1.34) (Table 2).\u003c/p\u003e\n\u003cp\u003eFinally, as displayed in Figure 1, the all-cause mortality risk in the three occupational sitting groups was analyzed across the five levels of LTPA, using the model with the inactive/mostly sitting group as the reference. At each LTPA level from \u0026ldquo;inactive\u0026rdquo; to \u0026ldquo;high\u0026rdquo;, individuals mostly sitting at work show significantly higher risks than those alternating sitting and non-sitting, as well as than those mostly non-sitting, while the HRs estimated for these latter two groups are quite similar. At very high LTPA, no substantial differences can be observed between mostly sitting (HR: 0.65, 95% CI: 0.59-0.71), alternating sitting and non-sitting (HR: 0.64, 95% CI: 0.57-0.72), and mostly non-sitting (HR: 0.75, 95% CI: 0.66-0.85).\u003c/p\u003e\n\u003cp\u003eIndividuals mostly sitting at work who engaged in low LTPA are less at risk than the reference group (HR: 0.92, 95% CI: 0.87-0.96), but more at risk than individuals alternating sitting and non-sitting engaged in the same LTPA level (HR: 0.79, 95% CI: 0.75-0.84) and more at risk than individuals mostly non-sitting engaged in no (HR: 0.83, 95% CI: 0.78-0.87) and low (HR: 0.82, 95% CI: 0.74-0.90) LTPA. Only at medium LTPA, the risk for individuals mostly sitting at work becomes similar (HR=0.86, 95%CI, 0.82-0.90) to that of individuals alternating sitting and non-sitting and to that of individuals mostly non-sitting at no and low LTPA. At medium, high, and very high LTPA the HRs estimated for the alternating sitting and non-sitting group are quite like those estimated for the mostly non-sitting group, ranging between 0.65 and 0.75. To reach the same risk, individuals mostly sitting at work need to engage in very high LTPA.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWe found that individuals who mostly sit at work had higher mortality risks than those who mostly do not sit at work. This finding held across numerous subpopulations considered in the analysis, including those defined by gender, age, smoking, BMI, and pre-existing health conditions. For example, the risk for all-cause mortality was higher among smokers who mostly sat at work than among smokers who mostly did not sit at work. Our study finds that alternating sitting and non-sitting or increasing LTPA can alleviate harms associated with prolonged occupational sitting. For example, individuals who alternated sitting and non-sitting at work had a 13% reduction in risk for all-cause mortality compared to individuals who mostly sat at work. In addition, we found that the risk for all-cause mortality among individuals who mostly sat at work but had high LTPA was comparable to the risk among individuals who mostly did not sit at work but had low LTPA.\u003c/p\u003e \u003cp\u003eFew studies have specifically examined risks associated with prolonged occupational sitting.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e However, our findings are in line with several other studies showing increased risk for mortality among individuals who experienced prolonged sitting in general.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e The 1.15 hazard ratio for all-cause mortality, comparing 8-11 hours of prolonged sitting to less than 4 hours of prolonged sitting, reported in a recent cohort study by Eklund and colleagues,\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e is remarkably similar to our observed hazard ratio of 1.16 comparing individuals who mostly sit at work to individuals who mostly do not sit at work. Further, despite meaningful differences in approach, our study is consistent with the above-mentioned meta-analysis in suggesting that detrimental effects of prolonged sitting can be offset by physical activity. Overall, our findings from a large prospective cohort help to strengthen the increasingly accumulating evidence on the association between sedentary lifestyle and health risks. Prior studies have showed harms associated with total siting times,\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e TV watching times,\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e and leisure time mainly spent sitting.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e As previously noted, evidence on the health risks associated with occupational sitting does exist but is less evident as the heterogeneity of study designs and measures makes it difficult to draw definitive conclusions.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eSeveral explanations have been proposed to explain the harms of prolonged sitting, including a lack of exercise of the large muscles in the lower limbs and trunk with increased blood flow to lower extremities, as well as the presence of a biomarker for low-grade inflammation,\u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e that can lead to reduced insulin action,\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e diabetes, obesity, metabolic syndrome,\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e and reduced kidney function.\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e,\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e Since individuals working long hours often share many characteristics with those who have a sedentary life style, not surprisingly a similar amplification of CVD risks has been reported in a number of studies.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e,\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOur findings have several implications in terms of possible interventions for reducing the risks associated with prolonged occupational sitting. First, the attenuated risk among individuals who alternate sitting and non-sitting at work suggests that in addition to increasing LTPA volume, negative health consequences can also be reduced by taking breaks, which might be prompted by mobile phones, wearable devices,\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e or employer-designed break times. The former option has been formally explored with prospective experimental studies that have provided considerable evidence of positive effects of breaking up prolonged sitting time on metabolic outcomes.\u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e Practical solutions such as standing tables and activity-permissive workstations can also reduce occupational sedentary time effectively, without compromising work performance.\u003csup\u003e\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e Second, while the health risks of prolonged occupational sitting could be detrimental for those who are also physically inactive, it is reassuring to find that those risks could be offset by only 30 min/day of exercise. Time for such exercise could be facilitated by employers with, for example, designated areas for engaging in LTPA or optional group activities.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cp\u003eThis study has a number of strengths. First, it is based on a large single cohort, with prolonged occupational sitting and amount of physical activity defined consistently for the entire cohort, which is in contrast to the heterogeneity often encountered in pooled studies.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e Second, the metric used to express the volume of physical activity, namely MET-h/week, is difficult to collect but has been shown to be valid in a highly cited publication.\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e Third, study subjects had a complete medical examination including biological data, which made possible to adjust for possible confounders. Fourth, we were able to link the data to the national death registry and excluded individuals who died within the first two years of entry into the cohort to eliminate those with pre-existing health conditions, thus minimizing the potential for reverse causation.\u003c/p\u003e \u003cp\u003eThe present study has also some important limitations. First, prolonged occupational sitting and physical activity were both self-reported, so data could be biased. Participants tend to provide what they perceive to be desired answers, indicating they exercise more and sit less than what would be measured by an objective method.\u003csup\u003e\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e However, the participants were asked as many as 100 questions during their check-ups, making over- or under-reporting less likely. Second, the fact that the participants paid out of pocket for their health check-ups may have attracted individuals with higher socio-economic status (SES). However, the risks were calculated based on internal comparison of subgroups, thus minimizing the effect of SES. Third, while we have three categories of prolonged occupational sittings to demonstrate a dose-response effect, a precise quantification of the number of hours spent sitting at work every day was not available.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe risks associated with prolonged occupational sitting are serious and can be minimized via alternating sitting and non-sitting or by additional physical activity. While comparisons between prolonged sitting and smoking are controversial,\u003csup\u003e\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e we argue that the comparison is useful to at least emphasize the normalization of the risk behavior and the opportunities for change, at individual and system levels. In occupational settings, the opportunities for system change to reduce risks are numerous and include allowance for more frequent breaks, provision of standing desks, or designated workplace areas for physical activity.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eWayne Gao and Mattia Sanna received intracollegiate research funding: TMU110-AE1-B06 and TMU109-AE1-B17 from Taipei Medical University.\u003c/p\u003e\n\u003cp\u003eThis study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW109-TDU-B-212-114004), MOST Clinical Trial Consortium for Stroke (MOST 109-2321-B-039-002), China Medical University Hospital (DMR-109-231), Tseng-Lien Lin Foundation, Taichung, Taiwan\u003c/p\u003e\n\u003ch2\u003eConflict of interest\u003c/h2\u003e\n\u003cp\u003eNone declared.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMatthews CE, Keadle SK, Troiano RP, et al. 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Hyping health effects: a news analysis of the 'new smoking' and the role of sitting. \u003cem\u003eBritish Journal of Sports Medicine.\u003c/em\u003e 2019;53(16):1039\u0026ndash;1040. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bjsports-2018-099432\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003ch1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:justify;line-height:200%;font-size:19px;font-family:\"Times New Roman\",serif;'\u003eTable 1 Distribution of socio-demographic characteristics, smoking and drinking, LTPA, and metabolic indicators by occupational sitting status.\u003c/h1\u003e\n\u003ctable style=\"border: none;width:100.0%;border-collapse:collapse;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width:35.14%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:16.22%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:16.22%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eMostly sitting\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:16.22%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eAlternating sitting and non-sitting\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:16.2%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eMostly non-sitting\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eN\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e(%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eN\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e(%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eN\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan 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style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(45.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e33,066\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(64.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eWomen\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e256,077\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(53.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e161,671\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(55.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e76,069\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(54.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e18,337\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:none;border-bottom: solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(35.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width:12.2%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eEducation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eMiddle school or lower\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e93,260\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(19.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e37,911\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(13.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e36,038\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(26.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e19,311\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(38.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eHigh school\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e99,827\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(21.0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e46,309\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(16.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e39,500\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(28.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e14,018\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(27.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eJunior college\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e99,166\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(20.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e60,726\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(21.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e30,435\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(22.0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e8,005\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(15.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eCollege or higher\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e182,806\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(38.5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e141,500\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(49.4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e32,236\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(23.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e9,070\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:none;border-bottom: solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(18.0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:12.2%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eSmoking status\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eNever-smoker\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e338,745\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(72.4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e216,833\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(76.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e93,362\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(69.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e28,550\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(57.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eEx-smoker\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e28,306\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(6.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e16,071\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(5.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e8,038\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(5.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e4,197\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(8.5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eCurrent smoker\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e100,611\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(21.5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e50,019\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(17.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e33,775\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(25.0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e16,817\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:none;border-bottom: solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(33.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:12.2%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eDrinking status\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eNon-drinker\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e373,541\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(81.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e235,079\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(84.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e104,659\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(78.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e33,803\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(69.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eModerate drinker\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:31.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e49,679\u003c/span\u003e\u003c/p\u003e\n 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style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e2,925\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(5.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eVery 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style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(3.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e2,602\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:none;border-bottom: solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(5.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width:12.2%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eBody mass index\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e\u0026lt;18.5\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n 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style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(9.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e11,659\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(8.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e3,491\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(6.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e18.5-24.9\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n 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style=\"color:black;\"\u003e25-29.9\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e108,616\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(22.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New 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style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e30 or above\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e20,463\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(4.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e11,891\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(4.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e6,193\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(4.4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e2,379\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:none;border-bottom: solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(4.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:12.2%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eSystolic blood pressure\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e\u0026lt;140 mmHg\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e398,343\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(82.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e242,655\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(83.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e114,796\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(81.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e40,892\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(79.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e\u0026gt;=140 mmHg or on medication\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e83,345\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(17.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e47,420\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(16.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e25,414\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(18.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e10,511\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:none;border-bottom: solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: .65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(20.4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:12.2%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eFasting blood sugar level\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e\u0026lt;126 mg/dL\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e458,481\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(95.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e276,273\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(95.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e133,544\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(95.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e48,664\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(94.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e\u0026gt;=126 mg/dL or on medication\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e23,207\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(4.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e13,802\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(4.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e6,666\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(4.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e2,739\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:none;border-bottom: solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: .65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(5.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:12.2%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eTotal cholesterol\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.96%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e\u0026lt;240 mg/dL\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e426,931\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(88.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e257,678\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(88.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e124,016\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(88.5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e45,237\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: 15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(88.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:22.96%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e\u0026gt;=240 mg/dL or on medication\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e54,487\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(11.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e32,258\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(11.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e16,114\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.12%;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(11.5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:.65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e6,115\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:8.1%;border-top:none;border-left:none;border-bottom: solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height: .65in;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cspan style=\"color:black;\"\u003e(11.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cspan style='font-size:16px;line-height:107%;font-family:\"Times New Roman\",serif;color:white;'\u003e\u003cbr\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003ch1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:justify;line-height:200%;font-size:19px;font-family:\"Times New Roman\",serif;'\u003eTable 2 Overall and by subgroup Cox regression analysis output.\u003c/h1\u003e\n\u003ctable style=\"width: 100%;border: none;border-collapse:collapse;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width:350.45pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003ePopulation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width:173.7pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eAll-cause\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width:173.65pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eExpanded CVD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:16.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eDeaths\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:16.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eHR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:16.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e[95% CI]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:16.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eDeaths\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:16.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eHR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:16.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003e[95% CI]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eAll participants\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e15,045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.11, 1.20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e4,646\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.35, 1.58]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor currentcolor black;border-style: none none none solid;border-width: medium medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e7,257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.97, 1.05]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,928\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.04, 1.23]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor black black;border-style: none none solid solid;border-width: medium medium 1pt 1pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,955\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;border-color: currentcolor currentcolor black;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eMen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e8,077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.08, 1.19]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2,426\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.29, 1.55]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,658\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.96, 1.06]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e946\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.03, 1.26]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e726\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eWomen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e6,968\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.12, 1.31]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2,220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.22, 1.66]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor currentcolor black;border-style: none none none solid;border-width: medium medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,599\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.95, 1.12]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e982\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.91, 1.25]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor black black;border-style: none none solid solid;border-width: medium medium 1pt 1pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e871\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;border-color: currentcolor currentcolor black;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eAge\u0026lt;60\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e5,563\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.14, 1.28]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.47, 1.90]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,665\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.95, 1.07]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e787\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.06, 1.38]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e409\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eAge\u0026ge;60\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e9,482\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.49, 1.66]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,358\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.76, 2.15]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor currentcolor black;border-style: none none none solid;border-width: medium medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,592\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.00, 1.12]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.02, 1.27]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor black black;border-style: none none solid solid;border-width: medium medium 1pt 1pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,993\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;border-color: currentcolor currentcolor black;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e553\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eSmokers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e5,561\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.08, 1.20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,675\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.28, 1.59]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2,671\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.95, 1.07]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e653\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.97, 1.23]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2,190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e503\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eNever-smokers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e8,737\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.11, 1.24]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2,722\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.31, 1.65]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor currentcolor black;border-style: none none none solid;border-width: medium medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e4,180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.96, 1.08]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.02, 1.30]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor black black;border-style: none none solid solid;border-width: medium medium 1pt 1pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,560\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;border-color: currentcolor currentcolor black;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e391\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eBMI\u0026ge;25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e5,835\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.06, 1.21]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2,061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.32, 1.71]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2,805\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.91, 1.05]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e867\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.02, 1.34]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eBMI\u0026ge;30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e995\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.01, 1.42]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e376\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.07, 2.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor currentcolor black;border-style: none none none solid;border-width: medium medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e436\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.80, 1.16]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.77, 1.51]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor black black;border-style: none none solid solid;border-width: medium medium 1pt 1pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;border-color: currentcolor currentcolor black;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eHypertensives\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e8,418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.14, 1.28]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,253\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.28, 1.57]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,599\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.95, 1.08]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.97, 1.20]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border-top:none;border-left:solid black 1.0pt;border-bottom:solid black 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,749\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e567\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border-top:none;border-left: none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:110.5pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u003cstrong\u003eDiabetics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly sitting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.1pt;border:none;border-left:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3,531\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.09, 1.32]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.15pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,693\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[1.27, 1.71]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAlternating sitting and non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor currentcolor black;border-style: none none none solid;border-width: medium medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,298\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.35pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.25pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.88, 1.08]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e539\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:39.45pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:77.05pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e[0.88, 1.23]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:239.95pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMostly non-sitting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.1pt;border-color: currentcolor currentcolor currentcolor black;border-style: none none none solid;border-width: medium medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e608\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.6pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.15pt;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003e233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:116.5pt;border:none;border-right:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.6pt;\"\u003e\n \u003cp style='margin:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Times New Roman\",serif;'\u003eRef.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"sedentary behavior, prolonged occupational sitting, physical activity, cardiovascular mortality, all-cause mortality","lastPublishedDoi":"10.21203/rs.3.rs-1134870/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1134870/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground\u003c/p\u003e\u003cp\u003eFor 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.\u003c/p\u003e\u003cp\u003eThis 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.\u003c/p\u003e\u003cp\u003eMethods\u003c/p\u003e\u003cp\u003eA 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.\u003c/p\u003e\u003cp\u003eResults\u003c/p\u003e\u003cp\u003eThe 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 (\u0026lt;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.\u003c/p\u003e\u003cp\u003eConclusions\u003c/p\u003e\u003cp\u003eAs 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.\u003c/p\u003e","manuscriptTitle":"CVD risk from prolonged occupational sitting attenuated by additional physical activity – Evidence from a prospective cohort of 481,688 Asian adults","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-01-06 19:43:26","doi":"10.21203/rs.3.rs-1134870/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bd8bb57c-45c1-4b01-902b-739d67690533","owner":[],"postedDate":"January 6th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-06-19T13:51:04+00:00","versionOfRecord":[],"versionCreatedAt":"2022-01-06 19:43:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1134870","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1134870","identity":"rs-1134870","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}