Abstract
Osteoarthritis (OA) affects over 500 million people globally, making it a significant public health concern. While various risk factors have been identified, the relationship between sedentary behavior and OA remains understudied. Data from the National Health and Nutrition Examination Survey 2007 to 2018 were analyzed. A total of 15,014 adults who met the inclusion criteria from 60,204 initial participants were included. Participants were categorized based on daily sitting time (≤9 hours vs >9 hours). Multiple logistic regression models were used to examine the association between sitting time and OA. Further analyses were stratified by participation in moderate recreational activities. The prevalence of OA was 8.9% (1329/15,014) in the study population. After adjusting for potential confounders, participants with >9 hours of daily sitting time had 36% increased risk of OA compared with those with ≤9 hours (95% confidence interval: 1.09-1.70, P < .05). This association was more pronounced among participants who did not engage in moderate recreational activities (odds ratio: 1.67, 95% confidence interval: 1.24-2.26, P < .001). Notably, the association between sitting >9 hours/day and OA was not significant among those who participated in moderate recreational activities. Subgroup analyses revealed that race and alcohol consumption might modify the relationship between sitting time and OA among physically inactive participants. Extended daily sitting time (>9 hours) is associated with an increased risk of OA, particularly among individuals who do not engage in moderate recreational activities. The finding that moderate recreational activities may modify the association between sitting >9 hours/day and OA warrants further investigation through prospective cohort studies.