Accelerometer-based measures of sedentary behavior and cardiometabolic risk in active older adults Abstract Purpose: Sedentary behavior has been proposed as an independent cardio-metabolic risk factor even in adults who are physically active through recreational activity. Because little is known about the metabolic e ects of sedentariness in seniors, the relationship between sedentary behavior and cardio-metabolic risk was examined in physically active older adults.Methods: Fi y-four community dwelling men and women > 65 years of age (mean 71.5 years) were enrolled in this cross-sectional observational study. Subjects were in good health and free of known diabetes. Activity levels (sedentary, light, moderate to vigorous activity time per day) were recorded with accelerometers worn continuously for 7 days. Cardio-metabolic risk factors measured consisted of the American Heart Association diagnostic criteria for metabolic syndrome (waist circumference, triglycerides, high-density lipoprotein, systolic blood pressure and fasting glucose) as well as low-density lipoprotein (LDL). e relationships between activity measures and cardio-metabolic risk factors were examined. Signi cant variables were then entered into a stepwise multivariate regression model.Results: All but one subject achieved exercise levels recommended by the American College of Sports Medicine. e average proportion of time spent at a sedentary activity level each day was 72.7%. From the regression analysis, the only signi cant association found between cardio-metabolic risk outcomes and activity predictors was between LDL and sedentary time, with LDL detrimentally associated with average sedentary time per day (Standardized Beta Correlation Coe cient 0.302, p< 0.05).Conclusion: Sedentary behavior is associated with an adverse metabolic e ect on LDL in seniors, even those who meet guideline recommendations for an active " t" adult.