BACKGROUND: Sedentary behavior is regarded as a distinct risk factor for cardiometabolic morbidity and mortality, but knowledge of the efficacy of interventions targeting reductions in sedentary behavior is limited. PURPOSE: To investigate the effect of an individualized face-to-face motivational counseling intervention aimed at reducing sitting time. DESIGN: A randomized, controlled, observer-blinded, community-based trial with two parallel groups using open-end randomization with 1:1 allocation. SETTING/PARTICIPANTS: A total of 166 sedentary adults were consecutively recruited from the population-based Health 2010 Study. INTERVENTION: Participants were randomized to a control (usual lifestyle) or intervention group with four individual theory-based counseling sessions. MAIN OUTCOME MEASURES: Objectively measured overall sitting time (ActivPAL 3, 7 days); secondary measures were breaks in sitting time, anthropometric measures, and cardiometabolic biomarkers, assessed at baseline and after 6 months. Data were collected in 2010 to 2012 and analyzed in 2013 to 2014 using repeated measures multiple regression analyses. RESULTS: Ninety-three participants were randomized to the intervention group and 73 to the control group, and 149 completed the study. The intervention group had a mean sitting time decrease of -0.27 hours/day, corresponding to 2.9% of baseline sitting time (hours/day); the control group increased mean sitting time by 0.06 hours/day. The between-group difference in change, -0.32 hours/day (95% CI -0.87 to 0.24, p = 0.26), was not statistically significant. Significant differences in change in fasting serum insulin of -5.9 pmol/L (95% CI -11.4 to -0.5, p = 0.03); homeostasis model assessment-estimated insulin resistance of -0.28 (95% CI -0.53 to -0.03, p = 0.03); and waist circumference of -1.42 cm (95% CI -2.54 to -0.29, p = 0.01) were observed in favor of the intervention group. CONCLUSIONS: Although the observed decrease in sitting time was not significant, a community-based, individually tailored, theory-based intervention program aimed at reducing sitting time may be effective for increasing standing and improving cardiometabolic health in sedentary adults. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov (NCT00289237).

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