title: Adiposity and insufficient MVPA predict cardiometabolic abnormalities in adults.
abstract: OBJECTIVE
  The purpose of this study is to compare the extent to which different combinations of objectively measured sedentary behavior (SB) and physical activity contribute to cardiometabolic health.
  
  
  METHODS
  A population representative sample of 5268 individuals, ages 20-85 yr, was included from the combined 2003-2006 National Health and Nutrition Examination Survey datasets. Activity categories were created on the combined basis of objectively measured SB and moderate-to-vigorous physical activity (MVPA) tertiles. Cardiometabolic abnormalities included elevated blood pressure, levels of triglycerides, fasting plasma glucose, C-reactive protein, homeostasis model assessment of insulin resistance value, and low HDL cholesterol level. Body mass index and dual-energy x-ray absorptiometry-derived percent body fat and android adiposity were also compared across groups. Predictors for a metabolically abnormal phenotype (≥3 cardiometabolic abnormalities or insulin resistance) were determined.
  
  
  RESULTS
  Adults with the least SB and greatest MVPA exhibited the healthiest cardiometabolic profiles, whereas adults with the greatest SB and lowest MVPA were older and had elevated risk. Time spent in SB was not a predictor of the metabolically abnormal phenotype when MVPA was accounted for. Adults with the highest MVPA across SB tertiles did not differ markedly in prevalence of obesity, adiposity, and/or serum cardiometabolic risk factors; however, less MVPA was associated with substantial elevations of obesity and cardiometabolic risk. Android adiposity (per kilogram) was independently associated with the metabolically abnormal phenotype in both men (odds ratio, 2.36 (95% CI, 1.76-3.17), P < 0.001) and women (odds ratio, 2.00 (95% CI, 1.63-2.45), P < 0.001). Among women, greater SB and less lifestyle moderate activity and MVPA were each independently associated with the metabolically abnormal phenotype, whereas only less MVPA was associated with it in men.
  
  
  CONCLUSIONS
  MVPA is a strong predictor of cardiometabolic health among adults, independent of time spent in SB.
authors.affiliation: 1Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI; 2Division of Rehabilitation Sciences/School of Health Professions, Department of Internal Medicine/Division of Geriatrics, University of Texas Medical Branch, Galveston, TX; 3Division of Cancer Control and Population Sciences-National Cancer Institute, National Institutes of Health, Bethesda, MD; and 4Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Peterson
authors.forename: Soham
authors.initials: S
authors.lastname: Al Snih
authors.forename: Jonathan
authors.initials: J
authors.lastname: Stoddard
authors.forename: James
authors.initials: J
authors.lastname: McClain
authors.forename: I-Min
authors.initials: IM
authors.lastname: Lee
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000503:physiopathology; D002320:Cardiovascular Physiological Phenomena; D015444:Exercise / Q000502:physiology*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000503:physiopathology; D012307:Risk Factors; D057185:Sedentary Behavior; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein