title: Associations of objectively measured physical activity and abdominal fat distribution.
abstract: OBJECTIVE
  Visceral adipose tissue (VAT) and physical activity are both independent predictors of Type 2 diabetes. Physical activity and overall obesity are inversely associated with each other. Yet the nature of the association between objectively measured dimensions of physical activity and abdominal fat distribution has not been well characterized. We aimed to do so in a middle-age to elderly population at high risk of diabetes.
  
  
  METHODS
  A cross-sectional analysis of 1134 participants of the ADDITION-PRO study. VAT and subcutaneous adipose tissue (SAT) were assessed one-dimensionally by ultrasonography and physical activity with combined accelerometry and HR monitoring. Linear regression of physical activity energy expenditure (PAEE) and time spent in different physical activity intensity levels on VAT and SAT was performed.
  
  
  RESULTS
  Median body mass index (BMI) was 26.6 kg·m and PAEE was 28.1 kJ·kg·d, with 18.9 h·d spent sedentary, 4.5 h·d in light-intensity physical activity, and 0.4 h·d in moderate-intensity physical activity. PAEE was significantly negatively associated with VAT, and in women, PAEE was also significantly negatively associated with SAT. The difference in VAT was -1.1 mm (95% confidence interval [CI] = -1.8 to -0.3) per 10-kJ·kg·d increment, and the corresponding difference in SAT for women was -0.6 mm (95% CI = -1.2 to -0.04) in models adjusted for age, sex, and waist circumference. Exchanging 1 h of light physical activity with moderate physical activity was significantly associated with VAT (-4.5 mm, 95% CI = -7.6 to -1.5). Exchanging one sedentary hour with light physical activity was significantly associated with both VAT (-0.9 mm, 95% CI = -0.1 to -1.8) and SAT (-0.4 mm, 95% CI = -0.0 to -0.7).
  
  
  CONCLUSIONS
  In this population with low physical activity levels, cross-sectional findings indicate that increasing overall physical activity and decreasing time spent sedentary is important to avoid the accumulation of metabolically deleterious VAT.
authors.affiliation: 1Steno Diabetes Center A/S, Gentofte, DENMARK; 2Section of General Medical Practice, Department of Public Health, Aarhus University, Aarhus, DENMARK; 3MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM; 4Department of Internal Medicine F, Gentofte Hospital, Gentofte, DENMARK; 5Department of Endocrinology, Hospital of Southwest Denmark, Esbjerg, DENMARK; 6University Clinic in Nephrology and Hypertension, Department of Medical Research, Holstebro Hospital, Holstebro, DENMARK; 7Department of Public Health, Public Research Center for Health, Strassen, LUXEMBOURG.
authors.forename: Annelotte
authors.initials: A
authors.lastname: Philipsen
authors.forename: Anne-Louise Smidt
authors.initials: AL
authors.lastname: Hansen
authors.forename: Marit Eika
authors.initials: ME
authors.lastname: Jørgensen
authors.forename: Søren
authors.initials: S
authors.lastname: Brage
authors.forename: Bendix
authors.initials: B
authors.lastname: Carstensen
authors.forename: Annelli
authors.initials: A
authors.lastname: Sandbaek
authors.forename: Thomas Peter
authors.initials: TP
authors.lastname: Almdal
authors.forename: Jeppe
authors.initials: J
authors.lastname: Gram
authors.forename: Erling Bjerregaard
authors.initials: EB
authors.lastname: Pedersen
authors.forename: Torsten
authors.initials: T
authors.lastname: Lauritzen
authors.forename: Daniel Rinse
authors.initials: DR
authors.lastname: Witte
mesh_terms: D050153:Abdominal Fat; D000368:Aged; D050218:Body Fat Distribution; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors