title: Moderate activity and fitness, not sedentary time, are independently associated with cardio-metabolic risk in U.S. adults aged 18-49.
abstract: This cross-sectional study is one of the first to examine and compare the independent associations of objectively measured sedentary time, moderate to vigorous physical activity (MVPA) and fitness with cardio-metabolic risk factors. We studied 543 men and women (aged 18-49 years) from the NHANES 2003-2004 survey. Sedentary time and MVPA were measured by accelerometry. Fitness was assessed with a submaximal treadmill test. Cardio-metabolic risk factors included: waist circumference (WC), BMI, blood pressure, fasting glucose, HDL- and non HDL cholesterol, triglycerides (TG), and C-reactive protein (CRP). Sedentary time, MVPA and fitness were used as predictors for the cardio-metabolic outcomes in a multiple regression analysis. Standardized regression coefficients were computed. Results show that sedentary time was associated with HDL-cholesterol (β=-0.080, p=0.05) and TG (β=0.080, p=0.03). These results became non-significant after adjustment for MVPA and fitness. MVPA was associated with WC (β=-0.226), BMI (β=-0.239), TG (β=-0.108) and HDL-cholesterol (β=0.144) (all p<0.05). These results remained significant after adjustment for sedentary time and fitness. Fitness was associated with WC (β=-0.287), BMI (β=-0.266), systolic blood pressure (β=-0.159), TG (β=-0.092), and CRP (β=-0.130) (all p<0.05). After adjustment for sedentary time and MVPA these results remained significant. These differences in relative importance of sedentary time, MVPA and fitness on cardio-metabolic-risk are important in the design of prevention programs. In this population, the strength of the associations between MVPA and fitness with cardio-metabolic markers appeared to be similar; both MVPA and fitness showed independent associations with cardio-metabolic risk factors. In contrast, sedentary time showed no independent associations with cardio-metabolic risk after correction for fitness and MVPA.
authors.affiliation: Department of Human Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. jeroen.vandervelde@maastrichtuniversity.nl.|Division of Endocrinology, Department of Internal Medicine, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. jeroen.vandervelde@maastrichtuniversity.nl.
authors.forename: Jeroen H P M
authors.initials: JH
authors.lastname: van der Velde
authors.affiliation: Department of Human Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. hans.savelberg@maastrichtuniversity.nl.
authors.forename: Hans H C M
authors.initials: HH
authors.lastname: Savelberg
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. n.schaper@mumc.nl.
authors.forename: Nicolaas C
authors.initials: NC
authors.lastname: Schaper
authors.affiliation: Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. a.koster@maastrichtuniversity.nl.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Koster
mesh_terms: D061725:Accelerometry; D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009043:Motor Activity; D009749:Nutrition Surveys; D010809:Physical Fitness; D012307:Risk Factors; D057185:Sedentary Behavior; D014481:United States / Q000453:epidemiology; D055815:Young Adult