title: Moderate-to-vigorous physical activity as a mediator between sedentary behavior and cardiometabolic risk in Spanish healthy adults: a mediation analysis.
abstract: BACKGROUND
  Public health strategies for cardiovascular prevention highlight the importance of physical activity, but do not consider the additional potentially harmful effects of sedentary behavior. This study was conducted between 2010 and 2012 and analyzed between 2013 and 2014. The aim of the study was to analyze the relationship between sedentary behavior and cardiometabolic risk factors in the Spanish adult population and to examine whether this relationship is mediated by moderate-to-vigorous physical activity (MVPA).
  
  
  METHODS
  The cross-sectional study included 1122 healthy subjects belonging to the EVIDENT study. Sedentary behavior was objectively measured over 7 days using Actigraph accelerometers. We assessed waist circumference (WC), triglycerides-to-HDL-C ratio (TG/HDL-C), and mean arterial pressure (MAP), and undertook homeostasis model assessment (HOMA-IR). Linear regression models were fitted according to Baron and Kenny procedures for mediation analysis.
  
  
  RESULTS
  TG/HDL-C and HOMA-IR were significantly higher in adults who spent more minutes in sedentary activities after adjusting for potential covariates. However when MVPA was added to the ANCOVA models as covariate the effect of sedentary time on HOMA-IR disappeared. In addition, MVPA acted as a full mediator of the relationship between sedentary time and HOMA-IR. In contrast, subjects with lower levels of MVPA presented worse cardiometabolic profiles than those from higher MVPA categories, even after controlling for sedentary time and other potential confounders.
  
  
  CONCLUSIONS
  These results suggest that both MVPA and sedentary time should be considered when developing cardiometabolic risk guidelines.
  
  
  BACKGROUND
  NCT01083082 .
authors.affiliation: Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago, Chile. antonio.garcia.h@usach.cl.
authors.forename: Antonio
authors.initials: A
authors.lastname: García-Hermoso
authors.affiliation: Health and Social Research Center, Universidad de Castilla-La Mancha, Edificio Melchor Cano, Centro de Estudios Socio-Sanitarios, Santa Teresa Jornet s/n, 16071, Cuenca, Spain. Vicente.Martinez@uclm.es.|Universidad Autónoma de Chile, Santiago, Chile. Vicente.Martinez@uclm.es.
authors.forename: Vicente
authors.initials: V
authors.lastname: Martínez-Vizcaíno
authors.affiliation: Health and Social Research Center, Universidad de Castilla-La Mancha, Edificio Melchor Cano, Centro de Estudios Socio-Sanitarios, Santa Teresa Jornet s/n, 16071, Cuenca, Spain. Mairena.Sanchez@uclm.es.|School of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain. Mairena.Sanchez@uclm.es.
authors.forename: Mairena
authors.initials: M
authors.lastname: Sánchez-López
authors.affiliation: The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain. donrecio@gmail.com.
authors.forename: Jose I
authors.initials: JI
authors.lastname: Recio-Rodriguez
authors.affiliation: The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain. magomez@usal.es.
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Gómez-Marcos
authors.affiliation: The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain. Lgarciao@usal.es.
authors.forename: Luis
authors.initials: L
authors.lastname: García-Ortiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D008076:Cholesterol, HDL; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008075:Lipoproteins, HDL; D008297:Male; D024821:Metabolic Syndrome / Q000517:prevention & control*; D008875:Middle Aged; D012307:Risk Factors; D057185:Sedentary Behavior; D013030:Spain; D014280:Triglycerides; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; C034396:HDL-triglyceride; D008075:Lipoproteins, HDL; D014280:Triglycerides