title: Physical activity and non-movement behaviours: their independent and combined associations with metabolic syndrome.
abstract: BACKGROUND
  Metabolic syndrome (MetS) is a prevalent risk condition associated with a higher risk of chronic conditions, including diabetes and cardiovascular diseases. Physical activity and non-movement behaviours (NMB), including sleep, screen time and sedentary activity, have been associated with MetS. In light of the increasing prevalence of NMBs, and the moderate rates of physical activity guideline adherence in Canada, this analysis examines the independent and combined associations of NMB and physical activity with MetS.
  
  
  METHODS
  Data on Canadians 18 years and older from the Canadian Health Measures Survey (n = 2901) were used to examine the moderating effect of moderate-to-vigorous physical activity (MVPA) guideline adherence (150 minutes or more of MVPA/week, based on accelerometer) on the association of NMBs (sleep based on self-report, screen time based on self-report, and sedentary time based on accelerometer) with MetS. Logistic regression analyses were conducted and sampling weights were applied to represent the Canadian adult population.
  
  
  RESULTS
  A graded association between PA and MetS was observed, with those achieving less MVPA than guidelines having a higher odds of MetS (OR 2.9, 95 % CI: 1.9-4.5 for < 75 mins/week of MVPA, and OR 1.8, 95 % CI: 1.2-2.8 for 75-150 mins/week, as compared to those accumulating 150 mins/week or more). When examining the moderating effect of PA on the association between NMBs and MetS, we found that (1) for participants who met guidelines, no level of any NMB was significantly associated with MetS and (2) for those who did not achieve guidelines, there was an increased odds of MetS based on excess NMB time(OR 3.2, 95 % CI: 1.5-6.8 for 1.4-2.1 h/day and OR 4.4, 95 % CI: 2.5-7.9 for ≥2.1 h/day of screen time and 75-150 mins/week of MVPA, OR 1.7, 95 % CI: 1.1-2.5 for ≥8 h/day of sleep time and <75 mins/week of MVPA, and OR 2.2, 95 % CI: 1.3-3.8 for 9.2-10.3 h/day of sedentary time and <75 mins/week of MVPA).
  
  
  CONCLUSIONS
  Adhering to physical activity guidelines may mitigate the associations of NMBs with MetS. Given the novel findings that associations between NMBs and MetS were not significant among Canadians meeting PA guidelines, these results suggest the beneficial role of physical activity to prevent chronic disease risk.
authors.affiliation: Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada. deepa.rao@uottawa.ca.
authors.forename: Deepa P
authors.initials: DP
authors.lastname: Rao
authors.affiliation: School of Psychology, University of Ottawa, Ottawa, ON, Canada. horpana@uottawa.ca.
authors.forename: Heather
authors.initials: H
authors.lastname: Orpana
authors.affiliation: School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada. dkrewski@uottawa.ca.
authors.forename: Daniel
authors.initials: D
authors.lastname: Krewski
mesh_terms: D061725:Accelerometry / Q000706:statistics & numerical data; D000328:Adult; D002170:Canada / Q000453:epidemiology; D003201:Computers / Q000706:statistics & numerical data*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D057185:Sedentary Behavior; D057566:Self Report; D012890:Sleep / Q000502:physiology*; D013690:Television / Q000706:statistics & numerical data*; D055815:Young Adult