title: Self-initiated changes in physical activity levels improve cardiometabolic profiles: A longitudinal follow-up study.
abstract: While studies have described the importance of higher physical activity levels (PAL) in weight loss, the impact of self-initiated PAL on health status warrants further study. We aimed to prospectively examine the effects of self-initiated longitudinal PAL changes on body mass index (BMI) and cardiometabolic parameters in normal weight, overweight and obese adults.
  
  
  
  We included 4840 adults (mean age 41.6 ± 7.9 years, 79% male) undergoing routine health screening examinations. Self-reported PAL, height, weight, blood pressure and blood samples were collected at baseline and after a mean (95% confidence interval) follow up of 536 (531-541) days. Subjects were stratified according to BMI [39.8% normal weight (<25 kg/m2), 45.1% overweight (25.0-29.9 kg/m2), and 19.1% obese (≥30 kg/m2)]. In normal weight individuals, BMI increased from baseline to follow-up, irrespective of PAL changes. On the other hand, overweight and obese individuals that increased PAL experienced a decrease in BMI by -0.9% and -3.1%, respectively (p < 0.05). Overweight and obese individuals that increased PAL also experienced a decrease in -5.8% -4.6% in non-HDL concentrations from baseline to follow-up (p < 0.05). Finally, in overweight individuals, LDL cholesterol concentrations decreased from baseline to follow-up, irrespective of PAL changes whereas in obese individuals, a maintenance or increased PAL were associated with a decrease in -4.7% and -6.1% (p < 0.05), respectively.
  
  
  
  In a large cohort of screening patients, longitudinal self-initiated PAL is associated with improved BMI and cardiometabolic profile in overweight and obese individuals.
authors.affiliation: Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. Electronic address: raphaelritti@gmail.com.
authors.forename: R M
authors.initials: RM
authors.lastname: Ritti-Dias
authors.affiliation: Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: G G
authors.initials: GG
authors.lastname: Cucato
authors.affiliation: Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: W L
authors.initials: WL
authors.lastname: do Prado
authors.affiliation: Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: R D O
authors.initials: RD
authors.lastname: Conceição
authors.affiliation: Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Lipid Clinic Heart Institute (InCor), University of Sao Paulo, Medical School Hospital, Sao Paulo, Brazil.
authors.forename: R D
authors.initials: RD
authors.lastname: Santos
authors.affiliation: Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: M S
authors.initials: MS
authors.lastname: Bittencourt
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006184:Habits; D006801:Humans; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012648:Self Care; D013997:Time Factors; D015431:Weight Loss
chemical_list: D008055:Lipids
keywords: Body mass index; Cardiovascular risk; Exercise; Triglycerides