title: Leisure-time physical activity, sedentary behaviors, sleep, and cardiometabolic risk factors at baseline in the PREDIMED-PLUS intervention trial: A cross-sectional analysis.
abstract: Limited data exists on the interrelationships between physical activity (PA), sedentary behaviors and sleep concerning cardiometabolic risk factors in aged adults at high cardiovascular disease risk. Our aim was to examine independent and joint associations between time spent in leisure-time PA, sedentary behaviors and sleep on the prevalence of obesity, type 2 diabetes (T2D) and components of the metabolic syndrome (MetS) in Mediterranean individuals at high cardiovascular risk. Cross-sectional analyses were performed on baseline data from 5776 Spanish adults (aged 55-75y in men; 60-75y in women) with overweight/obesity and MetS, from October 2013 to October 2016, in the PREDIMED-PLUS trial. Employing multivariable-adjusted Cox regression with robust variance and constant time (given the cross-sectional design), higher prevalence of obesity, T2D and abdominal obesity as component of the MetS were associated with greater time in TV-viewing (Relative Risk, RR: 1.02, 95%CI: 1.01, 1.03; RR:1.04, 95%CI: 1.02, 1.06 and RR: 1.01 95%CI: 1.00, 1.02; respectively, all P < .01). Conversely, greater time in moderate-vigorous PA (MVPA) was associated with lower prevalence of obesity, T2D, abdominal obesity and low HDL-cholesterol (RR: 0.95, 95%CI: 0.93, 0.97; RR: 0.94, 95%CI: 0.89, 0.99; RR: 0.97, 95%CI: 0.96, 0.98; and RR: 0.95, 95%CI: 0.91, 0.99, respectively, all P < .05). For these outcomes, theoretically substituting 1-h/day of MVPA for 1-h/day TV-viewing was also significantly associated with lower prevalence (RR 0.91 to 0.97, all P < .05). Similar lower RR in these outcomes was observed when substituting 1-h/day of MVPA for 1-h/day of sleeping. Longer time watching TV and not meeting MVPA recommendations were jointly associated with higher RR of the prevalence of obesity and T2D. We concluded that, in senior individuals at high cardiovascular risk, greater time spent on MVPA and fewer on sedentary behaviors was inversely associated with prevalence of obesity, T2D, and some of the components of MetS.
authors.affiliation: Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain.|CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Rosique-Esteban
authors.affiliation: Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain.|CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Díaz-López
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Preventive Medicine and Public Health, University of Navarra-Navarra Institute for Health Research, Pamplona, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martínez-González
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Preventive Medicine, University of Valencia, Valencia, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Corella
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Servicio de Endocrinología, Hospital del Mar, Barcelona, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Goday
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.
authors.forename: J Alfredo
authors.initials: JA
authors.lastname: Martínez
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Instituto de Investigación Sanitaria de Palma (IdISPa), University Hospital of Son Espases, Palma de Mallorca, Spain.
authors.forename: Dora
authors.initials: D
authors.lastname: Romaguera
authors.affiliation: University of Miguel Hernández, Alicante, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: Vioque
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Cardiology, University Hospital Araba, Vitoria, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Arós
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, IMIBIC, University of Córdoba, Córdoba, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Garcia-Rios
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, Malaga, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Tinahones
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Internal Medicine, Hospital Clínic, IDIBAPS August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Estruch
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Facultad de Ciencias de la Educación, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Fernández-García
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Family Medicine, Distrito Sanitario Atencion Primaria Sevilla, Sevilla, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Lapetra
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: Luís
authors.initials: L
authors.lastname: Serra-Majem
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Lipid Unit, Department of Internal Medicine, Bellvitge Biomedical Research Institute (IDIBELL)-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pinto
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.
authors.forename: Josep A
authors.initials: JA
authors.lastname: Tur
authors.affiliation: Departament of Preventive Medicine and Public Health, University of Granada; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Aurora
authors.initials: A
authors.lastname: Bueno-Cavanillas
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Clínic, Barcelona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Vidal
authors.affiliation: Department of Health Sciences, University of Jaen; Jaen, Spain; CIBERESP, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Delgado-Rodríguez
authors.affiliation: Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Madrid Institute for Advanced Studies (IMDEA) Food Institute, Madrid, Spain.
authors.forename: Lidia
authors.initials: L
authors.lastname: Daimiel
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Endocrinology and Nutrition, University Hospital Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Vázquez
authors.affiliation: Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Rubio
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Lipids, Hospital Clínic, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
authors.affiliation: Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain.|CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
mesh_terms: D000368:Aged; D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000150:complications; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D057185:Sedentary Behavior; D012890:Sleep; D013030:Spain / Q000453:epidemiology
chemical_list: D015415:Biomarkers