Is all physical activity equal? Investigating the total and domain-specific relationships between physical activity and cardiometabolic health in U.S. adults (NHANES 2013-2018).

BACKGROUND

Metabolic syndrome (MetS) increases the risk of cardiovascular disease morbidity and mortality. Physical activity (PA) reduces the likelihood of MetS, but it is a complex behavior and is accumulated in multiple domains.

PURPOSE

To cross-sectionally investigate the total and domain-specific relationships between PA and MetS in U.S. adults.

METHODS

Data from 3,408 adults participating in the National Health and Nutrition Examination Survey (2013-2018) were analyzed. Blood pressure (BP), waist circumference (WC), fasting blood glucose (GLU), triglycerides (TRIG), and high-density lipoprotein (HDL) were measured. MetS and its risk factors were the primary and secondary outcomes, respectively. Weekly minutes of total PA and domain-specific PA (i.e., leisure-time (LTPA), transportation (TPA), occupational & household (OHPA)), were self-reported. For each exposure, participants were grouped into weekly PA: (1) 0 min, (2) 1-149 min, (3) 150-299 min, (4) 300-599 min, and (5) 600 + minutes. Logistic regression estimated the odds of having MetS, and its risk factors from PA.

RESULTS

Total PA was associated with lower odds of most MetS risk factors. Compared to no LTPA, and independent of TPA and OHPA, engaging in 150-299 and 300-599 min/week of LTPA was associated with 30% (OR = 0.70 [95%CI: 0.50, 0.98]) and 43% (OR = 0.57 [95%CI: 0.35, 0.92]) lower odds of MetS, respectively. LTPA was also associated with lower odds of having high WC, GLU, TRIG, and low HDL (ORs = 0.52-0.68). Compared to no TPA, and independent of LTPA and OHPA, engaging in 300-599 min/week of TPA was associated with 54% lower odds of MetS (OR = 0.46 [95%CI: 0.25, 0.84]) and 40% lower odds of having a high WC (OR = 0.40 [95%CI: 0.21, 0.76]). Engaging in OHPA was not associated with MetS but was associated with greater odds of having a high WC (OR = 1.44 [95%CI: 1.03, 2.01]), and GLU (ORs = 1.52-1.83), independent of LTPA and TPA.

CONCLUSION

Total PA, seemingly driven by LTPA, was inversely associated with cardiometabolic health. TPA also showcases some protective associations, while OHPA appears to not confer cardiometabolic health benefits. Longitudinal data should confirm these associations using more robust PA measurement tools.