The association between the intensity of physical activity and the risk of sarcopenia in adolescents: NHANES 2011-2018.

PURPOSE

The association between moderate physical activity (MPA) and vigorous physical activity (VPA) with the risk of sarcopenia in adolescents remains unclear. This study aims to examine their relationships systematically.

METHOD

This study utilized NHANES data from 2011 to 2018 from 6,415 adolescent participants. Weighted logistic regressions were conducted to investigate the effect of MPV and VPA on the risk of sarcopenia. Using weighted logistic regression with restricted cubic splines (RCS) to model potential nonlinear associations, threshold effect analysis to identify critical inflection points, and likelihood ratio tests for model comparison. Based on these thresholds, participants were stratified into six MVPA exposure groups: no-moderate (MPA = 0), low-moderate (0 < MPA < threshold), high-moderate (MPA ≥ threshold), no-vigorous (VPA = 0), low-vigorous (0 < VPA < threshold), and high-vigorous (VPA ≥ threshold). Distinct exercise patterns were derived from systematic combinations of these exposure categories. Weighted logistic regression was used to analyze the effect of exercise pattern.

RESULTS

After adjusting for multiple covariates, VPA decreased the risk of sarcopenia by 56%, whereas MPA reduced it by 24%. A "U-shaped" nonlinear relationship was observed between moderate physical activity (MPA), vigorous physical activity (VPA), and the risk of sarcopenia, with inflection points occurring at 40 min per week for MPA and 600 min per week for VPA. Nine distinct PA patterns were classified, ranging from patterns A to I. Compared to not engaging in any duration of VPA or MPA (pattern A), performing MPA < 40 min per week (pattern B; OR 0.63, 95%CI: 0.39, 1.04; P = 0.069) or engaging in VPA > 600 min and MPA > 40 min weekly (pattern I; OR 0.41, 95%CI: 0.17, 1.01; P = 0.052 ) did not reduce the risk of adolescent sarcopenia. Performing VPA > 600 min per week (pattern G) per week reduced risk of sarcopenia significantly (OR 0.13, 95%CI: 0.05, 0.35; P < 0.001).

CONCLUSIONS

This study reveals a nonlinear dose-response relationship between PA and sarcopenia risk in adolescents. Both insufficient and excessive exercise did not reduce adolescent sarcopenia risk. Performing VPA > = 600 min per week reduced risk of sarcopenia significantly.