Association of Joint Body Weight Profile and Physical Activity with Cardiovascular Disease Risk in Montana Adults

Abstract

Background: There is much debate surrounding the fat but fit paradox, namely, questioning the extent to which physical fitness protects obese/overweight populations from premature mortality. The purpose of this study was to examine the link between joint body weight (BW) profile and physical activity (PA) (BW.PA) and cardiovascular disease (CVD) risk in adults. Methods: Data for this study came from the 2019 Montana Behavioral Risk Factor Surveillance System (BRFSS). Participants were firstly assigned to one of three BW groups (normal weight, overweight, obese) using CDC BMI criteria, secondly assigned to one of three PA groups (active, insufficiently active, inactive) using self-reported moderate-to-vigorous PA (MVPA), and finally assigned to one of the resulting nine joint BW.PA groups. Three main CVD risk factors (hypertension, hypercholesterolemia, diabetes) were used as separate and then combined outcomes. Logistic regression was employed to estimate the odds of having a CVD risk factor for each BW.PA group, relative to “normal weight and active”. Results: A direct linear trend in odds ratios (ORs) was observed across BW.PA groups for each CVD risk factor, from “normal weight and active” to “obese and inactive”. Fully adjusted regression models showed increased odds of having any of the three CVD risk factors (versus having none) for adults “overweight and active” (OR = 2.22, 95% CI: 1.73 – 2.85) and adults “obese and active” (OR = 4.03, 95% CI: 3.08 – 5.27), compared to those “normal weight and active”. Odds were also significantly (p Conclusion: This study found that BW profile was a strong and consistent predictor of three primary CVD risk factors. Obese adults were much more likely to have CVD risk, regardless of PA participation. Hence, fat but fit may not be a paradox among adults in Montana.