Abstract
Patterns of physical activity (PA) that optimize both fitness and fatness may better predict cardiometabolic health. Reduced rank regression (RRR) was applied to identify combinations of the type (e.g., football vs. skipping), location and timing of activity, explaining variation in cardiorespiratory fitness (CRF) and Body Mass Index (BMI). Multivariable regressions estimated longitudinal associations of PA pattern scores with cardiometabolic health in n = 579 adolescents aged 13–17 years from the Malaysian Health and Adolescent Longitudinal Research Team study. PA pattern scores in boys were associated with higher fitness (r = 0.3) and lower fatness (r = −0.3); however, in girls, pattern scores were only associated with higher fitness (r = 0.4) (fatness, r = −0.1). Pattern scores changed by β = −0.01 (95% confidence interval (CI) −0.04, 0.03) and β = −0.08 (95% CI −0.1, −0.06) per year from 13 to 17 years in boys and girls respectively. Higher CRF and lower BMI were associated with better cardiometabolic health at 17 years, but PA pattern scores were not in either cross-sectional or longitudinal models. RRR identified sex-specific PA patterns associated with fitness and fatness but the total variation they explained was small. PA pattern scores changed little through adolescence, which may explain the limited evidence on health associations. Objective PA measurement may improve RRR for identifying optimal PA patterns for cardiometabolic health.
Highlights
Among adults, regular physical activity (PA) is associated with reduced risk of obesity, cardiovascular disease, type 2 diabetes and all-cause mortality [1]
We investigated whether intermediate variables (CRF and Body Mass Index (BMI)) were individually associated with cardiometabolic health, cross-sectionally and longitudinally
PA pattern scores in both boys and girls remained largely static over time and there was no evidence for an association between change in PA pattern scores and cardiometabolic health at 17 years, despite direct associations of the specified Rank Regression (RRR) intermediates (CRF and BMI) with cardiometabolic health
Summary
Regular physical activity (PA) is associated with reduced risk of obesity, cardiovascular disease, type 2 diabetes and all-cause mortality [1]. PA is associated with improved cardiometabolic health, including lower levels of obesity and lower levels of insulin, glucose, lipids and blood pressure [2,3,4,5]. As PA levels track from adolescence into adulthood [6,7,8], establishing PA patterns that promote health in adolescence is important for future disease prevention. The link between PA and cardiometabolic health is partially mediated by cardiovascular respiratory fitness (fitness) and obesity (fatness) [9,10,11]. Fitness is a function of genetic factors and the frequency of higher intensity PA improves cardiometabolic health [12].
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