Abstract
This study aimed to examine the cross-sectional associations of thigh accelerometry-assessed sedentary behaviour and moderate-to-vigorous physical activity (MVPA) with cardio-metabolic health markers and prevalent diabetes in a population sample of middle-aged British adults. Participants (n=4892) from the age-46-to-48 wave of the 1970 British Cohort Study were fitted with a waterproofed activPAL3 micro device. Total/prolonged sedentary time, breaks and MVPA were the main exposures. We dichotomized prolonged sedentary time and MVPA based on the corresponding median, generating four combinations as categorical exposures. Outcomes comprised of diabetes and seven cardio-metabolic health markers. We used logistic regression and generalized linear models to examine independent/joint associations, conducting a minimally adjusted model including demographics and contextual covariates, and further adjusted for total sedentary time and/or MVPA as applicable. Each set of 10 sedentary breaks and 1h of prolonged sedentary time were associated with HbA1c (mmol/mol) [B=-0.18 (-0.33, -0.03) and 2.35 (1.01, 3.69), respectively]. Each set of 10 sedentary breaks and 1h of MVPA were favourably associated with diabetes [adjusted odds ratio (AOR): 0.80 (0.71, 0.99) and 0.42 (0.26, 0.67), respectively]. Joint analyses showed that only the low MVPA × long sedentary time combination had significantly higher odds for diabetes than the referent high MVPA × short sedentary time combination [AOR: 1.89 (1.17, 3.03)]. Each set of additional 10 sedentary breaks per day was associated with 20% lower odds for diabetes. A low physical activity level combined with long sedentary time might synergistically deteriorate cardio-metabolic health.
Highlights
Physical inactivity is a major global health issue, causing 5.3 million deaths per year and 7% of type 2 diabetes cases.[1]
This study aimed to examine the cross-sectional associations of thigh accelerometry-assessed sedentary behaviour and moderate-to-vigorous physical activity (MVPA) with cardio-metabolic health markers and prevalent diabetes in a population sample of middle-aged British adults
Because a previous metaanalysis based on hip/waist-worn accelerometry suggested a potential non-linear association of total sedentary time and MVPA with all-cause mortality,[4] we examined the shape of the association between total sedentary time or MVPA with cardio-metabolic health markers
Summary
Physical inactivity is a major global health issue, causing 5.3 million deaths per year and 7% of type 2 diabetes cases.[1] Sedentary behaviour, defined as low energy expenditure (≤ 1.5 metabolic equivalents) in a sitting or reclining posture during waking times, has been associated with cardio-metabolic health markers and elevated mortality risk.[2] Current public health guidelines suggest both increasing physical activity and decreasing sitting time to ameliorate the cardio-metabolic health burden.[3] the quantification of sitting guidelines has been problematic due to inconsistencies in how ‘sedentary behaviour’ has been measured to date[3] and the lack of evidence in particular longitudinal studies on which guidelines are based. Very few general-population epidemiological studies have examined associations between thigh-measured postures and comprehensive cardio-metabolic profiles
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