Multiple trajectories of any intensities of physical activity are better than sustained sedentary time on improving waist circumference and body mass index among Chinese adults: China Health and Nutrition Survey, 2004-2018

Abstract

Higher levels of physical activity (PA) may be associated with more favorable measures of adiposity, and sedentary time (ST) is associated with adverse health outcomes independent of PA. We hypothesized that multiple routes of different PA intensities PA combined with ST would be associated with coexisting latent waist circumference (WC) and body mass index (BMI) trajectories among Chinese adults. Thus, we aimed to determine multiple routes of PA and ST and their associations with trajectories of WC and BMI. We used data from 13 137 adults in the China Health and Nutrition Survey between 2004 and 2018. Using group-based multitrajectory modeling, we determined multiple trajectories of light-, moderate-, and vigorous-intensity PA (LPA, MPA) and ST (PA trajectories) and concurrent WC and BMI trajectories. Then, we explored logit regressions between them. We identified 4 PA trajectories. The majority (high LPA, 43.5%) exhibited decreasing high LPA levels. The rest were high ST (9.0%), decreased MPA (15.8%), and high vigorous-intensity PA (31.7%). People with high ST showed higher odds of having abdominal obesity (odds ratio [OR]=2.23) or severe abdominal obesity (OR=1.73) than those with decreased MPA (OR=1.85 and 1.71) and high LPA (OR=1.43 for abdominal obesity). They also showed higher odds of being overweight (OR=1.73) than those with decreased MPA (OR=1.58) and high LPA (OR=1.39). Any level of PA is better than sustained ST for improving adiposity indicators among Chinese adults.