Ten-year Change In Sedentary Behavior And Cardiorespiratory Fitness Are Independently Associated With Clustered Cardio-metabolic Risk

Abstract

PURPOSE: We aimed to study the independent associations between change in sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA) and objectively measured cardiorespiratory fitness (CRF) over 10 years, and concurrent change in clustered cardio-metabolic risk and its individual components (waist circumference, fasting glucose, HDL-cholesterol, triglycerides and blood pressure). We also determined whether any associations were mediated by change in waist circumference or dietary intake. METHODS: A population-based sample of 425 adults (age (mean±SD) 55.83±9.40; 65%men) were followed prospectively for 9.6±0.52 years. Participants self-reported SB and MVPA and performed a maximal cycle ergometer test to estimate peak oxygen uptake at baseline (2002–2004) and follow up (2012–2014). Multiple linear regression and the product of coefficients method were used to examine independent associations and mediation effects, respectively. RESULTS: Greater increase in SB was associated with more detrimental change in clustered cardio-metabolic risk (standardized β = 0.12, p<0.01) and triglycerides (standardized β = 0.12, p<0.05), independently of baseline and change in MVPA and CRF. Greater increase in MVPA was associated with greater increase in HDL-cholesterol, independent of baseline and change in SB and CRF (standardized β = 0.15, p<0.01). Greater decrease in CRF was associated with more detrimental change in clustered cardio-metabolic risk and all other individual components, independently of baseline and change in SB (absolute standardized β ranging from 0.12 to 0.38, p<0.05). Change in waist circumference mediated the relationship between change in CRF and change in fasting glucose, HDL-cholesterol and triglycerides (a*b [95% CI]: fasting glucose: −0.11 [−0.18, −0.04]; HDL-cholesterol: 0.15 [0.08, 0.22]; triglycerides: −0.40 [−0.81, −0.01]). CONCLUSIONS: A combination of decreasing SB and increasing MVPA and CRF is most beneficial towards cardio-metabolic health. However, some associations between changes in CRF and changes in cardio-metabolic risk were mediated through changes in waist circumference. Therefore, from a public health perspective, lifestyle intervention programs need to focus on all three components, which is decreasing SB, increasing MVPA and CRF.