Sedentary Behavior, Cardiorespiratory Fitness, Physical Activity, and Cardiometabolic Risk in Men: The Cooper Center Longitudinal Study

Study Questions:

What is the association between sedentary behavior and cardiometabolic risk, while taking into account cardiorespiratory fitness (fitness) and physical activity?

Methods:

The investigators examined the association of sedentary behavior, physical activity, and fitness (exposure variables) to cardiometabolic biomarkers and metabolic syndrome (outcome measures) among a historic cohort (January 2, 1981, through October 16, 2012) of men. First, they estimated the association (cross-sectionally and longitudinally) of sedentary behavior along with physical activity and fitness to lipids and lipoproteins, glucose, blood pressure, and markers of adiposity, including body mass index, waist circumference, and body fat percentage. The authors then prospectively examined the effects of baseline sedentary time on the incidence of metabolic syndrome, while adjusting for physical activity, fitness, and other covariates in multivariate models.

Results:

Multivariate analysis of baseline data revealed that in comparison with the reference group (9 hours/week of sedentary time), more sedentary behavior was significantly associated with a higher triglyceride level, a higher triglycerides–high-density lipoprotein cholesterol ratio, and a higher body mass index, waist circumference, and body fat percentage (p < 0.05 for trend), after adjusting for physical activity and covariates. When adjusting for fitness and covariates, prolonged sedentary time was only associated with a higher triglyceride–high-density lipoprotein cholesterol ratio (p = 0.02 for trend). Sedentary time was not associated with the incidence of metabolic syndrome in multivariate models. Longitudinal analyses revealed that a 1 MET increase in fitness was significantly (p < 0.05) associated with almost all biomarkers when adjusting for sedentary behavior, with little moderation observed.

Conclusions:

The authors concluded that the association between prolonged sedentary time and cardiometabolic biomarkers is markedly less pronounced when taking fitness into account.

Perspective:

This study reports increased sedentary behavior to be related to numerous biomarkers when controlling for physical activity and to a lesser extent when taking fitness into account. However, when prospectively examining the effect of sedentary time on metabolic syndrome, no significant findings were observed. Thus, although these findings suggest the need to encourage achieving higher levels of fitness through meeting physical activity guidelines to decrease metabolic risk, the effects of reducing sedentary time on cardiometabolic risk biomarkers warrant further research using objective measurement.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Sports and Exercise Cardiology, Hypertriglyceridemia, Lipid Metabolism, Nonstatins, Exercise

Keywords: Outcome Assessment (Health Care), Multivariate Analysis, Physical Fitness, Exercise, Blood Pressure, Glucose, Metabolic Syndrome X, Waist Circumference, Cholesterol, Body Mass Index, Biological Markers, Research Personnel, Adiposity, Sedentary Lifestyle, Triglycerides, Lipoproteins, HDL


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