Association Between Leisure Time Physical Activity and HDL-C in the Elsa-Brasil Study Participants: Are There Any Gender Differences in the Dose-Response Effect?

Background: High levels of high-density lipoprotein (HDL-C) are known for their protective effect against cardiovascular diseases and the regular practice of leisure time physical activity (LTPA) may be associated with their increase.

Objective: To verify the existence of differences between genders in the dose-response effect regarding the association between LTPA and HDL-C in the ELSA-Brasil study cohort.

Methods: Cross-sectional study with data from wave 2 of 13,931 participants of both genders (7,607 women) from the Longitudinal Study of Adult Health ELSA-Brasil. The LTPA was measured using the International Physical Activity Questionnaire (IPAQ) and classified into four categories: sedentary, low active, active and very active. The discriminatory power of LTPA at different intensities analyzed for high HDL-C was tested using ROC curves. Associations, adjusted for confounders between LTPA and HDL-C were analyzed by logistic regression. A 95% confidence interval was used.

Results: A positive association, with a dose-response effect, was observed between LTPA and HDL-C in both men and women. With regard to intensity, only vigorous physical activity discriminated high HDL-C in men, while both walking and moderate and vigorous physical activity discriminated high HDL-C in women.

Conclusions: LTPA shows a positive association with gradient dose-response and HDL-C, but in men, the association is not observed for those classified as physically unfit. In women, both walking intensity and moderate or vigorous physical activity can discriminate high HDL-C levels, whereas only vigorous intensity-exercise discriminate elevated HDL-C levels in men, demonstrating that males need to do more physical activity for this benefit to be observed.