Effects of Physical Activity and Sedentary Behaviors on Cardiovascular Disease and the Risk of All-cause Mortality in Overweight or Obese Middle-aged and Older Adults

Overview

Journal Front Public Health

Specialty Public Health

Date 2024 Feb 27

PMID 38410660

Authors

Yongqiang Zhang

Xia Liu

Affiliations

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Abstract

Aim: The aim of this study was to respectively explore the relationships between physical activity and sedentary behaviors and cardiovascular disease (CVD) and all-cause mortality risk in overweight/obese middle-aged and older patients, and also assess the interaction between physical activity and sedentary behaviors.

Methods: Data of middle-aged and older adults with body mass index (BMI) ≥25 kg/m were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2007-2018 in this retrospective cohort study. Weighted univariate and multivariate logistic regression analyses were used to explore the associations between physical activity and sedentary behaviors and CVDs; weighted univariate and multivariate Cox regression analyses were used to explore the relationships between physical activity and sedentary behaviors with the risk of all-cause mortality. The interaction effect between physical activity and sedentary behaviors on CVD and all-cause mortality was also assessed. We further explored this interaction effect in subgroups of age and BMI. The evaluation indexes were odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs).

Results: Among 13,699 eligible patients, 1,947 had CVD, and 1,560 died from all-cause mortality. After adjusting for covariates, patients who had high sedentary time seemed to have both high odds of CVD [OR = 1.24, 95% CI: (1.06-1.44)] and a high risk of all-cause mortality [HR = 1.20, 95% CI: (1.06-1.37)]. Furthermore, being insufficiently active was linked to high odds of CVD [OR = 1.24, 95% CI: (1.05-1.46)] as well as a high risk of all-cause mortality [HR = 1.32, 95% CI: (1.15-1.51)]. High sedentary time and being insufficiently active had an interaction effect on both high odds of CVD [OR = 1.44, 95% CI: (1.20-1.73)] and high risk of all-cause mortality [HR = 1.48, 95% CI: (1.24-1.76)]. Individuals of different ages with/without obesity need to focus on the potential CVD/mortality risk of high sedentary time and low physical activity (all < 0.05).

Conclusion: Reducing sedentary time combined with increasing physical activity may benefit health by reducing both the risk of CVD and all-cause mortality in overweight or obese middle-aged and older adults.

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References

Schnurr T, Stallknecht B, Sorensen T, Kilpelainen T, Hansen T . Evidence for shared genetics between physical activity, sedentary behaviour and adiposity-related traits. Obes Rev. 2020; 22(4):e13182. DOI: 10.1111/obr.13182. View

Ciumarnean L, Milaciu M, Negrean V, Orasan O, Vesa S, Salagean O . Cardiovascular Risk Factors and Physical Activity for the Prevention of Cardiovascular Diseases in the Elderly. Int J Environ Res Public Health. 2022; 19(1). PMC: 8751147. DOI: 10.3390/ijerph19010207. View

Jespersen T, Kruse N, Mehta T, Kuwabara M, Noureddine L, Jalal D . Light wine consumption is associated with a lower odd for cardiovascular disease in chronic kidney disease. Nutr Metab Cardiovasc Dis. 2018; 28(11):1133-1139. PMC: 6588355. DOI: 10.1016/j.numecd.2018.06.018. View

Jellinger P, Smith D, Mehta A, Ganda O, Handelsman Y, Rodbard H . American Association of Clinical Endocrinologists' Guidelines for Management of Dyslipidemia and Prevention of Atherosclerosis. Endocr Pract. 2012; 18 Suppl 1:1-78. DOI: 10.4158/ep.18.s1.1. View

Stamatakis E, Gale J, Bauman A, Ekelund U, Hamer M, Ding D . Sitting Time, Physical Activity, and Risk of Mortality in Adults. J Am Coll Cardiol. 2019; 73(16):2062-2072. DOI: 10.1016/j.jacc.2019.02.031. View

Zhang J, Ren Z, Zhang Q, Zhang R, Zhang C, Liu J . Lower hydration status increased diabetic retinopathy among middle-aged adults and older adults: Results from NHANES 2005-2008. Front Public Health. 2022; 10:1023747. PMC: 9643860. DOI: 10.3389/fpubh.2022.1023747. View

Piercy K, Troiano R, Ballard R, Carlson S, Fulton J, Galuska D . The Physical Activity Guidelines for Americans. JAMA. 2018; 320(19):2020-2028. PMC: 9582631. DOI: 10.1001/jama.2018.14854. View

Dogra S, Wolf M, Jeffrey M, Foley R, Logan-Sprenger H, Jones-Taggart H . Disrupting prolonged sitting reduces IL-8 and lower leg swell in active young adults. BMC Sports Sci Med Rehabil. 2019; 11:23. PMC: 6798359. DOI: 10.1186/s13102-019-0138-4. View

Clark K, Sharp S, Womack C, Kurti S, Hargens T . Increased sedentary time and decreased physical activity increases lipoprotein associated phospholipase A in obese individuals. Nutr Metab Cardiovasc Dis. 2022; 32(7):1703-1710. DOI: 10.1016/j.numecd.2022.04.023. View

10.

Booth F, Laye M, Lees S, Rector R, Thyfault J . Reduced physical activity and risk of chronic disease: the biology behind the consequences. Eur J Appl Physiol. 2007; 102(4):381-90. DOI: 10.1007/s00421-007-0606-5. View

11.

Hales C, Carroll M, Fryar C, Ogden C . Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. NCHS Data Brief. 2020; (360):1-8. View

12.

Akins J, Crawford C, Burton H, Wolfe A, Vardarli E, Coyle E . Inactivity induces resistance to the metabolic benefits following acute exercise. J Appl Physiol (1985). 2019; 126(4):1088-1094. DOI: 10.1152/japplphysiol.00968.2018. View

13.

Dhana K, Berghout M, Peeters A, Ikram M, Tiemeier H, Hofman A . Obesity in older adults and life expectancy with and without cardiovascular disease. Int J Obes (Lond). 2016; 40(10):1535-1540. DOI: 10.1038/ijo.2016.94. View

14.

Kraus W, Powell K, Haskell W, Janz K, Campbell W, Jakicic J . Physical Activity, All-Cause and Cardiovascular Mortality, and Cardiovascular Disease. Med Sci Sports Exerc. 2019; 51(6):1270-1281. PMC: 6527136. DOI: 10.1249/MSS.0000000000001939. View

15.

Wanders L, Gijbels A, Bakker E, Trouwborst I, Jardon K, Manusama K . Physical activity and sedentary behavior show distinct associations with tissue-specific insulin sensitivity in adults with overweight. Acta Physiol (Oxf). 2023; 237(4):e13945. DOI: 10.1111/apha.13945. View

16.

Kelly R, Kelly M, Kelly P . Metabolomics, physical activity, exercise and health: A review of the current evidence. Biochim Biophys Acta Mol Basis Dis. 2020; 1866(12):165936. PMC: 7680392. DOI: 10.1016/j.bbadis.2020.165936. View

17.

Afshin A, Reitsma M, Murray C . Health Effects of Overweight and Obesity in 195 Countries. N Engl J Med. 2017; 377(15):1496-7. DOI: 10.1056/NEJMc1710026. View

18.

Han J, Ju Y, Lee S . Physical activity, sedentary behavior, and cardiovascular disease risk in Korea: a trajectory analysis. Epidemiol Health. 2023; 45:e2023028. PMC: 10266925. DOI: 10.4178/epih.e2023028. View

19.

Li Y, Wang J, Cai Y, Chen H . Association of Serum Vitamin D With Periodontal Disease. Int Dent J. 2023; 73(5):777-783. PMC: 10509416. DOI: 10.1016/j.identj.2023.06.004. View

20.

Gebel K, Ding D, Chey T, Stamatakis E, Brown W, Bauman A . Effect of Moderate to Vigorous Physical Activity on All-Cause Mortality in Middle-aged and Older Australians. JAMA Intern Med. 2015; 175(6):970-7. DOI: 10.1001/jamainternmed.2015.0541. View