Temporal physical activity patterns are associated with obesity in U.S. adults

Abstract

Few attempts have been made to incorporate multiple aspects of physical activity (PA) to classify patterns linked with health. Temporal PA patterns integrating time and activity counts were created to determine their association with health status. Accelerometry data from the National Health and Nutrition Examination Survey 2003-2006 was used to pattern PA counts and time of activity from 1999 adults with one weekday of activity. Dynamic time warping and kernel k-means clustering partitioned 4 participant clusters representing temporal PA patterns. Multivariate regression models determined associations between clusters and health status indicators and obesity, type 2 diabetes, and metabolic syndrome. Cluster 1 with a temporal PA pattern of the lowest activity counts reaching 4.8e⁴ cph from 6:00-23:00 was associated with higher body mass index (BMI) (β = 2.5 ± 0.6 kg/m², 95% CI: 1.0, 4.1), higher waist circumference (WC) (β = 6.4 ± 1.3 cm, 95% CI: 2.8, 10.0), and higher odds of obesity (OR: 2.4; 95% CI: 1.3, 4.4) compared with Cluster 3 with activity counts reaching 9.6e⁴-1.2e⁵ cph between 16:00-21:00. Cluster 1 was also associated with higher BMI (β = 1.5 ± 0.5 kg/m², 95% CI: 0.1, 2.8) and WC (β = 3.6 ± 1.3 cm, 95% CI: 0.1, 7.0) compared to Cluster 4 with activity counts reaching 9.6e⁴ cph between 8:00-11:00. A Temporal PA pattern with the lowest PA counts had significantly higher mean BMI and WC compared to temporal PA patterns of higher activity counts performed early (8:00-11:00) or late (16:00-21:00) throughout the day. Temporal PA patterns appear to meaningfully link to health status.

Keywords: Adults; Body mass index; Health status; Obesity; Physical activity patterns; Temporal; Timing; Waist circumference.

Fig. 1.

Heat maps for CDTW clusters (A-D) which depict activity counts ranging from 0 counts/hour (cph) to > 1.2e⁵ cph (y-axis) for U.S. adults ages 20–65 y as drawn from NHANES 2003–2006 over a 24-hour day from time 0=12:00 to 24:00 the next day (x-axis). The proportion of the sample is indicated by the inverse gray-scale legend with 0.0% of the cluster participants to 12.6% of the cluster participants.

Fig. 2.

Heat maps for CDTW clusters (C1-C4) which depict the distribution of the largest activity occasion within each cluster for U.S. adults ages 20–65 y as drawn from NHANES 2003–2006. The activity counts ranged from 0 cph to >1.2e⁵ cph(y-axis) over a 24-hour day from time 0=12:00 to 24:00 the next day (x-axis). The proportion of the sample is indicated by the inverse color-scale legend with 0.0% of the cluster participants to 6.1% of the cluster participants.