Meta-Analysis

. 2024 Jun;67(6):1051-1065.

doi: 10.1007/s00125-024-06090-y. Epub 2024 Mar 13.

Relationship of device measured physical activity type and posture with cardiometabolic health markers: pooled dose-response associations from the Prospective Physical Activity, Sitting and Sleep Consortium

Matthew N Ahmadi^{1

2}, Joanna M Blodgett³, Andrew J Atkin⁴, Hsiu-Wen Chan⁵, Borja Del Pozo Cruz^{6

7

8}, Kristin Suorsa^{9

10}, Esmee A Bakker^{11

12}, Richard M Pulsford¹³, Gregore I Mielke⁵, Peter J Johansson^{14

15}, Pasan Hettiarachchi¹⁴, Dick H J Thijssen¹¹, Sari Stenholm^{9

10}, Gita D Mishra⁵, Armando Teixeira-Pinot¹⁶, Vegar Rangul¹⁷, Lauren B Sherar¹⁸, Ulf Ekelund^{19

20}, Alun D Hughes^{21

22

23}, I-Min Lee^{24

25}; ProPASS collaboration; Andreas Holtermann²⁶, Annemarie Koster²⁷, Mark Hamer³, Emmanuel Stamatakis^{28

29}

Affiliations

¹ Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. matthew.ahmadi@sydney.edu.au.
² School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. matthew.ahmadi@sydney.edu.au.
³ Institute of Sport, Exercise and Health, Division of Surgery and Interventional Sciences, UCL, London, UK.
⁴ School of Health Sciences and Norwich Epidemiology Centre, University of East Anglia, Norwich, UK.
⁵ School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
⁶ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁷ Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Cádiz, Spain.
⁸ Faculty of Education, University of Cádiz, Cádiz, Spain.
⁹ Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
¹⁰ Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
¹¹ Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands.
¹² Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.
¹³ Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
¹⁴ Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
¹⁵ Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden.
¹⁶ School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
¹⁷ HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
¹⁸ School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
¹⁹ Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
²⁰ Department of Chronic Diseases, Norwegian Public Health Institute, Oslo, Norway.
²¹ MRC Unit for Lifelong Health and Ageing, UCL Institute of Cardiovascular Science, UCL, London, UK.
²² UCL BHF Research Accelerator, University College London, London, UK.
²³ University College London Hospitals NIHR Biomedical Research Centre, London, UK.
²⁴ Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
²⁵ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
²⁶ National Research Centre for the Working Environment, Copenhagen, Denmark.
²⁷ Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
²⁸ Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
²⁹ School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

PMID: 38478050
PMCID: PMC11058050
DOI: 10.1007/s00125-024-06090-y

Meta-Analysis

Relationship of device measured physical activity type and posture with cardiometabolic health markers: pooled dose-response associations from the Prospective Physical Activity, Sitting and Sleep Consortium

Matthew N Ahmadi et al. Diabetologia. 2024 Jun.

. 2024 Jun;67(6):1051-1065.

doi: 10.1007/s00125-024-06090-y. Epub 2024 Mar 13.

Authors

Affiliations

¹ Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. matthew.ahmadi@sydney.edu.au.
² School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. matthew.ahmadi@sydney.edu.au.
³ Institute of Sport, Exercise and Health, Division of Surgery and Interventional Sciences, UCL, London, UK.
⁴ School of Health Sciences and Norwich Epidemiology Centre, University of East Anglia, Norwich, UK.
⁵ School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
⁶ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁷ Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Cádiz, Spain.
⁸ Faculty of Education, University of Cádiz, Cádiz, Spain.
⁹ Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
¹⁰ Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
¹¹ Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands.
¹² Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.
¹³ Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
¹⁴ Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
¹⁵ Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden.
¹⁶ School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
¹⁷ HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
¹⁸ School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
¹⁹ Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
²⁰ Department of Chronic Diseases, Norwegian Public Health Institute, Oslo, Norway.
²¹ MRC Unit for Lifelong Health and Ageing, UCL Institute of Cardiovascular Science, UCL, London, UK.
²² UCL BHF Research Accelerator, University College London, London, UK.
²³ University College London Hospitals NIHR Biomedical Research Centre, London, UK.
²⁴ Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
²⁵ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
²⁶ National Research Centre for the Working Environment, Copenhagen, Denmark.
²⁷ Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
²⁸ Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
²⁹ School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

PMID: 38478050
PMCID: PMC11058050
DOI: 10.1007/s00125-024-06090-y

Abstract

Aims/hypothesis: The aim of this study was to examine the dose-response associations of device-measured physical activity types and postures (sitting and standing time) with cardiometabolic health.

Methods: We conducted an individual participant harmonised meta-analysis of 12,095 adults (mean ± SD age 54.5±9.6 years; female participants 54.8%) from six cohorts with thigh-worn accelerometry data from the Prospective Physical Activity, Sitting and Sleep (ProPASS) Consortium. Associations of daily walking, stair climbing, running, standing and sitting time with a composite cardiometabolic health score (based on standardised z scores) and individual cardiometabolic markers (BMI, waist circumference, triglycerides, HDL-cholesterol, HbA_1c and total cholesterol) were examined cross-sectionally using generalised linear modelling and cubic splines.

Results: We observed more favourable composite cardiometabolic health (i.e. z score <0) with approximately 64 min/day walking (z score [95% CI] -0.14 [-0.25, -0.02]) and 5 min/day stair climbing (-0.14 [-0.24, -0.03]). We observed an equivalent magnitude of association at 2.6 h/day standing. Any amount of running was associated with better composite cardiometabolic health. We did not observe an upper limit to the magnitude of the dose-response associations for any activity type or standing. There was an inverse dose-response association between sitting time and composite cardiometabolic health that became markedly less favourable when daily durations exceeded 12.1 h/day. Associations for sitting time were no longer significant after excluding participants with prevalent CVD or medication use. The dose-response pattern was generally consistent between activity and posture types and individual cardiometabolic health markers.

Conclusions/interpretation: In this first activity type-specific analysis of device-based physical activity, ~64 min/day of walking and ~5.0 min/day of stair climbing were associated with a favourable cardiometabolic risk profile. The deleterious associations of sitting time were fully attenuated after exclusion of participants with prevalent CVD and medication use. Our findings on cardiometabolic health and durations of different activities of daily living and posture may guide future interventions involving lifestyle modification.

Keywords: Cardiometabolic health; Individual participant meta-analysis; Physical activity type; Posture; Running; Sitting; Stair climbing; Standing; Walking; Wearables.

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Figures

**Fig. 1**
Association of physical activity types (a) and posture (b) with overall cardiometabolic health. Adjusted for age, sex, smoking, alcohol consumption, sleep duration, self-rated health, medication use, prevalent CVD and cohort, and mutually adjusted for physical activity types and posture using the residual method. n=9001. Data shown are point estimates (95% CI). The horizontal dotted line indicates a z score of 0. Histograms represent the time distribution for each activity type and posture. Covariate effect size estimates are shown in ESM Table 4

**Fig. 2**
Association of physical activity types and posture with BMI (a) and waist circumference in men (b) and women (c). Adjusted for age, sex, smoking, alcohol consumption, sleep duration, self-rated health, medication use, prevalent CVD and cohort, and mutually adjusted for physical activity types and posture using the residual method. BMI, n=12,095; waist circumference, n=11,897. Data shown are point estimates (95% CI). Histograms represent the time distribution for each activity type and posture

**Fig. 3**
Association of physical activity types and posture with total cholesterol (a), triglyceride (b), HDL-cholesterol (c) and HbA_1c (d). Adjusted for age, sex, smoking, alcohol consumption, sleep duration, self-rated health, medication use, prevalent CVD and cohort, and mutually adjusted for physical activity types and posture using the residual method. Total cholesterol, n=10,728; triglycerides, n=9417; HDL-cholesterol, n=10,729; HbA_1c, n=10,346. Data shown are point estimates (95% CI). Histograms represent the time distribution for each activity type and posture

See this image and copyright information in PMC

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Relationship of device measured physical activity type and posture with cardiometabolic health markers: pooled dose-response associations from the Prospective Physical Activity, Sitting and Sleep Consortium

Affiliations

Relationship of device measured physical activity type and posture with cardiometabolic health markers: pooled dose-response associations from the Prospective Physical Activity, Sitting and Sleep Consortium

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous