Contributions of changes in physical activity, sedentary time, diet and body weight to changes in cardiometabolic risk

Andersen, E. et al. (2021) Contributions of changes in physical activity, sedentary time, diet and body weight to changes in cardiometabolic risk. International Journal of Behavioral Nutrition and Physical Activity, 18, 166. (doi: 10.1186/s12966-021-01237-1)

Abstract

Background: Increased physical activity (PA), reduced time spent sedentary (SED), healthier diet and reduced body weight may all have a positive impact on cardiometabolic risk. The relative importance of change in each of these variables on cardiometabolic risk, however, is unclear. We therefore sought to investigate the relative contributions of changes in PA, SED, diet and body weight on cardiometabolic risk. Methods: This is a secondary analysis of data collected from the EuroFIT randomised controlled trial, which was a 12-week group-based lifestyle intervention for overweight middle-aged men delivered by coaches in football club stadia aiming to improve PA, SED, diet, and body weight. PA and SED were assessed by accelerometry, diet using the Dietary Instrument for Nutrition Education (DINE). An overall cardiometabolic risk score was derived from combining z-scores for glucose, HbA1c, insulin, lipids and blood pressure. In total, 707 men (from the overall cohort of 1113) with complete data for these variables at baseline and 12-month follow-up were included in the multivariable linear regression analyses. Results: In multivariable analyses, change in number of steps (explaining 5.1% of R2) and dietary factors (less alcohol, fatty and sugary food, and more fruit and vegetables) (together explaining 4.5% of R2), but not changes in standing time or SED, were significantly associated with change in body weight. Changes in number of steps (R2 = 1.7%), fatty food score (R2 = 2.4%), and sugary food score (R2 = 0.4%) were significantly associated with change in cardiometabolic risk score in univariable models. However, in multivariable models which included changes in weight as well as changes in steps and dietary variables, change in weight explained a substantially larger proportion of the change in cardiometabolic risk score, explaining 14.1% of R2 (out of an overall model R2 of 19.0%). When baseline (as well as change) values were also included in the model, 38.8% of R2 for change in cardiometabolic risk score was explained overall, with 14.1% of R2 still explained by change in weight. Conclusion: Change in body weight, together with baseline cardiometabolic risk explained most of the change in cardiometabolic risk. Thus, the benefits of increasing physical activity and improving diet on cardiometabolic risk appear to act largely via an effect on changes in body weight. Trial registration: International Standard Randomised Controlled Trials, ISRCTN-81935608. Registered 06052015. https://www.isrctn.com/ISRCTN81935608?q=&filters=recruitmentCountry:Portugal&sort=&offset=7&totalResults=92&page=1&pageSize=10&searchType=basic-search.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wyke, Professor Sally and Gray, Professor Cindy and McConnachie, Professor Alex and Gill, Professor Jason and Sattar, Professor Naveed
• Authors: Andersen, E., van der Ploeg, H. P., van Mechelen, W., Gray, C. M., Mutrie, N., van Nassau, F., Jelsma, J. G. M., Anderson, A. S., Silva, M. N., Pereira, H. V., McConnachie, A., Sattar, N., Sørensen, M., Røynesdal, Ø. B., Hunt, K., Roberts, G. C., Wyke, S., and Gill, J. M.R.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Social Scientists working in Health and Wellbeing
• Journal Name: International Journal of Behavioral Nutrition and Physical Activity
• Publisher: BioMed Central
• ISSN: 1479-5868
• ISSN (Online): 1479-5868
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in International Journal of Behavioral Nutrition and Physical Activity 18: 166
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
190675		EUROFIT: Social innovation to improve physical activity and sedentary behaviour through elite European football	Sally Wyke	European Commission (EC)	602170	S&PS - Institute of Health & Wellbeing (Social Sciences)