Cardiometabolic risk describes a collection of factors known to increase the likelihood of cardiovascular disease. It includes lipid and glucose metabolism as well as adiposity and hypertension.
We know that being more physically active is associated with lower cardiometabolic risk. However, it is not clear whether more specific or tailored physical activity guidance can be given in relation to cardiometabolic risk. Further, given the increasing prevalence of chronic disease, there is need to focus research on those with chronic disease. Indeed, this was highlighted in the most recent World Health Organization physical activity guidelines. Thus, our study included two groups — people with and people without chronic disease. We explored whether overall physical activity or the intensity of activity was more strongly associated with lower cardiometabolic risk in both these groups.
Our study, published in Medicine & Science in Sports & Exercise®, used data from existing trial datasets from the Leicester Diabetes Centre in the U.K. We used data from wrist-worn physical activity monitors, taken from a sample of over 1,500 adults with and without a chronic disease. From these data, we generated metrics that describe overall physical activity and the distribution of activity intensity across the day. These metrics can be used to gain insight into whether the intensity or overall level of physical activity is more important for health, or whether they are both important.
In addition to the physical activity data, we generated a clustered cardiometabolic risk score incorporating waist circumference, mean arterial pressure, haemoglobin A1c, triglycerides, and HDL cholesterol. We determined whether associations between cardiometabolic risk and physical activity differed between those with and without a chronic disease.
We found that in people without a chronic disease, both more overall and more intense physical activity were associated with cardiometabolic risk. However, in those with a chronic disease, only more overall physical activity was associated with cardiometabolic risk. This implies that for those with a chronic disease, the focus should be on being more physically active even at low intensities, supporting “every minute counts” messaging. However, those who are healthy may gain extra benefit from incorporating higher intensity physical activity in their daily routines.
As with most guidance, contextualizing the information is important to improve uptake, (e.g., presenting this message in the form of walking). In those with a chronic disease, cardiometabolic risk was lower in those who walked for 60 minutes across the day, regardless of walking speed. For the healthy adults, risk was lower in those who were more physically active overall, but also accumulated at least 10 minutes of brisk walking.
Our results further support the importance of physical activity in relation to cardiometabolic risk. They also suggest that it may be appropriate to tailor the emphasis on intensity of physical activity according to health status. However, it should be noted that our results are cross-sectional. Thus, we cannot be sure whether the physical activity led to better health markers or vice versa. If confirmed, our results suggest that physical activity prescriptions could be tailored to specific populations and/or to intensity preferences.
Nathan Dawkins, PhD, is a lecturer in sport and exercise science at Leeds Trinity University and completed his Ph.D. at the Diabetes Research Centre, University of Leicester. His research focuses on developing methods for assessing physical activity using wearable accelerometer devices and understanding the role of physical activity in the prevention of chronic disease.
Alex Rowlands, PhD, is an associate professor at the Diabetes Research Centre, University of Leicester. His research focuses on the use of accelerometry-based wearable monitors to quantify human movement patterns and their associations with health. He is associate editor for the Journal for the Measurement of Physical Behaviours and Pediatric Exercise Science. He has been a member of ACSM since 2014.
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