Moderate Activity and Fitness, Not Sedentary Time, Are Independently Associated with Cardio-Metabolic Risk in U.S. Adults Aged 18–49
Abstract
:1. Introduction
2. Experimental Section
2.1. Study Population
2.2. Accelerometry
2.3. Cardiorespiratory Fitness
2.4. Cardio-Metabolic Outcomes
2.5. Covariates
2.6. Statistical Analysis
3. Results
Characteristic | Total (N = 543) | Men (N = 297) | Women (N = 246) | |||
---|---|---|---|---|---|---|
Age (years), mean ± SE | 32.19 | 0.57 | 32.02 | 0.91 | 32.37 | 0.73 |
Ethnicity, % | ||||||
non-Hispanic white | 70.35% | 69.18% | 71.61% | |||
non-Hispanic black | 11.04% | 11.13% | 10.95% | |||
Mexican American | 11.16% | 12.72% | 9.46% | |||
Other | 7.45% | 6.97% | 7.98% | |||
Waist Circumference (cm), mean ± SE | 92.74 | 0.63 | 96.74 | 0.86 | 88.40 | 0.62 |
Body Mass Index (kg/m2), mean ± SE | 27.05 | 0.25 | 27.56 | 0.28 | 26.51 | 0.35 |
Average valid wear time (min), mean ± SE | 851.87 | 4.50 | 861.68 | 5.82 | 841.21 | 8.62 |
Valid days, % | ||||||
N valid days = 1 | 6.81% | 5.72% | 8.13% | |||
N valid days = 2 | 7.73% | 8.42% | 6.91% | |||
N valid days ≥ 3 | 85.46% | 85.86% | 84.96% | |||
Percent Sedentary Time (%), mean ± SE | 53.20 | 0.50 | 51.44 | 0.78 | 55.11 | 0.66 |
Sedentary Time per day (min), mean ± SE | 455.03 | 4.90 | 444.61 | 5.52 | 466.36 | 7.19 |
Percent MVPA a (%), mean ± SE | 4.13 | 0.17 | 5.11 | 0.23 | 3.06 | 0.14 |
MVPA a during day (min) , mean ± SE | 35.07 | 1.40 | 43.82 | 1.96 | 25.55 | 1.30 |
Fitness (mL/kg/min) , mean ± SE | 39.31 | 0.49 | 42.62 | 0.43 | 35.71 | 0.70 |
SBP b (mmHg), mean ± SE | 113.66 | 0.41 | 117.18 | 1.02 | 109.83 | 0.60 |
DBP b (mmHg), mean ± SE | 69.27 | 0.56 | 70.65 | 0.68 | 67.76 | 0.79 |
Fasting Glucose (mmoL/L), mean ± SE | 5.11 | 0.03 | 5.25 | 0.04 | 4.96 | 0.04 |
HDL-cholesterol (mmoL/L), mean ± SE | 1.42 | 0.02 | 1.28 | 0.04 | 1.56 | 0.04 |
non-HDL-Cholesterol (mmoL/L), mean ± SE | 3.48 | 0.04 | 3.60 | 0.08 | 3.34 | 0.05 |
Triglycerides (mmoL/L) c, mean ± SE | 1.19 | 0.04 | 1.31 | 0.05 | 1.07 | 0.05 |
C-Reactive Protein (mg/L) c, mean ± SE | 1.44 | 0.09 | 1.16 | 0.11 | 1.82 | 0.11 |
Metabolic syndrome, % | 16.77% | 19.40% | 13.91% |
Independent variable | Cardio-metabolic marker | Quartile 1 (Lowest) | Quartile 2 | Quartile 3 | Quartile 4 (Highest) | p * | ||||
---|---|---|---|---|---|---|---|---|---|---|
Mean | SE | Mean | SE | Mean | SE | Mean | SE | |||
% Sedentary Time | Waist Circumference (cm) | 92.20 | 1.07 | 92.75 | 1.72 | 93.93 | 1.22 | 91.90 | 2.08 | 0.65 |
Body Mass Index (kg/m2) | 26.77 | 0.41 | 27.48 | 0.76 | 27.29 | 0.44 | 26.62 | 0.71 | 0.72 | |
SBP a (mmHg) | 113.35 | 1.25 | 114.57 | 1.13 | 113.09 | 0.88 | 113.69 | 0.95 | 0.78 | |
DBP a (mmHg) | 68.98 | 1.00 | 70.12 | 0.96 | 69.29 | 0.91 | 68.59 | 1.18 | 0.76 | |
Fasting Glucose (mmoL/L) | 5.16 | 0.06 | 5.08 | 0.05 | 5.11 | 0.06 | 5.08 | 0.05 | 0.71 | |
HDL-cholesterol (mmoL/L) | 1.45 | 0.04 | 1.47 | 0.04 | 1.39 | 0.04 | 1.35 | 0.03 | 0.10 | |
non-HDL-Cholesterol (mmoL/L) | 3.39 | 0.10 | 3.36 | 0.11 | 3.60 | 0.10 | 3.56 | 0.13 | 0.49 | |
Triglycerides (mmoL/L) b | 1.09 | 0.06 | 1.15 | 0.06 | 1.21 | 0.07 | 1.32 | 0.08 | 0.27 | |
C-Reactive Protein (mg/L) b | 1.23 | 0.12 | 1.43 | 0.18 | 1.67 | 0.11 | 1.45 | 0.15 | 0.20 | |
% MVPA | Waist Circumference (cm) | 95.70 | 2.30 | 94.03 | 1.67 | 93.71 | 1.00 | 87.29 | 1.09 | <0.01 |
Body Mass Index (kg/m2) | 28.45 | 0.87 | 27.51 | 0.75 | 27.20 | 0.36 | 24.94 | 0.32 | <0.01 | |
SBP a (mmHg) | 116.01 | 0.81 | 112.21 | 1.36 | 113.45 | 0.71 | 112.86 | 1.44 | 0.13 | |
DBP a (mmHg) | 70.91 | 0.96 | 68.54 | 0.88 | 70.55 | 0.93 | 67.04 | 0.90 | <0.01 | |
Fasting Glucose (mmoL/L) | 5.21 | 0.07 | 5.11 | 0.04 | 5.09 | 0.04 | 5.02 | 0.05 | 0.09 | |
HDL-cholesterol (mmoL/L) | 1.35 | 0.06 | 1.32 | 0.04 | 1.40 | 0.05 | 1.60 | 0.05 | <0.01 | |
non-HDL-Cholesterol (mmoL/L) | 3.68 | 0.09 | 3.49 | 0.11 | 3.44 | 0.09 | 3.27 | 0.07 | 0.03 | |
Triglycerides (mmoL/L) b | 1.33 | 0.07 | 1.28 | 0.06 | 1.14 | 0.06 | 1.01 | 0.05 | 0.01 | |
C-Reactive Protein (mg/L) b | 2.00 | 0.12 | 1.49 | 0.12 | 1.34 | 0.17 | 1.04 | 0.12 | <0.01 | |
Fitness | Waist Circumference (cm) | 98.07 | 1.53 | 92.95 | 2.18 | 91.35 | 1.31 | 87.83 | 1.27 | <0.01 |
Body Mass Index (kg/m2) | 29.26 | 0.79 | 26.96 | 0.68 | 26.52 | 0.55 | 25.21 | 0.47 | <0.01 | |
SBP a (mmHg) | 116.36 | 1.68 | 113.49 | 1.07 | 113.03 | 0.94 | 111.44 | 1.03 | 0.19 | |
DBP a (mmHg) | 70.88 | 1.09 | 70.10 | 0.85 | 69.68 | 1.38 | 65.64 | 0.83 | <0.01 | |
Fasting Glucose (mmoL/L) | 5.23 | 0.05 | 5.11 | 0.06 | 5.08 | 5.01 | 5.01 | 0.07 | 0.05 | |
HDL-cholesterol (mmoL/L) | 1.42 | 0.05 | 1.38 | 0.05 | 1.41 | 0.05 | 1.45 | 0.06 | 0.83 | |
non-HDL-Cholesterol (mmoL/L) | 3.67 | 0.09 | 3.53 | 0.15 | 3.53 | 0.11 | 3.11 | 0.09 | 0.01 | |
Triglycerides (mmoL/L) b | 1.26 | 0.07 | 1.27 | 0.10 | 1.17 | 0.06 | 1.02 | 0.06 | 0.12 | |
C-Reactive Protein (mg/L) b | 2.24 | 0.16 | 1.39 | 0.12 | 1.41 | 0.13 | 0.90 | 0.11 | <0.01 |
Independent variable | Cardio-metabolic marker | Model 1 | Model 2 | Model 2 + Sedentary Time | Model 2 + MVPA | Model 2 + Fitness | Model 2 + MVPA + Fitness | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
β | p | β | p | β | p | β | p | β | p | ||||
% Sedentary Time | Waist Circumference (cm) | −0.011 | 0.84 | −0.074 | 0.21 | −0.019 | 0.74 | −0.072 | 0.23 | ||||
Body Mass Index (kg/m2) | −0.004 | 0.94 | −0.070 | 0.29 | −0.012 | 0.85 | −0.067 | 0.31 | |||||
Systolic Blood Pressure (mmHg) | 0.006 | 0.91 | 0.007 | 0.91 | 0.030 | 0.64 | 0.002 | 0.96 | 0.030 | 0.63 | |||
Diastolic Blood Pressure (mmHg) | −0.006 | 0.90 | −0.005 | 0.92 | −0.009 | 0.87 | −0.008 | 0.87 | −0.009 | 0.87 | |||
Fasting Glucose (mmoL/L) | −0.043 | 0.15 | −0.043 | 0.13 | −0.058 | 0.04 | −0.043 | 0.11 | −0.058 | 0.04 | |||
HDL-cholesterol (mmoL/L) | −0.080 | 0.11 | −0.080 | 0.05 | −0.044 | 0.28 | −0.080 | 0.04 | −0.044 | 0.27 | |||
non-HDL-Cholesterol (mmoL/L) | 0.127 | 0.09 | 0.127 | 0.11 | 0.116 | 0.12 | 0.112 | 0.12 | 0.116 | 0.12 | |||
Log Triglycerides (mmoL/L) | 0.080 | 0.04 | 0.080 | 0.03 | 0.055 | 0.10 | 0.067 | 0.04 | 0.055 | 0.11 | |||
Log C-Reactive Protein (mg/L) | 0.055 | 0.07 | 0.055 | 0.06 | 0.047 | 0.14 | 0.055 | 0.07 | 0.047 | 0.13 | |||
Model 2 + Sedentary Time + Fitness | |||||||||||||
% MVPA | Waist Circumference (cm) | −0.226 | <0.01 | −0.260 | <0.01 | −0.188 | 0.01 | −0.221 | <0.01 | ||||
Body Mass Index (kg/m2) | −0.239 | <0.01 | −0.271 | <0.01 | −0.205 | <0.01 | −0.236 | <0.01 | |||||
Systolic Blood Pressure (mmHg) | 0.000 | 1.00 | 0.081 | 0.27 | 0.095 | 0.21 | 0.101 | 0.19 | 0.115 | 0.15 | |||
Diastolic Blood Pressure (mmHg) | −0.048 | 0.29 | −0.012 | 0.78 | −0.017 | 0.75 | −0.001 | 0.99 | −0.005 | 0.92 | |||
Fasting Glucose (mmoL/L) | −0.080 | 0.02 | −0.050 | 0.07 | −0.078 | 0.01 | −0.043 | 0.13 | −0.070 | 0.03 | |||
HDL-cholesterol (mmoL/L) | 0.206 | <0.01 | 0.144 | <0.01 | 0.123 | 0.01 | 0.155 | <0.01 | 0.134 | <0.01 | |||
non-HDL-Cholesterol (mmoL/L) | −0.154 | 0.13 | −0.078 | 0.47 | −0.023 | 0.82 | −0.068 | 0.54 | −0.013 | 0.90 | |||
Log Triglycerides (mmoL/L) | −0.162 | <0.01 | −0.108 | 0.01 | −0.082 | 0.02 | −0.098 | 0.01 | −0.072 | 0.03 | |||
Log C-Reactive Protein (mg/L) | −0.125 | <0.01 | −0.061 | 0.07 | −0.038 | 0.27 | −0.046 | 0.19 | −0.024 | 0.51 | |||
Model 2 + Sedentary Time + MVPA | |||||||||||||
Fitness | Waist Circumference (cm) | −0.287 | <0.01 | −0.287 | <0.01 | −0.259 | <0.01 | −0.258 | <0.01 | ||||
Body Mass Index (kg/m2) | −0.266 | <0.01 | −0.266 | <0.01 | −0.236 | <0.01 | −0.235 | <0.01 | |||||
Systolic Blood Pressure (mmHg) | −0.241 | <0.01 | −0.159 | 0.03 | −0.159 | 0.03 | −0.171 | 0.03 | −0.171 | 0.03 | |||
Diastolic Blood Pressure (mmHg) | −0.135 | 0.01 | −0.098 | 0.08 | −0.098 | 0.09 | −0.098 | 0.09 | −0.098 | 0.09 | |||
Fasting Glucose (mmoL/L) | −0.099 | 0.02 | −0.071 | 0.07 | −0.071 | 0.06 | −0.060 | 0.11 | −0.060 | 0.10 | |||
HDL-cholesterol (mmoL/L) | 0.000 | 0.91 | −0.079 | 0.09 | −0.079 | 0.07 | −0.089 | 0.03 | −0.089 | 0.03 | |||
non-HDL-Cholesterol (mmoL/L) | −0.180 | 0.02 | −0.097 | 0.20 | −0.083 | 0.22 | −0.086 | 0.26 | −0.086 | 0.24 | |||
Log Triglycerides (mmoL/L) | −0.158 | <0.01 | −0.092 | <0.01 | −0.092 | <0.01 | −0.086 | 0.01 | −0.086 | <0.01 | |||
Log C-Reactive Protein (mg/L) | −0.200 | <0.01 | −0.130 | <0.01 | −0.124 | <0.01 | −0.124 | <0.01 | −0.124 | <0.01 |
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Li, J.; Siegrist, J. Physical activity and risk of cardiovascular disease—A meta-analysis of prospective cohort studies. Int. J. Environ. Res. Public Health 2012, 9, 391–407. [Google Scholar] [CrossRef] [PubMed]
- Warburton, D.E.; Nicol, C.W.; Bredin, S.S. Health benefits of physical activity: The evidence. CMAJ 2006, 174, 801–809. [Google Scholar] [CrossRef] [PubMed]
- Physical Activity Guidelines Advisory Committee Report, 2008. Available online: http://www.Health.Gov/paguidelines/report/pdf/committeereport.Pdf (accessed on 20 November 2014).
- Hamilton, M.T.; Healy, G.N.; Dunstan, D.W.; Zderic, T.W.; Owen, N. Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behavior. Curr. Cardiovasc. Risk Rep. 2008, 2, 292–298. [Google Scholar] [CrossRef] [PubMed]
- Pate, R.R.; O’Neill, J.R.; Lobelo, F. The evolving definition of “sedentary”. Exerc. Sport Sci. Rev. 2008, 36, 173–178. [Google Scholar] [CrossRef] [PubMed]
- Bankoski, A.; Harris, T.B.; McClain, J.J.; Brychta, R.J.; Caserotti, P.; Chen, K.Y.; Berrigan, D.; Troiano, R.P.; Koster, A. Sedentary activity associated with metabolic syndrome independent of physical activity. Diabetes Care 2011, 34, 497–503. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Healy, G.N.; Matthews, C.E.; Dunstan, D.W.; Winkler, E.A.; Owen, N. Sedentary time and cardio-metabolic biomarkers in us adults: Nhanes 2003–2006. Eur. Heart J. 2011, 32, 590–597. [Google Scholar] [CrossRef] [PubMed]
- Gennuso, K.P.; Gangnon, R.E.; Matthews, C.E.; Thraen-Borowski, K.M.; Colbert, L.H. Sedentary behavior, physical activity, and markers of health in older adults. Med. Sci. Sport. Exercise 2013, 45, 1493–1500. [Google Scholar] [CrossRef]
- Owen, N.; Healy, G.N.; Matthews, C.E.; Dunstan, D.W. Too much sitting: The population-health science of sedentary behavior. Exerc. Sport Sci. Rev. 2010, 38, 105–113. [Google Scholar] [CrossRef] [PubMed]
- LaMonte, M.J.; Barlow, C.E.; Jurca, R.; Kampert, J.B.; Church, T.S.; Blair, S.N. Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome a prospective study of men and women. Circulation 2005, 112, 505–512. [Google Scholar] [CrossRef] [PubMed]
- Lee, D.; Sui, X.; Ortega, F.; Kim, Y.; Church, T.; Winett, R.; Ekelund, U.; Katzmarzyk, P.; Blair, S. Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women. Brit. J. Sport. Med. 2011, 45, 504–510. [Google Scholar] [CrossRef]
- Lee, D.-C.; Sui, X.; Artero, E.G.; Lee, I.-M.; Church, T.S.; McAuley, P.A.; Stanford, F.C.; Kohl, H.W.; Blair, S.N. Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men the aerobics center longitudinal study. Circulation 2011, 124, 2483–2490. [Google Scholar] [CrossRef] [PubMed]
- Minder, C.M.; Shaya, G.E.; Michos, E.D.; Keenan, T.E.; Blumenthal, R.S.; Nasir, K.; Carvalho, J.A.; Conceição, R.D.; Santos, R.D.; Blaha, M.J. Relation between self-reported physical activity level, fitness, and cardiometabolic risk. Amer. J. Cardiol. 2014, 113, 637–643. [Google Scholar] [CrossRef] [PubMed]
- Sassen, B.; Cornelissen, V.A.; Kiers, H.; Wittink, H.; Kok, G.; Vanhees, L. Physical fitness matters more than physical activity in controlling cardiovascular disease risk factors. Eur. J. Cardiovasc. Prev. Rehabil. 2009, 16, 677–683. [Google Scholar] [CrossRef] [PubMed]
- Williams, P.T. Physical fitness and activity as separate heart disease risk factors: A meta-analysis. Med. Sci. Sport. Exercise 2001, 33, 754–761. [Google Scholar] [CrossRef]
- National Health and Nutrition Examination Survey Data Nhanes 2003–2004. Available online: Http://wwwn.Cdc.Gov/nchs/nhanes/search/nhanes03_04.Aspx (accessed on 20 November 2014).
- Troiano, R.P.; Berrigan, D.; Dodd, K.W.; Masse, L.C.; Tilert, T.; McDowell, M. Physical activity in the United States measured by accelerometer. Med. Sci. Sport. Exercise 2008, 40, 181–188. [Google Scholar] [CrossRef]
- National Health and Nutrition Examination Survey: Cardiovascular Fitness Procedures Manual. Available online: http://www.Cdc.Gov/nchs/nhanes/nhanes20032004/cvx_c.Htm#protocol_and_procedure (accessed on 20 November 2014).
- Grundy, S.M.; Cleeman, J.I.; Daniels, S.R.; Donato, K.A.; Eckel, R.H.; Franklin, B.A.; Gordon, D.J.; Krauss, R.M.; Savage, P.J.; Smith, S.C. Diagnosis and management of the metabolic syndrome an American heart association/national heart, lung, and blood institute scientific statement. Circulation 2005, 112, 2735–2752. [Google Scholar] [CrossRef] [PubMed]
- Nelson, R.K.; Horowitz, J.F.; Holleman, R.G.; Swartz, A.M.; Strath, S.J.; Kriska, A.M.; Richardson, C.R. Daily physical activity predicts degree of insulin resistance: A cross-sectional observational study using the 2003–2004 national health and nutrition examination survey. Int. J. Behav. Nutr. Phys. Act. 2013, 10. [Google Scholar] [CrossRef] [PubMed]
- Bring, J. How to standardize regression coefficients. Amer. Stat. 1994, 48, 209–213. [Google Scholar]
- Ford, E.S.; Caspersen, C.J. Sedentary behaviour and cardiovascular disease: A review of prospective studies. Int. J. Epidemiol. 2012, 41, 1338–1353. [Google Scholar] [CrossRef] [PubMed]
- Thorp, A.A.; Owen, N.; Neuhaus, M.; Dunstan, D.W. Sedentary behaviors and subsequent health outcomes in adults: A systematic review of longitudinal studies, 1996–2011. Amer. J. Prev. Med. 2011, 41, 207–215. [Google Scholar] [CrossRef]
- Healy, G.N.; Wijndaele, K.; Dunstan, D.W.; Shaw, J.E.; Salmon, J.; Zimmet, P.Z.; Owen, N. Objectively measured sedentary time, physical activity, and metabolic risk the Australian diabetes, obesity and lifestyle study (AUSDIAB). Diabetes Care 2008, 31, 369–371. [Google Scholar] [CrossRef] [PubMed]
- Helmerhorst, H.J.; Wijndaele, K.; Brage, S.; Wareham, N.J.; Ekelund, U. Objectively measured sedentary time may predict insulin resistance independent of moderate-and vigorous-intensity physical activity. Diabetes 2009, 58, 1776–1779. [Google Scholar] [CrossRef] [PubMed]
- Koster, A.; Caserotti, P.; Patel, K.V.; Matthews, C.E.; Berrigan, D.; van Domelen, D.R.; Brychta, R.J.; Chen, K.Y.; Harris, T.B. Association of sedentary time with mortality independent of moderate to vigorous physical activity. PLoS One 2012, 7. [Google Scholar] [CrossRef] [PubMed]
- Scheers, T.; Philippaerts, R.; Lefevre, J. Sensewear-determined physical activity and sedentary behavior and metabolic syndrome. Med. Sci. Sport. Exercise 2013, 45, 481–489. [Google Scholar] [CrossRef]
- Ekelund, U.; Luan, J.; Sherar, L.B.; Esliger, D.W.; Griew, P.; Cooper, A.; International Children’s Accelerometry Database (ICAD) Collaborators. Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents. JAMA 2012, 307, 704–712. [Google Scholar] [CrossRef] [PubMed]
- Blair, S.N.; Kampert, J.B.; Kohl, H.W.; Barlow, C.E.; Macera, C.A.; Paffenbarger, R.S.; Gibbons, L.W. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 1996, 276, 205–210. [Google Scholar] [CrossRef] [PubMed]
- Haskell, W.L.; Lee, I.-M.; Pate, R.R.; Powell, K.E.; Blair, S.N.; Franklin, B.A.; Macera, C.A.; Heath, G.W.; Thompson, P.D.; Bauman, A. Physical activity and public health: Updated recommendation for adults from the american college of sports medicine and the american heart association. Circulation 2007, 116, 1423–1434. [Google Scholar]
- Ekblom-Bak, E.; Hellenius, M.-L.; Ekblom, O.; Engström, L.-M.; Ekblom, B. Independent associations of physical activity and cardiovascular fitness with cardiovascular risk in adults. Eur. J. Cardiovasc. Prev. Rehabil. 2010, 17, 175–180. [Google Scholar] [CrossRef] [PubMed]
- O’Donovan, G.; Hillsdon, M.; Ukoumunne, O.C.; Stamatakis, E.; Hamer, M. Objectively measured physical activity, cardiorespiratory fitness and cardiometabolic risk factors in the health survey for England. Prev. Med. 2013, 57, 201–205. [Google Scholar] [CrossRef] [PubMed]
- Lavie, C.J.; Church, T.S.; Milani, R.V.; Earnest, C.P. Impact of physical activity, cardiorespiratory fitness, and exercise training on markers of inflammation. JCRP 2011, 31, 137–145. [Google Scholar] [PubMed]
- Myers, J.; Kaykha, A.; George, S.; Abella, J.; Zaheer, N.; Lear, S.; Yamazaki, T.; Froelicher, V. Fitness versus physical activity patterns in predicting mortality in men. Amer. J. Med. 2004, 117, 912–918. [Google Scholar] [CrossRef] [PubMed]
- Bouchard, C.; Rankinen, T. Individual differences in response to regular physical activity. Med. Sci. Sport. Exercise 2001, 33, S446–S451. [Google Scholar] [CrossRef]
- Blair, S.N.; Cheng, Y.; Holder, J.S. Is physical activity or physical fitness more important in defining health benefits? Med. Sci. Sport. Exercise 2001, 33, S379–S399. [Google Scholar] [CrossRef]
- Franks, P.W.; Ekelund, U.; Brage, S.; Wong, M.-Y.; Wareham, N.J. Does the association of habitual physical activity with the metabolic syndrome differ by level of cardiorespiratory fitness? Diabetes Care 2004, 27, 1187–1193. [Google Scholar] [CrossRef] [PubMed]
- Shephard, R.J. Limits to the measurement of habitual physical activity by questionnaires. Brit. J. Sport. Med. 2003, 37, 197–206. [Google Scholar] [CrossRef]
- Faulkner, J.; Parfitt, G.; Eston, R. Prediction of maximal oxygen uptake from the ratings of perceived exertion and heart rate during a perceptually-regulated sub-maximal exercise test in active and sedentary participants. Eur. J. Appl. Physiol. 2007, 101, 397–407. [Google Scholar] [CrossRef] [PubMed]
- Tudor-Locke, C.; Camhi, S.M.; Troiano, R.P. A catalog of rules, variables, and definitions applied to accelerometer data in the national health and nutrition examination survey, 2003–2006. Prev. Chronic Dis. 2012, 9. [Google Scholar] [CrossRef]
- Li, J.; Loerbroks, A.; Angerer, P. Physical activity and risk of cardiovascular disease: What does the new epidemiological evidence show? Curr. Opin. Cardiol. 2013, 28, 575–583. [Google Scholar] [CrossRef] [PubMed]
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Van der Velde, J.H.P.M.; Savelberg, H.H.C.M.; Schaper, N.C.; Koster, A. Moderate Activity and Fitness, Not Sedentary Time, Are Independently Associated with Cardio-Metabolic Risk in U.S. Adults Aged 18–49. Int. J. Environ. Res. Public Health 2015, 12, 2330-2343. https://doi.org/10.3390/ijerph120302330
Van der Velde JHPM, Savelberg HHCM, Schaper NC, Koster A. Moderate Activity and Fitness, Not Sedentary Time, Are Independently Associated with Cardio-Metabolic Risk in U.S. Adults Aged 18–49. International Journal of Environmental Research and Public Health. 2015; 12(3):2330-2343. https://doi.org/10.3390/ijerph120302330
Chicago/Turabian StyleVan der Velde, Jeroen H. P. M., Hans H. C. M. Savelberg, Nicolaas C. Schaper, and Annemarie Koster. 2015. "Moderate Activity and Fitness, Not Sedentary Time, Are Independently Associated with Cardio-Metabolic Risk in U.S. Adults Aged 18–49" International Journal of Environmental Research and Public Health 12, no. 3: 2330-2343. https://doi.org/10.3390/ijerph120302330