Associations between multiple positive health behaviours and cardiometabolic risk using three alternative measures of physical activity: NHANES 2005–2006

Abstract

Purpose: The study aimed to investigate the association between clustered cardiometabolic risk (CCMR) and health-behavior indices comprising three different measures of physical activity, screen time, diet and sleep in NHANES 2005-2006. Methods: CCMR was calculated by standardizing and summarizing measures of blood pressure, fasting glucose, triglycerides, insulin, high-density lipoprotein and waist circumference to create a Z-score. Three health behavior indices were constructed with a single point allocated to each of the following lower risk behaviors: muscle strengthening activity, healthy eating score, sleep disorder/disruption, sleep duration, screen time and physical activity (self-reported moderate-to-vigorous physical activity [MVPA] (Index Score-SR), accelerometer-measured MVPA (Index Score-MVPA) or accelerometer-measured steps Index Score-Steps). Linear regression models explored associations between index scores and CCMR. Results: In the sample (n=1537, 52% male, aged 45.5 [SE:0.9] years), reporting 0-5 vs. 6 health behaviors using Index Score-SR and Index Score-MVPA, and 0-4 vs. 6 health behaviors using Index Score-Steps, were associated with a significantly higher CCMR. The beta (β [95%CI]) for zero vs. six behaviors were: Index Score-SR (2.86 [2.02, 3.69], Index Score-MVPA (2.41 [1.49, 3.33] and Index Score-Steps (2.41 [1.68, 3.15]). Conclusion: Irrespective of the measure of physical activity, engaging in fewer positive health behaviors was associated with greater CCMR. Novelty bullets • Physical activity, screen time, diet and sleep may exert synergistic/cumulative effects on clustered cardiometabolic risk. • A greater number of positive health behaviors was associated with a lower clustered cardiometabolic risk factor score. • The reduction in cardiometabolic risk was similar irrespective of which physical activity measure was used.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author