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Moderate-to-vigorous intensity physical activity from young adulthood to middle age and metabolic disease: a 30-year population-based cohort study
  1. Jason M Nagata1,
  2. Eric Vittinghoff2,
  3. Kelley Pettee Gabriel3,
  4. Andrea K Garber1,
  5. Andrew E Moran4,
  6. Jamal S Rana5,6,
  7. Jared P Reis7,
  8. Stephen Sidney6,
  9. Kirsten Bibbins-Domingo2
  1. 1Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
  2. 2Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
  3. 3Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
  4. 4Division of General Medicine, Columbia University, New York, New York, USA
  5. 5Division of Cardiology, Kaiser Permanente Northern California, Oakland, California, USA
  6. 6Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
  7. 7Division of Cardiovascular Sciences, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
  1. Correspondence to Dr Jason M Nagata, Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA; jason.nagata{at}ucsf.edu

Abstract

Objectives To determine the association between moderate-to-vigorous intensity physical activity (MVPA) trajectories (course over age and time) through the adult life course and onset of metabolic disease (diabetes and dyslipidaemia).

Methods We analysed prospective community-based cohort data of 5115 participants in the Coronary Artery Risk Development in Young Adults study, who were black and white men and women aged 18–30 years at baseline (1985–1986) at four urban sites, collected through 30 years of follow-up. Individualised MVPA trajectories were developed for each participant using linear mixed models.

Results Lower estimated MVPA score at age 18 was associated with a 12% (95% CI 6% to 18%) higher odds of incident diabetes, a 4% (95% CI 1% to 7%) higher odds of incident low high-density lipoprotein (HDL) and a 6% (95% CI 2% to 11%) higher odds of incident high triglycerides. Each additional annual 1-unit reduction in the MVPA score was associated with a 6% (95% CI 4% to 9%) higher annual odds of diabetes incidence and a 4% (95% CI 2% to 6%) higher annual odds of high triglyceride incidence. Analysing various MVPA trajectory groups, participants who were in the most active group at age 18 (over 300 min/week), but with sharp declines in midlife, had higher odds of high low-density lipoprotein and low HDL incidence, compared with those in the most active group at age 18 with subsequent gains.

Conclusion Given recent trends in declining MVPA across the life course and associated metabolic disease risk, young adulthood is an important time period for interventions to increase and begin the maintenance of MVPA.

  • physical activity
  • exercise
  • diabetes
  • cholesterol

Data availability statement

Data may be obtained from a third party and are not publicly available. Data are available upon request and data use agreement with the CARDIA Study (https://www.cardia.dopm.uab.edu/).

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Data availability statement

Data may be obtained from a third party and are not publicly available. Data are available upon request and data use agreement with the CARDIA Study (https://www.cardia.dopm.uab.edu/).

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Footnotes

  • Twitter @jasonmnagata

  • Contributors JMN conducted the literature search, interpreted findings, and wrote, revised, and edited the manuscript. EV conceptualised the study, analysed data and edited the manuscript. KPG, SS, AKG, KB-D conceptualised the study, interpreted the data and provided critical revisions on the manuscript. AEM, JSR and JPR provided critical revisions on the manuscript. All authors approved the final draft.

  • Funding JMN is supported by the National Heart, Lung, and Blood Institute (K08HL159350) and the American Heart Association (CDA34760281). KB-D is supported by the National Institutes of Health (K24DK103992). The funders had no role in the study design. The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), the University of Minnesota (HHSN268201800006I) and the Kaiser Foundation Research Institute (HHSN268201800004I). This manuscript has been reviewed by CARDIA for scientific content.

  • Disclaimer The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health or the US Department of Health and Human Services.

  • Competing interests The authors have no conflicts of interest to report.

  • Patient and public involvement statement Patients or the public were not involved in the design, conduct, reporting or dissemination plans of our research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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