Assessment of leisure-time physical activity for the prediction of inflammatory status and cardiometabolic profile

doi:10.1016/j.jsams.2012.03.007

Journal of Science and Medicine in Sport

Volume 15, Issue 6, November 2012, Pages 511-518

https://doi.org/10.1016/j.jsams.2012.03.007 Get rights and content

Abstract

Objectives

Associations of leisure-time physical activity (LTPA), commuting and total physical activity with inflammatory markers, insulin resistance and metabolic profile in individuals at high cardiometabolic risk were investigated.

Design

This was a cross-sectional study.

Methods

A total of 193 prediabetic adults were compared according to physical activity levels measured by the international physical activity questionnaire; p for trend and logistic regression was employed.

Results

The most active subset showed lower BMI and abdominal circumference, reaching significance only for LTPA (p for trend = 0.02). Lipid profile improved with increased physical activity levels. Interleukin-6 decreased with increased total physical activity and LTPA (p for trend = 0.02 and 0.03, respectively), while adiponectin increased in more active subsets for LTPA (p for trend = 0.03). Elevation in adjusted OR for hypercholesterolemia was significant for lower LTPA durations (p for trend = 0.04). High apolipoprotein B/apolipoprotein A ratio was inversely associated with LTPA, commuting and total physical activity. Increase in adjusted OR for insulin resistance was found from the highest to the lowest category of LTPA (p for trend = 0.04) but significance disappeared after adjustments for BMI and energy intake. No association of increased C-reactive protein with physical activity domains was observed.

Conclusions

In general, the associations of LTPA, but not commuting or total physical activity, with markers of cardiometabolic risk reinforces the importance of initiatives to increase this domain in programs for the prevention of lifestyle-related diseases.

Introduction

Modern societies are characterized by physical inactivity that contributes to weight gain, obesity and its comorbidities.¹ The underlying mechanisms by which increased body adiposity predisposes individuals to metabolic disturbances and atherogenesis involve low-grade inflammation and insulin resistance.2, 3 In addition to other cells, adipose tissue also produces several cytokines, which regulate inflammatory status and insulin sensitivity. Inflammatory markers have been shown to predict cardiovascular disease,2, 3 particularly C-reactive protein (CRP) concentration, which may be a stronger predictor than LDL-cholesterol.⁴ Also, there is evidence that insulin resistance constitutes an independent cardiovascular risk factor.⁵

It is known that regular physical activity has beneficial effects on insulin resistance, enhancing insulin signaling, glucose transport and substrate metabolism in muscle.⁶ Modifications of gene expression of certain adipocytokines may represent another pathway for improving insulin sensitivity and lowering inflammatory status.⁷ Recently, it has been suggested that physical activity may play an important role as a potential modifier of the inflammatory process, possibly by attenuation of inflammation with consequent reduction in the incidence of several chronic diseases such as cardiovascular events.⁸ Systematic reviews have confirmed the benefits of total physical activity in reducing the risk of type 2 diabetes mellitus.⁹ Some data indicate that physical activity at leisure time may confer protection against metabolic syndrome.¹⁰ Concerning mortality, prospective studies have found lower mortality rates in physically active men compared with sedentary men.¹¹ Therefore, different studies have explored the impact of physical activity on body adiposity,¹² inflammation,¹³ metabolic status,¹⁰ or cardiovascular system.¹⁴ Most researches have focused on the benefits of total physical activity, which includes commuting, structured exercises and LTPA.13, 14 To the best of our knowledge, no studies on the impact of each separate domain of physical activity, and exploring several aspects regarding cardiometabolic health, are available.

Low physical activity level of people living in developing countries such as Brazil has been commonly attributed to work-related issues (long work commutes, laborsaving devices in workplace) and use of public transportation.¹⁵ In the last decade, an increase in insufficiently active individuals (less than 150 min/week of physical activity) was observed among Brazilians.¹⁶ For active individuals at leisure time, a more favorable cardiometabolic profile would be expected.10, 14, 17 Primary prevention of lifestyle-related diseases is particularly important for developing countries and programs to encourage exercise should be tailored for the local reality in order to enhance their effectiveness.

Knowledge about opportunities for improving daily physical activity levels may represent the first step toward orienting public health programs aimed at increasing physical activity in populations. Identification of early metabolic disturbances in individuals at high cardiometabolic risk is of great importance in order to direct preventive measures.

The aim of the present study was to investigate the associations of commuting, leisure-time physical activity (LTPA) and total physical activity with markers of inflammation, insulin resistance and metabolic profile in individuals at high cardiometabolic risk, seen under the public health system in Brazil.

Section snippets

Methods

Individuals attending a public health center, selected for a program for prevention of type 2 diabetes mellitus, participated in this cross-sectional study. These individuals, who seek for assistance under the Brazilian public health system, predominantly have low incomes and schooling. Of the 480 individuals screened, 233 were eligible for the program and 193 individuals had complete data for the purposes of the present study. Data were collected between 2008 and 2009. This study was approved

Results

Of the 193 participants, 63.7% were women (mean age 54.1 ± 12.8 years). Overall, the sample spent a mean of 191.1 (SD 206.6) min/week on total physical activity and 19.5 (SD 11.3) h/week watching television. Mean values of LTPA and commuting were 35.4 (68.3) and 155.7 (194.5) min/week, respectively. Table 1 shows clinical data and inflammatory markers of the sample according to gender. Only mean values of BMI, HDL-cholesterol, CRP and adiponectin concentrations were higher in women.

Stratifying

Discussion

Our study had the particularity of being conducted in adults at high cardiometabolic risk, seen under the Brazilian public health system. In Brazil, people seeking assistance at health units typically have low socioeconomic status and schooling. These individuals are an important target for preventive measures in developed and developing countries, considering the impact of non-communicable chronic diseases on mortality. Particularly among Brazilians, there is evidence that total physical

Conclusion

In summary, the association of LTPA, but not commuting or total physical activity, with a better cardiometabolic profile (lower adiposity, inflammatory status and insulin resistance and more favorable lipid profile) found in this sample of individuals at high cardiometabolic risk reinforces the importance of efforts to increase this domain of physical activity. We conclude that in Brazilian, and perhaps other, populations with similarly low socioeconomic conditions, programs aimed at increasing

Practical implications

•
The pro-inflammatory status and insulin resistance that precede cardiometabolic diseases may be ameliorated by physical activity.
•
Identification of early pathophysiological disturbances in individuals at high cardiometabolic risk is relevant to direct preventive measures.
•
Tendencies for less central adiposity and a lower grade of inflammation were found across the levels of total and LTPA.
•
Reduced LTPA was the only domain significantly associated with risk of insulin resistance and lipid

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The association between interleukin-6 promoter polymorphisms and rheumatoid arthritis by ethnicity: A meta-analysis of 33 studies
2021, Reumatologia Clinica
Citation Excerpt :
Diets, in which more carbohydrates are consumed, does mitigate the secondary IL-6 peak, caused by immune cells, after moderate exercise.57 Moreover, the more active the subject's lifestyle, the lower IL-6 production.58,59 In Latin American countries, it is possible that the lifestyle and quality of life does mitigate the effect the −174 polymorphism has on the development of RA in Latin American.
We performed a meta-analysis to determine the effect Interleukin-6 (IL-6) promoter polymorphism (−174 G>C, −572 G>C, and −597 G>A) have on the development rheumatoid arthritis (RA) by ethnicity.
PubMed, EBSCO, LILACS, and Scopus databases were searched for studies exploring the association between any IL6 polymorphisms and RA until November 2018. Genotype distributions were extracted and, depending on the level heterogeneity, determined by the ψ²-based Q test and the Inconsistency Index (I²), fixed-effects or random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (95%CIs) for the heterozygous, homozygous, dominant, recessive, and allelic genetic models.
From 708 identified publications, 33 were used in this analysis. For the −174 polymorphism, Asians (OR_heterozygous = 7.57, 95%CI: 2.28–25.14, OR_homozygous = 5.84, 95%CI: 2.06–16.56, OR_dominant = 7.21, 95%CI: 2.30–22.63, OR_recessive = 5.04, 95%CI: 1.78–14.28, OR_allelic = 6.60, 95%CI: 2.26–19.28, p < .05) and Middle East countries (OR_heterozygous = 2.30, 95%CI: 1.10–4.81, OR_dominant = 2.27, 95%CI: 1.22–4.22, OR_allelic = 2.29, 95%CI: 1.24–4.23, p < .05) were associated with a significant risk of developing RA. Whereas, for Latinos, the C-allele was associated with a benefit (OR_homozygous = 0.26, 95%CI: .08–.82, OR_recessive = .25, 95%CI: .08–.80, p < .05). For the −572 polymorphism, Asians demonstrated a significant association for the homozygous and recessive genetic models (8 studies, OR_homozygous = 1.56, 95%CI: 1.16–2.09, OR_recessive = 1.63, 95%CI: 1.08–2.45, p < .05). For the −597 polymorphism, no association was observed.
Here, the −174 G>C polymorphism increased the risk of developing RA in Asians and Middle East populations. Interestingly, for Latinos, the polymorphism was associated with a benefit. For the −572 polymorphism, only the Asian population showed an increased risk of developing RA for the CC genotype.
Realizamos un meta-análisis para determinar el efecto de los polimorfismos del promotor de interleucina-6 (IL-6) (-174 G >C, -572 G >C, y -597 G >A) sobre el desarrollo de artritis reumatoide (RA) analizado por etnicidad.
En las bases de datos PubMed, EBSCO, LILACS y Scopus se buscaron estudios con la asociación entre polimorfismo de IL-6 y RA publicados hasta noviembre 2018. se obtuvieron las distribuciones de genotipo y de acuerdo al nivel de heterogeneidad el efecto fijo o aleatorio fueron utilizados para calcular los Odds Ratio (OR) con intervalos de confianza del 95% para los modelos genéticos heterocigoto, homocigoto, dominante, recesivo y alélico.
De 708 estudios identificados, 33 fueron utilizados para este análisis. Para el polimorfismo -174, los países Asiáticos (OR_heterocigoto = 7,57, 95%CI: 2,28–25,14, OR_homocigoto = 5,84, 95%CI: 2,06-16,56, OR_dominante = 7,21, 95%CI: 2,30-22,63, OR_recesivo = 5,04, 95%CI: 1,78-14,28, OR_alélico = 6,60, 95%CI: 2,26-19,28, p < 0,05) y del Medio Oriente (OR_heterocigoto = 2,30, 95%CI: 1,10-4,81, OR_dominante = 2,27, 95%CI: 1,22-4,22, OR_alélico = 2,29, 95%CI: 1,24-4,23, p< 0,05) están asociados con el riesgo de desarrollar RA significativamente. Mientras que, para los Latinos, el alelo-C está asociado con un beneficio (OR_homocigoto = 0,26, 95%CI: 0,08-0,82, OR_recesivo = 0,25, 95%CI: 0,08-0,80, p< 0,05). Para el polimorfismo -572, los Asiáticos están asociados significativamente con los modelos genéticos homocigoto y recesivo (8 estudios, OR_homocigoto = 1,56, 95%CI: 1,16-2,09, OR_recesivo = 1,63, 95%CI: 1,08-2,45, p< 0,05). Para el polimorfismo -597, no se observó asociación.
El polimorfismo -174 G >C aumenta el riesgo de desarrollar RA en población Asiática y Medio Oriente. Curiosamente, para los Latinos el polimorfismo está asociado con un beneficio. Para el polimorfismo -572, solo la población Asiática demuestra una aumento en el riesgo de desarrollar RA con el genotipo CC.
Changes in walking, body mass index, and cardiometabolic risk factors following residential relocation: Longitudinal results from the CARDIA study
2016, Journal of Transport and Health
Citation Excerpt :
These findings suggest that the built environment may represent a promising intervention point for community-level efforts to promote physical activity and prevent obesity. Additionally, epidemiological studies of the relationships of physical activity and body weight with cardiometabolic health outcomes (Green et al., 2014; Gordon-Larsen et al., 2009; Pires et al., 2012; Autenrieth et al., 2009) suggest that the built environment may also be associated with more distal measures of cardiometabolic risk. Relatively few studies have examined the relationship between the built environment and cardiometabolic risk factors (Leal and Chaix, 2011), although some research has found measures of neighborhood walkability to be favorably associated with blood pressure (Chaix et al., 2008; Agyemang et al., 2007), risk of type 2 diabetes (Müller-Riemenschneider et al., 2013), odds of metabolic syndrome (Baldock et al., 2012; Dengel et al., 2009), and other composite indicators of cardiometabolic risk (Coffee et al., 2013).
While many studies have found the built environment to be associated with walking, most have used cross-sectional research designs and few have examined more distal cardiometabolic outcomes. This study contributes longitudinal evidence based on changes in walking, body mass index (BMI), and cardiometabolic risk following residential relocation.
We examined 1079 participants in the CARDIA study who moved residential locations between 2000 and 2006 (ages 32–46 in 2000, 49% white/51% black, 55% female). We created a walkability index from measures of population density, street connectivity, and food and physical activity resources, measured at participants’ pre- and post-move residential locations. Outcomes measured before and after the move included walking, BMI, waist circumference, blood pressure, insulin resistance, triglycerides, cholesterol, atherogenic dyslipidemia, and C-reactive protein. Fixed effects (FE) models were used to estimate associations between within-person change in walkability and within-person change in each outcome. These estimates were compared to those from random effects (RE) models to assess the implications of unmeasured confounding.
In FE models, a one-SD increase in walkability was associated with a 0.81 mmHg decrease in systolic blood pressure [95% CI: (−1.55, −0.07)] and a 7.36 percent increase in C-reactive protein [95% CI: (0.60, 14.57)]. Although several significant associations were observed in the RE models, Hausman tests suggested that these estimates were biased for most outcomes. RE estimates were most commonly biased away from the null or in the opposite direction of effect as the FE estimates.
Greater walkability was associated with lower blood pressure and higher C-reactive protein in FE models, potentially reflecting competing health risks and benefits in dense, walkable environments. RE models tended to overstate or otherwise misrepresent the relationship between walkability and health. Approaches that base estimates on variation between individuals may be subject to bias from unmeasured confounding, such as residential self-selection.
Walkability and cardiometabolic risk factors: Cross-sectional and longitudinal associations from the Multi-Ethnic Study of Atherosclerosis
2016, Health and Place
Citation Excerpt :
Regular physical activity can reduce fasting glucose levels, and thus reduce the risk of type 2 diabetes, by facilitating the uptake, transport, and regulation of muscle glucose (Goodyear and Kahn, 1998; Hayes and Kriska, 2008; Sigal et al., 2004; Goodpaster and Brown, 2005). Through its influence on lipid metabolism (Pires et al., 2012), physical activity can lead to improved lipid profiles including lower triglyceride levels (Pires et al., 2012; Green et al., 2014; Gordon-Larsen et al., 2009), greater high-density lipoprotein cholesterol levels (Pires et al., 2012; Donnelly et al., 2000; Murphy et al., 2002), lower total cholesterol levels (Murphy et al., 2002), and lower lipid accumulation (Green et al., 2014). The cardiovascular benefits of physical activity also include improved blood pressure, and past research has found moderate activities such as active commuting (walking or cycling to work) (Gordon-Larsen et al., 2009) and daily walking (Moreau et al., 2001) to be associated with lower diastolic (Gordon-Larsen et al., 2009) and systolic (Moreau et al., 2001) blood pressure.
We used data from 3227 older adults in the Multi-Ethnic Study of Atherosclerosis (2004–2012) to explore cross-sectional and longitudinal associations between walkability and cardiometabolic risk factors. In cross-sectional analyses, linear regression was used to estimate associations of Street Smart Walk Score® with glucose, triglycerides, HDL and LDL cholesterol, systolic and diastolic blood pressure, and waist circumference, while logistic regression was used to estimate associations with odds of metabolic syndrome. Econometric fixed effects models were used to estimate longitudinal associations of changes in walkability with changes in each risk factor among participants who moved residential locations between 2004 and 2012 (n=583). Most cross-sectional and longitudinal associations were small and statistically non-significant. We found limited evidence that higher walkability was cross-sectionally associated with lower blood pressure but that increases in walkability were associated with increases in triglycerides and blood pressure over time. Further research over longer time periods is needed to understand the potential for built environment interventions to improve cardiometabolic health.
Associations of occupational, transportation, household and leisure-time physical activity patterns with metabolic risk factors among middle-aged adults in a middle-income country
2013, Preventive Medicine
Citation Excerpt :
Our findings suggest that physical activities derived from occupation, household and transportation domains were also important sources of energy expenditure, rather than leisure-time physical activity alone. While previous studies reported strong evidence that leisure-time physical activity was beneficially associated with metabolic syndrome (Holme et al., 2007; Pires et al., 2012), the current study reported significant protective effects of occupational, transportation and household activities against metabolic syndrome in this cohort, but not leisure activity, which is similar to a recent study (Mabry et al., 2012). Cameron et al. (2004) suggested that genetic factors, age and cultural background could contribute to these contradicting results.
This study investigates physical activity in different domains and its association with metabolic risk factors among middle-aged adults.
The study was performed in Kuala Lumpur, Malaysia from August 2010–August 2011. Body mass index (BMI), waist circumference, systolic/diastolic blood pressure, and fasting blood glucose/lipid profile were measured in 686 Malay participants (mean age 45.9 ± 6.5 years). Self-reported physical activity was obtained with the validated IPAQ (Malay version) and categorized into low-, moderate- and high-activity levels across occupational, transportation, household and leisure-time domains.
Participants spent most of their time on household (567.5, 95% CI: 510–630 MET-minutes/week) and occupational activities (297, 95% CI: 245–330 MET-minutes/week). After adjusted for gender and smoking, participants with low-activity levels in occupational, transport and household domains were associated with significantly higher odds for metabolic syndrome (2.02, 95% CI: 1.33–3.05; 1.49, 95% CI: 1.01–2.21; 1.96, 95% CI: 1.33–2.91). Significantly higher odds for obesity and abdominal obesity were consistently reported among those with low-activity levels across all four domains.
High-activity levels in occupational, transportation and household domains were each negatively associated with metabolic syndrome among our cohort. Increase participation of physical activity across all four domains (including leisure-time activity) should be encouraged.
Association between active commuting and low-grade inflammation: a population-based cross-sectional study
2024, European Journal of Public Health
Dose– and Intensity–Response Associations Between Leisure-Time Physical Activity and Markers of Inflammation and Oxidative Stress in Older Adults
2022, Journal of Aging and Physical Activity

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Original researchAssessment of leisure-time physical activity for the prediction of inflammatory status and cardiometabolic profile

Abstract

Objectives

Design

Methods

Results

Conclusions

Introduction

Section snippets

Methods

Results

Discussion

Conclusion

Practical implications

Lancet

Ann Epidemiol

Physical activity in the prevention and treatment of obesity and its comorbidities

Med Sci Sports Exerc

Adipose tissue, inflammation, and cardiovascular disease

Circ Res

Abdominal obesity and metabolic syndrome

Nature

Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in prediction of first cardiovascular events

N Engl J Med

Hyperinsulinemia as an independent risk factor for ischemic heart disease

N Engl J Med

Exercise, glucose transport, and insulin sensitivity

Annu Rev Med

Differential effects of exercise on insulin-signaling gene expression in human skeletal muscle

J Appl Physiol

Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms

Circulation

Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review

Diabetes Care

Leisure-time physical activity and the metabolic syndrome in the Finnish Diabetes Prevention Study

Diabetes Care

Leisure time physical activity and the 16-year risks of mortality from coronary heart disease and all-causes in the multiple risk factor intervention trial (MRFIT)

Int J Sports Med

Physical activity plays an important role in body weight regulation

J Obes

Anti-inflammatory effect of lifestyle changes in the Finnish Diabetes Prevention Study

Diabetologia

Original research
Assessment of leisure-time physical activity for the prediction of inflammatory status and cardiometabolic profile