Importance of Overall Activity and Intensity of Activity for Cardiometabolic Risk in Those with and Without a Chronic Disease

Higher levels of physical activity are associated with lower cardio-metabolic risk. However, the relative contribution of overall activity and the intensity of activity is unclear. Our aim was to determine the relative contribution of overall activity and intensity distribution of activity to cardio-metabolic risk in in a cross-sectional analysis of apparently healthy office workers and in people with one or more chronic disease. Clustered cardio-metabolic risk score was calculated from mean arterial pressure, HDL cholesterol, triglycerides and HbA1c. Open-source software (GGIR) was used to generate average acceleration and intensity gradient from wrist-worn accelerometer data for two datasets: office-workers who did not have a self-reported medical condition (N = 399, 70% women) and adults with ≥1 chronic disease (N = 1,137, 34% women). Multiple linear regression analyses were used to assess the relative contribution of overall activity and intensity of activity to cardio-metabolic risk. When mutually adjusted, both overall activity and intensity of activity were independently associated with cardio-metabolic risk in the healthy group (p < 0.05). However, for the chronic disease group, while mutually adjusted associations for average acceleration were significantly associated with cardio-metabolic risk (p < 0.001), intensity was not. In healthy individuals, cardio-metabolic risk was lower in those with high overall activity and/or intensity of activity, and who also undertook at least 10 minutes brisk walking. In those with a chronic disease, risk was lower in those who undertook at least 60 minutes slow walking. These findings suggest interventions aiming to optimise cardio-metabolic health in healthy adults could focus on increasing both intensity and amount of physical activity. However, in those with chronic disease increasing the amount of activity undertaken, regardless of intensity, may be more appropriate.