The associations of "weekend warrior" and regularly active physical activity with abdominal and general adiposity in US adults

Association between weekend warrior physical activity pattern and bone mineral density among adults: national health and nutrition examination survey

This cross-sectional analysis utilized data from the NHANES database and employed multivariable linear regression analyses to examine the relationship between physical activity (PA) patterns and femoral neck bone mineral density (BMD). The results demonstrated that both weekend warrior (WW) and regularly active (RA) patterns were positively associated with femoral neck BMD, particularly among younger adults (< 50 years old), males, and unmarried individuals.

PURPOSE

This study aims to explore the association between PA patterns and femoral neck BMD, and to examine the difference between the WW and RA patterns.

METHODS

Data were obtained from NHANES participants aged ≥ 18 years. PA patterns were self-reported through questionnaires and categorized into four groups: inactive, insufficiently active, weekend warrior, and regularly active. Multivariable linear regression analyses were conducted to evaluate the association between PA patterns and femoral neck BMD. Subgroup analyses and interaction effects were used to examine the potential differences across subgroups. Sensitivity analyses were used to examine the robustness and consistency of the findings.

RESULTS

A total of 16,937 adults (mean age 53.6 ± 17.2 years) were included, comprising 8677 men (51.2%) and 8260 women (48.8%). Based on PA patterns, participants were classified as inactive (n = 9123), insufficiently active (n = 2559), weekend warriors (n = 952), and regularly active (n = 4303). After adjusting for relevant covariates, both the WW and RA groups showed significantly higher femoral neck BMD compared to the inactive group (WW: β = 0.027, 95% CI: 0.020, 0.033, P < 0.001; RA: β = 0.034, 95% CI: 0.025, 0.044, P < 0.001). No statistically significant difference in BMD was found between the WW and RA groups (P = 0.151). These findings were consistent across sensitivity and subgroup analyses. Further subgroup analysis suggested that younger adults (< 50 years old), males, and unmarried individuals may derive greater BMD benefits from the WW and RA patterns.

CONCLUSIONS

Among US adults, the WW PA pattern was significantly associated with increased femoral neck BMD, with benefits comparable to those observed in the RA pattern.

Whether joint leisure time physical activity and dietary quality alleviates metabolic syndrome and its components: evidence from the National Health and Nutrition Examination Survey (2007-2018)

OBJECTIVES

The incidence of metabolic syndrome (MetS) is increasing, which is one of the major threats to human health. Whether joint leisure time physical activity (LTPA) and dietary quality (DQ) can reduce the risk of developing MetS and its components is worth exploring. Therefore, this study aimed to investigate the individual and combined effects of LTPA and DQ on MetS and its components.

METHODS

Data were extracted from the National Health and Nutrition Examination Survey from 2007 to 2018. LTPA was classified as inactive, insufficiently active (IA), weekend warrior (WW), and regular active (RA); DQ was categorized as high dietary quality (HDQ) and low dietary quality (LDQ). Afterwards, population characteristics of MetS were analyzed. Then, univariate and multivariate logistic regression were used to analyze individual and combined effects of LTPA and DQ on MetS and its components. Subgroup analysis and restricted cubic spline (RCS) were used to examine the robustness and non-linearity.

RESULTS

This study included 31,482 adults aged 20 or older. Results showed that RA, HDQ and RA&HDQ were significantly negatively correlated with MetS and its components. IA&HDQ was significantly and negatively correlated with MetS, waist circumference and high-density lipoprotein cholesterol. WW&HDQ was not significantly associated with MetS, but was significantly negatively linked to fasting glucose and blood pressure. No significant interaction effect was observed in subgroup analysis. RCS analysis revealed a significant non-linear negative correlation between LTPA and MetS.

CONCLUSIONS

This research indicates that RA and HDQ alone or in combination are associated with a lower risk of developing MetS and its components and could serve as effective preventive and therapeutic strategies against MetS and its associated risk factors. The decline in MetS risk become even more significant after exercise for 500 min/week. Similar trends are observed among fasting glucose, blood pressure, and triglyceride levels.

Associations of physical activity volume and intensity with depression symptoms among US adults

Background

This study aimed to investigate the associations of physical activity (PA) volume and intensity with the risk of depression symptoms.

Methods

The data utilized in this study came from the 2011-2014 National Health and Nutrition Examination Survey. PA was measured using a triaxial accelerometer and calculated using the Monitor-Independent Movement Summary (MIMS), MIMS units are a novel metric derived from wrist-worn accelerometer data, representing the intensity of PA for each minute across the entire monitoring period. PA volume and intensity were expressed by the average of daily accumulated MIMS (Daily MIMS) and peak 30-min MIMS (Peak-30MIMS; Peak 30-min intensity), respectively. Depression symptoms were defined as Patient Health Questionnaire-9 score ≥10. Weighted logistic regression and restricted cubic splines were used to evaluate the associations between PA metrics and depression symptoms.

Results

After adjusting for all covariates, higher Daily MIMS and Peak-30MIMS were associated with lower depression risk. Each additional 1,000 units in Daily MIMS and 1-unit in Peak-30MIMS were associated with a 5% [Odds ratio (OR) = 0.95, 95% confidence interval (95% CI): 0.94, 0.98] and 2% (OR = 0.98, 95% CI: 0.97, 0.99) reduction in depression risk, respectively. When including both MIMS metrics in the same model, the association between Peak-30MIMS and depression remained significant (p = 0.02), whereas Daily MIMS did not (p = 0.60). The spline analysis indicated a monotonic decrease in the OR with higher Daily MIMS values (P for non-linear = 0.21). An initial increase followed by a decrease in OR was observed with rising Peak-30MIMS values (P for non-linear <0.01).

Conclusion

Our findings indicate that higher PA volume and intensity are associated with lower depression risk. The association between PA volume and reduced depression risk was negated after adjusting for PA intensity in US adults.

Exploring the link between Di-2-ethylhexyl phthalate (DEHP) exposure and muscle mass: A systematic investigation utilizing NHANES data analysis, network toxicology and molecular docking approaches

Sarcopenia is a syndrome characterized by a progressive, widespread decline in muscle mass and strength. DEHP, a plasticizer involved in daily life and widely used, has been found in various everyday items and causes developmental dysregulation, reproductive impairments, tumorigenesis, and transgenerational disease. However, much remains to be discovered regarding the association between exposure to this environmental toxin and sarcopenia, as well as the toxic targets and molecular mechanisms. This research elucidated the relationship between contact with DEHP and the development of sarcopenia by integrating NHANES data analysis, network toxicology, and molecular docking. 3199 adults were enrolled, and multiple linear regressions were performed to reveal a significant negative correlation between lnDEHP and ALMBMI. Eighty-eight targets associated with DEHP and sarcopenia were identified. Subsequent STRING and Cytoscape screening stressed 20 key targets, including CASP3, BCL2, MMP9, BCL2L1, APP, and CTSS. GO and KEGG enrichment analyses revealed that these targets are involved in ligand-receptor interactions, apoptosis, and calcium signaling pathways. Molecular docking simulations using CB-dock confirmed the high-affinity binding interactions between DEHP and these key targets. This study validated the relationship between DEHP exposure and muscle mass. Further, it provided a theoretical basis for investigating the molecular mechanisms of DEHP exposure-induced skeletal muscle toxicity.

Association of Accelerometer-Derived Physical Activity Pattern With the Risks of All-Cause, Cardiovascular Disease, and Cancer Death

BACKGROUND

Current guidelines suggest engaging in a minimum of 150 minutes of moderate to vigorous physical activity (MVPA) each week to support overall health. However, the effect of concentrated versus evenly distributed physical activity (PA) on health outcomes remains uncertain. This study aims to investigate the associations of "weekend warrior" pattern, where most MVPA is completed in 1 to 2 days, and a more evenly spread MVPA pattern with mortality risk.

METHODS

Data from the UK Biobank were used, with participants having a full week of device-measured PA data from 2013 to 2015. Three MVPA patterns were defined: inactive, active weekend warrior, and active regular. The relationships between PA patterns and mortality risk were investigated using the Cox proportional hazards model.

RESULTS

During an 8.1-year median follow-up, 3965 adults died from all causes, including 667 from cardiovascular disease and 1780 from cancer. Both the active weekend warrior group (all-cause death: hazard ratio [HR], 0.68 [95% CI, 0.64-0.74]; cardiovascular disease death: HR, 0.69 [95% CI, 0.58-0.83]; cancer death: HR, 0.79 [95% CI, 0.71-0.89]) and the active regular group (all-cause death: HR, 0.74 [95% CI, 0.68-0.81]; cardiovascular disease death: HR, 0.76 [95% CI, 0.61-0.94]; cancer death: HR, 0.87 [95% CI, 0.76-0.99]) demonstrated a lower mortality risk compared with the inactive group after following the recommended 150 minutes of MVPA per week. Furthermore, there was no discernible difference in the mortality risk between the active regular group and the active weekend warrior group.

CONCLUSIONS

Engaging in PA concentrated within 1 to 2 days was related with a similar reduction in mortality risk as more evenly spread activity. Our findings are particularly significant for individuals who find it challenging to engage in regular PA due to time constraints.

Association between weekend warriors and MASLD-a cross-sectional study of the NHANES database 2017-2020

Background

The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) continues to rise each year, posing a significant threat to people in their physical and mental health, as well as imposing a considerable economic burden on healthcare systems. Furthermore, physical activity (PA) is recognized as one of the effective strategies for the prevention of MASLD. However, the epidemiological evidence on the association between weekend warriors' (WWs) exercise modes and MASLD is inconsistent. The primary objective of this study was to further investigate the association between weekend warriors and the prevalence of MASLD using the NHANES database.

Methods

This study included a total of 4,671 participants from the National Health and Nutrition Examination Survey (NHANES) database. PA questionnaires were used to assess participants' PA patterns, while vibration-controlled transient elastography (VECT) was used to assess the degree of hepatic steatosis, and other data were used to diagnose MASLD. Three distinct models were developed to compare the associations between various exercise patterns and the prevalence of MASLD through logistic regression, and to compare the differences between RA and WWs in the prevalence of MASLD.

Results

There is a clear link between the involvement of WWs or RA participants and the lower prevalence of MASLD. In the final adjusted model, participants with a weekend warrior physical activity pattern (odds ratio [OR]: 0.511, 95% confidence interval [CI]: 0.373-0.701, p = 0.00.6) and those in the regular activity population (OR: 0.621, 95% CI: 0.512-0.754, p: 0.00.3) showed significantly lower risk ratios compared to individuals in the inactive and under-exercised populations, and this was statistically significant. Using the regular activity population as a reference, the risk of prevalence of MASLD in the weekend warrior group (OR: 0.857, 95% CI: 0.548-1.339, p: 0.516) indicates that no statistically meaningful disparity was observed between the two groups.

Conclusion

In summary, our results demonstrate a significant correlation between WWs' activity patterns and their risk of MASLD, and they indicate that these patterns can improve MASLD with benefits comparable to those of RA. This provides additional options for individuals with MASLD who are unable to meet the recommended criteria in the exercise guidelines, along with treatment options for clinicians.

Association of weekend warriors and other physical activity patterns with hypertension in NHANES 2007-2018

To accommodate the fast-paced nature of modern life, the "Weekend Warriors (WW)" has emerged as a novel physical activity (PA) indicator. This study aims to investigate the relationship between WW and other PA patterns with hypertension, thereby addressing a significant research gap. Data from 30,697 participants in the National Health and Nutrition Examination Survey conducted between 2007 and 2018 were analyzed. We employed multiple regression analyses to examine the relationships among WW, other PA patterns, PA duration, PA intensity, and hypertension, with data stratified by various characteristics. Results showed that compared to the inactive group, the insufficiently PA pattern (OR = 0.9, 95% CI 0.8, 1.0), the WW group (OR = 0.9, 95% CI 0.7, 1.1), and the regularly active group (OR = 0.8, 95% CI 0.8, 0.9) were all negatively associated with hypertension, with the WW group showing a trend towards a reduced prevalence of hypertension (P for trend < 0.01). This association was particularly evident among middle-aged and older adults aged 41-80 years. Additionally, total moderate-to-vigorous physical activity (MVPA) time, as well as moderate and vigorous PA intensity, showed "L"-shaped and "U"-shaped relationships with hypertension, with inflection points at 2640 MET minutes, 45%, and 62%, respectively. Our study provides insights for selecting suitable PA patterns but indicates the need for further research.

Can weekend warriors and other leisure-time physical activity patterns reduce the atherogenic index of plasma (AIP)? A cross-sectional analysis based on NHANES 2007-2018

Background

With the shift in modern lifestyles, the relationship between physical activity (PA) and health has emerged as a significant concern in global public health. A sedentary lifestyle poses a substantial threat to cardiovascular health, particularly through the development of atherosclerosis, the primary pathological basis of cardiovascular disease (CVD) and a condition influenced by various lifestyle factors. The atherogenic index of plasma (AIP), a critical indicator for predicting cardiovascular disease risk, assesses an individual's risk of atherosclerosis by reflecting the ratio of high-density lipoprotein cholesterol (HDL-C) to triglycerides (TG). Despite the recognized importance of PA, the impact of various physical activity patterns on AIP remains unclear.

Methods

This study utilized the National Health and Nutrition Examination Survey (NHANES) database from the United States. PA was assessed via a questionnaire, and participants were categorized into four groups: inactive, insufficiently active, weekend warriors (WW), and regularly active (RA). The AIP was calculated via the ratio of HDL-C to TG, with covariates such as age, sex, race, and body mass index controlled. Multivariate regression analysis served as the primary analytical method.

Results

This study included a total of 24,504 participants. After adjusting for all potential covariates, RA (β=-0.044, P<0.0001) was associated with a significant reduction in AIP compared with WWs (β=0.01, P=0.65). Additionally, subgroup analysis and interaction tests showed that the PA-AIP association varied slightly among individuals with different education levels (P for interaction = 0.07) and marital statuses (P for interaction = 0.09), although these differences were small and did not reach statistical significance. Furthermore, restricted cubic splines (RCS) analysis revealed a significant, nonlinear, and negative correlation between total weekly PA and AIP among inactive individuals (P<0.001, nonlinearity P<0.001). The study found that 510 minutes of total physical activity per week is a threshold, beyond which the rate of decrease in AIP tends to slow down.

Conclusion

RA is more effective in reducing AIP than WWs are. For inactive adults, engaging in more than 510 minutes of PA per week significantly reduces the AIP.

Association between diabetes prevalence and weekend warrior activity patterns

OBJECTIVE

To investigate the association between the Weekend Warrior (WW) pattern and diabetes prevalence in American adults.

STUDY DESIGN

Cross-sectional analysis of data from the 2007-2016 National Health and Nutrition Examination Survey (NHANES).

METHODS

We examined the relationship between four physical activity (PA) patterns-inactive, insufficiently active, WW, and regularly active-and diabetes prevalence. Multivariable logistic regression, marginal average population effects (MAPE), subgroup, and sensitivity analyses were performed to assess these associations. Odds ratios (ORs) and average marginal effects (AME), along with 95 % confidence intervals (CIs) were calculated.

RESULTS

Individuals engaging in the WW pattern (OR = 0.60, 95 % CI: 0.40 to 0.89, p = 0.013; AME = -0.05, 95 % CI: -0.09 to -0.02, p = 0.004) and the regularly active pattern (OR = 0.69, 95 % CI: 0.60 to 0.80, p < 0.001; AME = -0.04, 95 % CI: -0.06 to -0.03, p < 0.001) showed significantly lower diabetes prevalence than those classified as inactive. Compared to individuals classified as inactive, those categorized as insufficiently active demonstrated no significant difference in diabetes prevalence. No significant difference was observed between the WW and regularly active patterns (OR = 0.86, 95 % CI: 0.56 to 1.35, p = 0.5; AME = -0.01, 95 % CI: -0.06 to 0.03, p = 0.501). Subgroup interaction analyses revealed no significant effect modification (all p for interaction >0.05), and sensitivity analyses confirmed the robustness of these findings.

CONCLUSION

Both the WW and regularly active patterns are associated with a lower prevalence of diabetes compared with inactive individuals.

CSE/H2S Signaling Pathways in Enhancing Muscle Function and Insulin Sensitivity During Exercise

Exercise plays a crucial role in maintaining metabolic health, enhancing muscle function, and improving insulin sensitivity, thereby preventing metabolic diseases such as type 2 diabetes. Emerging evidence highlights the significance of the cystathionine γ-lyase (CSE)/hydrogen sulfide (H2S) signaling pathway as a pivotal regulator in the molecular and physiological adaptations induced by exercise. This review comprehensively examines the biosynthesis and metabolism of H2S, its distribution in different muscle tissues, and the mechanisms by which CSE/H2S influences muscle contraction, repair, and protein synthesis. Additionally, it explores how CSE/H2S modulates insulin signaling pathways, glucose uptake, and lipid metabolism, thereby enhancing insulin sensitivity. The potential of H2S donors as exercise supplements is also discussed, highlighting their ability to improve exercise performance and metabolic health. Current research advancements, including the application of multi-omics approaches, are reviewed to provide a deeper understanding of the complex molecular networks involved. Furthermore, the challenges and future directions in CSE/H2S research are addressed, emphasizing the need for further mechanistic studies and clinical applications. This review underscores the therapeutic potential of targeting the CSE/H2S pathway to optimize the benefits of exercise and improve metabolic health.

The association between 'weekend warrior', regular exercise, and cognitive function in elderly individuals with and without depressive symptoms: A cross-sectional analysis from NHANES 2011-2014

BACKGROUND

While previous studies have suggested that both 'Weekend Warrior' (WW) and Regular Exercise (RE) patterns confer health benefits, the relationship between different types of physical activity (PA) and cognitive function (CF) in elderly individuals with and without depressive symptoms remains unclear.

METHODS

Our study leveraged the NHANES 2011-2014 dataset, focusing on older adults. We explore the relationship between PA and CF, stratifying by depressive status. Our statistical approach included multivariable regression analysis to identify relationships between PA levels and cognitive outcomes, along with advanced techniques such as smoothed curve fitting and threshold effect analysis to examine potential nonlinear associations and identify optimal PA pattern for cognitive health.

RESULTS

Analysis revealed a positive correlation between PA time and CF across all participants (β-depressive symptoms = 0.03, 95 % CI: 0.01-0.05; β-non-depressive symptoms = 0.01, 95%CI: 0.00-0.02). When comparing against the inactive, non-depressed participants partaking in WW showed improved cognitive scores (β-WW = 0.22, 95 % CI: 0.05-0.39), similar to those engaging in RE (β-RE = 0.15, 95 % CI: 0.09-0.21). However, among the depressed participants, significant cognitive improvements were observed in the RE (β-RE = 0.15, 95 % CI: 0.04-0.25), with the WW showing less definitive results (β-WW = 0.22, 95 % CI: -0.02-0.47).

LIMITATION

The cross-sectional nature limits causal inferences.

CONCLUSION

Our findings affirm the potential role of PA in enhancing CF among older subjects without depressive symptoms. However, only RE was associated with improved CF in those with depressive symptoms. These results are critical for crafting personalized PA guidelines to enhance cognitive health in the aging population.

The ZJU index is associated with the risk of sarcopenia in American adults aged 20-59: a cross-sectional study

BACKGROUND

The ZJU index is an innovative computational method which integrates BMI, FBG, TG, and ALT to AST ratio. It strongly correlates with measures of lipid metabolism and glucose intolerance. No researches have yet explored the relationship between the ZJU index and sarcopenia.

METHODS

We analyzed NHANES data from 2011 to 2018, dividing the ZJU index into quartiles. The association was investigated by adjusting for confounders using multivariable linear and logistic regression analysis. Results were visualized through RCS regression and threshold effect analyses. We conducted various subgroup and sensitivity analyses and plotted ROC curves to assess prediction efficacy, with the AUC as the measure of accuracy.

RESULTS

As the ZJU index increases, the prevalence of sarcopenia also rises. Following the control of potential confounders via logistic regression analysis, our research identified a distinct relationship between the ZJU index and sarcopenia, which was statistically significant (P < 0.001), with higher ZJU index values associated with increased risk (OR = 12.40, 95% CI: 8.46-18.17). Interaction analysis suggests that the relationship between the ZJU index and the risk of developing sarcopenia varies significantly between males and females across different ZJU index levels. ROC analysis for the ZJU index shows an AUC of 0.749.

CONCLUSIONS

The ZJU index significantly correlates with a heightened risk of sarcopenia in Americans, suggesting its potential as a predictive marker for sarcopenia.

Exploring the association of physical activity on cognitive function in older adults from observational and genetic insights: a combined NHANES and Mendelian randomization study

Background

Cognitive function (CF) deterioration is a pressing concern in geriatric research. This study aimed to explore the relationship between physical activity (PA) and CF in older adults.

Methods

This study adopted a dual approach, employing both observational and genetic approaches through data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 and Mendelian Randomization (MR) analysis. For the NHANES component, PA levels were evaluated using the Global Physical Activity Questionnaire, and CF was assessed via standardized tests. Multivariate regression, threshold effect analysis, smoothing curve fitting, and subgroup analyses were conducted to examine the association between PA and CF. In parallel, MR methods, using genetic variants as instrumental variables, assessed the causal impact of PA on CF and related conditions such as Alzheimer's disease and dementia.

Results

Observational findings from NHANES demonstrated a positive correlation between PA and CF, notably among female participants. The detailed analysis identified specific thresholds of PA that correlate with cognitive enhancements. However, MR results did not support a significant causal relationship between PA and CF or dementia-related outcomes, indicating an absence of a direct genetic basis for the observational associations.

Conclusion

Although observational data from NHANES suggest that PA is positively associated with CF in older adults, particularly among women, MR analysis did not confirm these findings as causally related. The discrepancy highlights the complexity of the PA-CF relationship and underscores the need for further research. These results emphasize the potential of PA as a modifiable risk factor for CF, though causal effects remain to be definitively established.

Diagnostic indicators and lifestyle interventions of metabolic-associated fatty liver disease

MAFLD has become a major global health problem and is the leading cause of liver disease worldwide. The disease progresses from a simple fatty liver to gradual fibrosis, which progresses to cirrhosis and even hepatocellular liver cancer. However, the methods currently used for diagnosis are invasive and do not facilitate clinical assessment of the condition. As a result, research on markers for the diagnosis of MAFLD is increasing. In addition, there are no clinical medications for the treatment of MAFLD, and lifestyle interventions remain effective in the prevention and treatment of MAFLD. In this review, we attempt to make a summary of the emerging diagnostic indicators and effective lifestyle interventions for MAFLD and to provide new insights into the diagnosis and treatment of MAFLD.

Physical activity patterns and cognitive function in elderly women: a cross-sectional study from NHANES 2011-2014

Background

Amid the backdrop of global aging, the increasing prevalence of cognitive decline among the elderly, particularly within the female demographic, represents a considerable public health concern. Physical activity (PA) is recognized as an effective non-pharmacological intervention for mitigating cognitive decline in older adults. However, the relationship between different PA patterns and cognitive function (CF) in elderly women remains unclear.

Methods

This study utilized data from National Health and Nutrition Examination Survey (NHANES) 2011-2014 to investigate the relationships between PA, PA patterns [inactive, Weekend Warrior (WW), and Regular Exercise (RE)], and PA intensity with CF in elderly women. Multivariate regression analysis served as the primary analytical method.

Results

There was a significant positive correlation between PA and CF among elderly women (β-PA: 0.003, 95% CI: 0.000-0.006, P = 0.03143). Additionally, WW and RE activity patterns were associated with markedly better cognitive performance compared to the inactive group (β-WW: 0.451, 95% CI: 0.216-0.685, P = 0.00017; β-RE: 0.153, 95% CI: 0.085-0.221, P = 0.00001). Furthermore, our results indicate a progressive increase in CF with increasing PA intensity (β-MPA- dominated: 0.16, 95% CI: 0.02-0.09, P = 0.0208; β-VPA-dominated: 0.21, 95% CI: 0.09-0.34, P = 0.0011; β-Total VPA: 0.31, 95% CI: -0.01-0.63, P = 0.0566).

Conclusion

Our study confirms a positive association between PA and CF in elderly women, with even intermittent but intensive PA models like WW being correlated with improved CF. These findings underscore the significant role that varying intensities and patterns of PA play in promoting cognitive health among older age groups, highlighting the need for adaptable PA strategies in public health initiatives targeting this population.

The association between different physical activity (PA) patterns and cardiometabolic index (CMI) in US adult population from NHANES (2007-2016)

Background

Physical activity (PA) is widely recommended for preventing and combating obesity, but the most effective PA pattern for treating obesity remains unclear. Cardiometabolic index (CMI), derived from waist height ratio and triglycerides to high-density lipoprotein-cholesterol ratio, is a novel indicator for evaluating obesity. However, the relationship between different PA patterns and CMI remains unelucidated.

Objective

This study aimed to explore the association between different PA patterns and CMI in U.S. adults.

Methods

Participants with complete information in CMI, PA patterns, and other covariates in the National Health and Nutrition Examination Survey database (2007-2016) were included in this study. Multivariate linear regression models were utilized to explore the relationship between PA patterns and CMI. Moreover, stratified analyses, interaction tests and restricted cubic spline (RCS) regression analysis were used to investigate the stability and nonlinearity of the association, respectively.

Results

A total of 16,442 adults were included in this study. After adjusting for all potential covariates, only the regularly active group was significantly associated with CMI reduction (β = -0.13, 95% CI: 0.19 to -0.07, P < 0.0001), while the weekend warriors group did not achieve equivalent CMI reduction (β = -0.09, 95% CI: 0.32 to 0.14, P = 0.4204). Subgroup analyses and interaction tests revealed that the CMI-PA association was more pronounced in the subgroup with age≤45 or >60, with higher education level, and who are current drinkers. Furthermore, RCS analysis indicated that total PA in a week was significantly, nonlinearly associated with CMI in non-inactive adults, and that a total of PA more than 330 min can reap favorable CMI reduction.

Conclusion

Being regularly active is associated with significant CMI reduction, while being weekend warriors and insufficiently active do not achieve equivalent benefits. For non-inactive individuals, engaging in PA for more than 330 min weekly helps to reduce CMI effectively.