Physical activity, measures of obesity, and cardiometabolic risk: The multi-ethnic study of atherosclerosis (MESA)

Background: The influence of higher physical activity on the relationship between adiposity and cardiometabolic risk is not completely understood. Methods: Between 2000-2002, data were collected on 6795 Multi-Ethnic Study of Atherosclerosis (MESA) participants. Self-reported intentional physical activity in the lowest quartile (0-105 MET-minutes/week) was categorized as inactive and the upper three quartiles (123-37,260 MET-minutes/week) as active. Associations of body mass index (BMI) and waist circumference categories, stratified by physical activity status (inactive or active) with cardiometabolic risk factors (dyslipidemia, hypertension, upper quartile of homeostasis model assessment of insulin resistance [HOMA-IR] for population, and impaired fasting glucose or diabetes) were assessed using logistic regression analysis adjusting for age, gender, race/ethnicity, and current smoking. Results: Among obese participants, those who were physically active had reduced odds of insulin resistance (47% lower; P <.001) and impaired fasting glucose/diabetes (23% lower; P = .04). These associations were weaker for central obesity. However, among participants with a normal waist circumference, those who were inactive were 63% more likely to have insulin resistance (OR [95% CI] 1.63 [1.24-2.15]) compared with the active reference group. Conclusions: Physical activity was inversely related to the cardiometabolic risk associated with obesity and central obesity.