Physical activity, sedentary time and gain in overall and central body fat: 7-year follow-up of the ProActive trial cohort

Int J Obes (Lond). 2015 Jan;39(1):142-8. doi: 10.1038/ijo.2014.66. Epub 2014 Apr 15.


Objective: The objective of this study is to examine the independent associations of time spent in moderate-to-vigorous physical activity (MVPA) and sedentary (SED-time), with total and abdominal body fat (BF), and the bidirectionality of these associations in adults at high risk of type 2 diabetes.

Design and subjects: We measured MVPA (min per day) and SED-time (h per day) by accelerometry, and indices of total (body weight, fat mass (FM), BF% and FM index) and abdominal BF (waist circumference (WC)) using standard procedures in 231 adults (41.3 ± 6.4 years) with parental history of type 2 diabetes (ProActive UK) at baseline, 1-year and 7-year follow-up. Mixed effects models were used to quantify the independent associations (expressed as standardised β-coefficients (95% confidence interval (CI))) of MVPA and SED-time with fat indices, using data from all three time points. All models were adjusted for age, sex, intervention arm, monitor wear time, follow-up time, smoking status, socioeconomic status and MVPA/SED-time.

Results: MVPA was inversely and independently associated with all indices of total BF (for example, 1 s.d. higher MVPA was associated with a reduction in FM, β = -0.09 (95% CI: -0.14, -0.04) s.d.) and abdominal BF (for example, WC: β = -0.07 (-0.12, -0.02)). Similarly, higher fat indices were independently associated with a reduction in MVPA (for example, WC: β = -0.25 (-0.36, -0.15); FM: β = -0.27 (-0.36, -0.18)). SED-time was positively and independently associated with most fat indices (for example, WC: β = 0.03 (-0.04, 0.09); FM: β = 0.10 (0.03, 0.17)). Higher values of all fat indices independently predicted longer SED-time (for example, WC: β = 0.10 (0.02, 0.18), FM: β = 0.15 (0.07, 0.22)).

Conclusions: The associations of MVPA and SED-time with total and abdominal BF are bidirectional and independent among individuals at high risk for type 2 diabetes. The association between BF and MVPA is stronger than the reciprocal association, highlighting the importance of considering BF as a determinant of decreasing activity and a potential consequence. Promoting more MVPA and less SED-time may reduce total and abdominal BF.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accelerometry
  • Adiposity
  • Adult
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / prevention & control*
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Evidence-Based Medicine
  • Exercise*
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice
  • Health Promotion
  • Humans
  • Male
  • Obesity / complications
  • Obesity / metabolism
  • Obesity / prevention & control*
  • Risk Factors
  • Sedentary Behavior*
  • Time Factors
  • Waist Circumference
  • Weight Gain*

Associated data

  • ISRCTN/ISRCTN61323766