Independent Associations between Sedentary Time, Moderate-To-Vigorous Physical Activity, Cardiorespiratory Fitness and Cardio-Metabolic Health: A Cross-Sectional Study

PLoS One. 2016 Jul 27;11(7):e0160166. doi: 10.1371/journal.pone.0160166. eCollection 2016.


We aimed to study the independent associations of sedentary time (ST), moderate-to-vigorous physical activity (MVPA), and objectively measured cardiorespiratory fitness (CRF) with clustered cardio-metabolic risk and its individual components (waist circumference, fasting glucose, HDL-cholesterol, triglycerides and blood pressure). We also investigated whether any associations between MVPA or ST and clustered cardio-metabolic risk were mediated by CRF. MVPA, ST, CRF and individual cardio-metabolic components were measured in a population-based sample of 341 adults (age 53.8 ± 8.9 years; 61% men) between 2012 and 2014. MVPA and ST were measured with the SenseWear pro 3 Armband and CRF was measured with a maximal exercise test. Multiple linear regression models and the product of coefficients method were used to examine independent associations and mediation effects, respectively. Results showed that low MVPA and low CRF were associated with a higher clustered cardio-metabolic risk (β = -0.26 and β = -0.43, both p<0.001, respectively). CRF explained 73% of the variance in the association between MVPA and clustered cardio-metabolic risk and attenuated this association to non-significance. After mutual adjustment for MVPA and ST, CRF was the most important risk factor for a higher clustered cardio-metabolic risk (β = -0.39, p<0.001). In conclusion, because of the mediating role of CRF, lifestyle-interventions need to be feasible yet challenging enough to lead to increases in CRF to improve someone's cardio-metabolic health.

MeSH terms

  • Blood Glucose / metabolism
  • Blood Pressure
  • Cardiorespiratory Fitness*
  • Cholesterol, HDL / blood
  • Exercise*
  • Female
  • Humans
  • Hypertension / epidemiology*
  • Male
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Sedentary Behavior*
  • Waist Circumference


  • Blood Glucose
  • Cholesterol, HDL

Grant support

This work was supported by the Fonds Wetenschappelijk Onderzoek, ( to JL, JGB and Steunpunt Beleidsrelevant Onderzoek Sport ( to JL, JGB. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.