Joint associations of device-measured physical activity and sleep duration with cardiometabolic health in the 1970 British Cohort Study

Abstract

Objectives

Multiple unhealthy lifestyle behaviors could synergistically exaggerate unfavorable health outcomes. The present study aimed to investigate the joint associations of device-measured sleep duration and physical activity with cardiometabolic health markers.

Design

A cross-sectional analysis embedded in the 46–48 years wave of the 1970 British Cohort Study.

Methods

4756 participants wore an activPAL3 micro accelerometer to measure physical activity and sleep duration. Outcomes included body mass index (BMI), glycated hemoglobin, triglycerides, c-reactive protein, systolic blood pressure, and total-to-high-density lipoprotein (HDL) cholesterol ratio, hypertension, and diabetes. We examined the joint associations of sleep (<7h, short; 7–9h, medium; >9h, long) and physical activity (median cut of step counts, 4740 steps/d; or moderate-to-vigorous physical activity, MVPA, 085h/d) with outcomes by generalized linear models or logistic regression.

Results

Low physical activity combined with either short or long sleep was associated with higher BMI (e.g., 2.32 [1.42, 3.23] (kg/m²) for short sleep) compared to the referent medium sleep and high physical activity combination. Low physical activity combined with long sleep was associated with a higher total-to-HDL cholesterol ratio (e.g., 0.31 [0.12, 0.49] for low step counts). Short sleep combined with low step counts showed higher odds for hypertension and diabetes (1.34 [1.06, 1.69] and 1.98 [1.07, 3.68], respectively), while short sleep combined with either low or high MVPA had higher odds for diabetes (2.04 [1.09, 3.82] and 2.07 [1.04, 4.15], respectively).

Conclusions

Low physical activity may exaggerate the detrimental associations between inadequate sleep with BMI, blood lipids, hypertension, and diabetes.