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Physical activity and diet on atherogenic index of plasma among adults in the United States: mediation considerations by central adiposity

European Journal of Clinical Nutrition volume 72, pages 826–831 (2018)Cite this article

Subjects

Abstract

Background/objectives

The potential interactive or combined association of moderate-to-vigorous physical activity (MVPA) and dietary behavior with atherogenic index of plasma (AIP) has yet to be explored in a representative sample of US adults. Thus, the study aim was to examine the association of MVPA and dietary behavior on AIP, with potential mediation considerations by central adiposity.

Subjects/methods

Data from the National Health and Nutrition Examination Survey were used (N = 2701 adults aged 20–85 years). AIP was evaluated via blood sample, MVPA was assessed via accelerometry, and two 24-h recalls were utilized to calculate Healthy Eating Index (HEI), a metric of dietary quality. Android-specific dual energy X-ray absorptiometry (DXA) was used to measure central adiposity.

Results

Meeting MVPA guidelines (OR = 0.58; 95% CI: 0.41–0.82; P = 0.004), but not meeting dietary guidelines (OR = 0.89; 95% CI: 0.69–1.15; P = 0.37), was associated with reduced odds of having an elevated (>0.24 mmol/L) AIP. Having one (OR = 0.68; 95% CI: 0.52–0.89; P = 0.007) or both (OR = 0.55; 95% CI: 0.37–0.82; P = 0.005) health-enhancing behaviors (adequate physical activity and/or healthy diet), when compared to having neither, was associated with reduced odds (32 and 45%) for having an elevated AIP. The relative excess risk due to interaction (RERI) was 0.06 (95% CI: −0.06 to 0.18; P = 0.31), suggesting there is no additive interaction between MVPA and dietary behavior on AIP. All associations were attenuated when including central adiposity as a covariate, suggesting a mediation effect of central adiposity.

Conclusions

MVPA is independently associated with reduced odds of having an elevated AIP, having both adequate levels of MVPA and a healthy diet does not substantively reduce the odds of AIP, and there is no additive interaction effect between MVPA and diet on AIP. Central adiposity mediated the relationship between MVPA and AIP.

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References

  1. Murphy SL, Kochanek KD, Xu J, Arias E. Mortality in the United States, 2014. NCHS Data Brief No. 267. 1–8 (U.S. Department of Health and Human Services, Washington, DC, 2015).

  2. Dobiasova M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem. 2001;34:583–8.

    Article  CAS  Google Scholar 

  3. Dobiasova M. Atherogenic index of plasma [log(triglycerides/HDL-cholesterol)]: theoretical and practical implications. Clin Chem. 2004;50:1113–5.

    Article  CAS  Google Scholar 

  4. Rader D, Hovingh GK. HDL and cariovascula disease. Lancet. 2014;384:618–25.

    Article  CAS  Google Scholar 

  5. Grundy SM, Denke MA. Dietary influences on serum lipids and lipoproteins. J Lipid Res. 1990;31:1149–72.

    CAS  PubMed  Google Scholar 

  6. Gaziano JM, Hennekens CH, O’Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation. 1997;96:2520–5.

    Article  CAS  Google Scholar 

  7. Bampi AB, Rochitte CE, Favarato D, Lemos PA, da Luz PL. Comparison of non-invasive methods for the detection of coronary atherosclerosis. Clinics. 2009;64:675–82.

    Article  Google Scholar 

  8. da Luz PL, Favarato D, Faria-Neto JR Jr., Lemos P, Chagas AC. High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease. Clinics. 2008;63:427–32.

    Article  Google Scholar 

  9. Tan MH, Johns D, Glazer NB. Pioglitazone reduces atherogenic index of plasma in patients with type 2 diabetes. Clin Chem. 2004;50:1184–8.

    Article  CAS  Google Scholar 

  10. Dobiasova M. AIP--atherogenic index of plasma as a significant predictor of cardiovascular risk: from research to practice. Vnitr Lek. 2006;52:64–71.

    CAS  PubMed  Google Scholar 

  11. Bhardwaj S, Bhattacharjee J, Bhatnagar M, Tyagi S. Atherogenic index of plasma, castelli risk index and atherogenic coefficient- new parameters in assessing cardiovascular risk. Int J Pharm Biol Sci. 2013;3:359–64.

    Google Scholar 

  12. Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. Can Med Assoc J. 2006;174:801–9.

    Article  Google Scholar 

  13. Stranska Z, Matoulek M, Vilikus Z, Svacina S, Stransky P. Aerobic exercise has beneficial impact on atherogenic index of plasma in sedentary overweight and obese women. Neuro Endocrinol Lett. 2011;32:102–8.

    PubMed  Google Scholar 

  14. Venojarvi M, Korkmaz A, Wasenius N, Manderoos S, Heinonen OJ, Lindholm H, et al. 12 weeks’ aerobic and resistance training without dietary intervention did not influence oxidative stress but aerobic training decreased atherogenic index in middle-aged men with impaired glucose regulation. Food Chem Toxicol. 2013;61:127–35.

    Article  CAS  Google Scholar 

  15. Ezeukwu AO, Agwubike EO, Uadia PO. Differential effects of continuous and interval exercise training on the atherogenic index of plasma in the non-obese young male. Zhonghua Minguo Xin Zang Xue Hui Za Zhi. 2015;31:337–44.

    Google Scholar 

  16. Edwards MK, Blaha MJ, Loprinzi PD. Influence of sedentary behavior, physical activity and cardiorespiratory fitness on the atherogenic index of plasma. J Clin Lipid. 2017;11:119–25.

    Article  Google Scholar 

  17. Mensink RP, Katan MB. Effect of dietary fatty acids on serum lipids and lipoproteins. A meta-analysis of 27 trials. Arterioscler Thromb. 1992;12:911–9.

    Article  CAS  Google Scholar 

  18. Kant AK. Dietary patterns and health outcomes. J Am Diet Assoc. 2004;104:615–35.

    Article  Google Scholar 

  19. Loprinzi PD, Smit E, Mahoney S. Physical activity and dietary behavior in US adults and their combined influence on health. Mayo Clin Proc. 2014;89:190–8.

    Article  Google Scholar 

  20. Colcombe S, Kramer AF. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci. 2003;14:125–30.

    Article  Google Scholar 

  21. Joseph RJ, Alonso-Alonso M, Bond DS, Pascual-Leone A, Blackburn GL. The neurocognitive connection between physical activity and eating behaviour. Obes Rev. 2011;12:800–12.

    Article  CAS  Google Scholar 

  22. Newby PK, Muller D, Hallfrisch J, Qiao N, Andres R, Tucker KL. Dietary patterns and changes in body mass index and waist circumference in adults. Am J Clin Nutr. 2003;77:1417–25.

    Article  CAS  Google Scholar 

  23. Slentz CA, Duscha BD, Johnson JL, Ketchum K, Aiken LB, Samsa GP, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study. Arch Intern Med. 2004;164:31–9.

    Article  Google Scholar 

  24. Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004;79:379–84.

    Article  CAS  Google Scholar 

  25. Loprinzi PD, Cardinal BJ, Lee H, Tudor-Locke C. Markers of adiposity among children and adolescents: implications of the isotemporal substitution paradigm with sedentary behavior and physical activity patterns. J Diabetes Metab Disord. 2015;14:46.

    Article  Google Scholar 

  26. Chen KY, Bassett DR Jr.. The technology of accelerometry-based activity monitors: current and future. Med Sci Sports Exerc. 2005;37(11 Suppl):S490–500.

    Article  Google Scholar 

  27. Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40:181–8.

    Article  Google Scholar 

  28. Ford ES, Bergmann MM, Boeing H, Li C, Capewell S. Healthy lifestyle behaviors and all-cause mortality among adults in the United States. Prev Med. 2012;55:23–7.

    Article  Google Scholar 

  29. Loprinzi PD, Branscum A, Hanks J, Smit E. Healthy lifestyle characteristics and their joint association with cardiovascular disease biomarkers in US adults. Mayo Clin Proc. 2016;91:432–42.

    Article  Google Scholar 

  30. Loprinzi PD. Health behavior characteristics and all-cause mortality. Prev Med Rep. 2016;3:276–8.

    Article  Google Scholar 

  31. Knol MJ, VanderWeele TJ, Groenwold RH, Klungel OH, Rovers MM, Grobbee DE. Estimating measures of interaction on an additive scale for preventive exposures. Eur J Epidemiol. 2011;26:433–8.

    Article  Google Scholar 

  32. Foster-Schubert KE, Alfano CM, Duggan CR, Xiao L, Campbell KL, Kong A, et al. Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese postmenopausal women. Obesity. 2012;20:1628–38.

    Article  CAS  Google Scholar 

  33. Schwingshackl L, Dias S, Hoffmann G. Impact of long-term lifestyle programmes on weight loss and cardiovascular risk factors in overweight/obese participants: a systematic review and network meta-analysis. Syst Rev. 2014;3:130.

    Article  Google Scholar 

  34. Varady KA, Jones PJ. Combination diet and exercise interventions for the treatment of dyslipidemia: an effective preliminary strategy to lower cholesterol levels? J Nutr. 2005;135:1829–35.

    Article  CAS  Google Scholar 

  35. Yu-Poth S, Zhao G, Etherton T, Naglak M, Jonnalagadda S, Kris-Etherton PM. Effects of the National Cholesterol Education Program’s Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis. Am J Clin Nutr. 1999;69:632–46.

    Article  CAS  Google Scholar 

  36. Durstine JL, Grandjean PW, Davis PG, Ferguson MA, Alderson NL, DuBose KD. Blood lipid and lipoprotein adaptations to exercise: a quantitative analysis. Sports Med. 2001;31:1033–62.

    Article  CAS  Google Scholar 

  37. Leon AS, Sanchez OA, Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc. 2001;33(6 Suppl):S502–15.

    Article  CAS  Google Scholar 

  38. Fahlman MM, Boardley D, Lambert CP, Flynn MG. Effects of endurance training and resistance training on plasma lipoprotein profiles in elderly women. J Gerontol A Biol Sci Med Sci. 2002;57:B54–60.

    Article  Google Scholar 

  39. Stefanick ML, Mackey S, Sheehan M, Ellsworth N, Haskell WL, Wood PD. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. N Engl J Med. 1998;339:12–20.

    Article  CAS  Google Scholar 

  40. Physical Activity Guidelines Advisory Committee. Physical activity guidelines advisory committee report, 2008 (Department of Health and Human Services, Washington, DC, 2008).

  41. Loprinzi PD, Lee H, Cardinal BJ. Dose response association between physical activity and biological, demographic, and perceptions of health variables. Obes Facts. 2013;6:380–92.

    Article  Google Scholar 

  42. Loprinzi PD, Sng E. Mode-specific physical activity and leukocyte telomere length among U.S. adults: Implications of running on cellular aging. Prev Med. 2016;85:17–9.

    Article  Google Scholar 

  43. Lee S, Kuk JL, Katzmarzyk PT, Blair SN, Church TS, Ross R. Cardiorespiratory fitness attenuates metabolic risk independent of abdominal subcutaneous and visceral fat in men. Diabetes Care. 2005;28:895–901.

    Article  Google Scholar 

  44. Guenther PM, Reedy J, Krebs-Smith SM, Reeve BB. Evaluation of the healthy eating index-2005. J Am Diet Assoc. 2008;108:1854–64.

    Article  Google Scholar 

  45. Guenther PM, Reedy J, Krebs-Smith SM, Reeve BB, & Basiotis PP. Development and evaluation of the healthy eating index-2005: technical report. In: Agriculture USDo, editor. (Center for Nutrition Policy and Promotion, Washington, DC, 2007).

  46. Shephard RJ, Limits to the measurement of habitual physical activity by questionnaires. Br J Sports Med. 2003;37:197–206.

    Article  CAS  Google Scholar 

  47. Loprinzi PDC BJ. Measuring children’s physical activity and sedentary behaviors. J Exerc Sci Fit. 2011;9:15–23.

    Article  Google Scholar 

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Funding

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Authors and Affiliations

  1. Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS, 38677, USA

    Meghan K Edwards

  2. Jackson Heart Study Vanguard Center of Oxford, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS, 38677, USA

    Paul D Loprinzi

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Contributions

All authors have approved the final version submitted for publication. MKE drafted the first draft of the manuscript, critically revised the manuscript and interpreted the statistical results. PDL computed the analyses and revised the manuscript.

Corresponding author

Correspondence to Paul D Loprinzi.

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Edwards, M.K., Loprinzi, P.D. Physical activity and diet on atherogenic index of plasma among adults in the United States: mediation considerations by central adiposity. Eur J Clin Nutr 72, 826–831 (2018). https://doi.org/10.1038/s41430-017-0066-x

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