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Leisure time physical activity is associated with improved diastolic heart function and is partly mediated by unsupervised quantified metabolic health
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Objectives: To investigate the association between leisure time physical activity (LTPA) and MRI-based diastolic function and the mediating role of metabolic health. Methods: This cross-sectional analysis comprised 901 participants (46% women, mean age (SD): 56 (6) years (The Netherlands, 2008–2012)). LTPA was assessed via questionnaire, quantified in metabolic equivalent of tasks (METs)-minutes per week and participants underwent abdominal and cardiovascular MRI. Confirmatory factor analysis was used to construct the metabolic load factor. Piecewise structural equation model with adjustments for confounders was used to determine associations between LTPA and diastolic function and the mediating effect of metabolic load. Results: Significant differences in mitral early/late peak filling rate (E/A) ratio per SD of LTPA (men=1999, women=1870 MET-min/week) of 0.18, (95% CI= 0.03 to 0.33, p=0.021) were observed in men, but not in women: −0.01 (−0.01 to 0.34, p=0.058). Difference in deceleration time of mitral early filling (E-DT) was 0.13 (0.01 to 0.24, p=0.030) in men and 0.17 (0.05 to 0.28, p=0.005) in women. Metabolic load, including MRI-based visceral and subcutaneous adipose tissue, fasting glucose, high-density lipoprotein cholesterol and triglycerides, mediated these associations as follows: E/A-ratio of 0.030 (0.000 to 0.067, 19% mediated, p=0.047) in men but not in women: 0.058 (0.027 to 0.089, p<0.001) and E-DT not in men 0.004 (−0.012 to 0.021, p=0.602) but did in women 0.044 (0.013 to 0.057, 27% mediated, p=0.006). Conclusions: A larger amount of LTPA was associated with improved diastolic function where confirmatory factor analysis-based metabolic load partly mediated this effect. Future studies should assess whether improving indicators of metabolic load alongside LTPA will benefit healthy diastolic function even more.
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Regular exercise provides physical and mental health benefits, and walking and cycling can contribute to decreasing transport-related greenhouse gas emissions and air pollution when acting as substitutes for fossil fuel-based transportation.
“Regular exercise provides physical and mental health benefits,89,90 and walking and cycling can contribute to decreasing transport-related greenhouse gas emissions and air pollution when acting as substitutes for fossil fuel-based transportation (indicators 3.1.3 and 3.2.1).91”
From The 2024 report of the Lancet Countdown on health and climate change: facing record-breaking threats from delayed action (2024) · cites this paper as [89]
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Metadata
- Authors
- Klarenberg, H., van der Velde, J. H., Peeters, C. F., Dekkers, I. A., de Mutsert, R., Jukema, J. W., Rosendaal, F. R., Leiner, T., Froeling, M., Jorstad, H., Boekholdt, S. M., Strijkers, G. J., & Lamb, H. J.
- Affiliations
- Amsterdam University Medical Centers (NL)
- Leiden University Medical Center (NL)
- Amsterdam Public Health (NL)
- University Medical Center Utrecht (NL)
- Corresponding author
- Klarenberg, Hugo
- ORCID
- Venue
- BMJ Open Sport & Exercise Medicine
- Publisher
- BMJ
- Published
- 2024-02
- Volume
- 10
- Issue
- 1
- Pages
- e001778
- ISSN
- 2055-7647 (ISSN-L)
- PMC
- PMC10860076
- OpenAlex
- W4391562078
- Cited by
- 4
- References
- 46
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Open Sport & Exercise Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion, cc-by)
- Socio-Environmental Systems Modeling (submittedVersion, cc-by-nc)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Leiden Repository (Leiden University) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Funders
- Universiteit Leiden
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (14741)
- Leids Universitair Medisch Centrum
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Keywords
- leisure-time physical activity, metabolic health, mediation analysis, metabolic burden, E/A ratio, deceleration time, visceral adipose tissue, subcutaneous adipose tissue, fasting blood glucose, HDL cholesterol, triglycerides, sex differences, cardiovascular MRI, wearable activity trackers, MET-min/week, sedentary behavior
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