Device measured sedentary behaviour, sleep, light and moderate-vigorous physical activity and cardio-metabolic health: A compositional individual participant data analysis in the ProPASS consortium

Background/AimsPhysical inactivity, sedentary behaviour (SB) and inadequate sleep are key behavioural risk factors of cardiometabolic diseases; each is mainly considered in isolation. The study aim was to investigate associations of five movement behaviour compositions with adiposity and cardiometabolic biomarkers. MethodsCross-sectional data from 15,246 participants from the Prospective Physical Activity, Sitting and Sleep consortium (ProPASS) were analysed. Time spent in sleep, SB, standing, light-intensity physical activity (LIPA) and moderate-vigorous physical activity (MVPA) made up the composition. Outcomes included BMI, waist circumference, HDL cholesterol, total:HDL cholesterol ratio, triglycerides and HbA1c. Compositional linear regression examined associations between compositions and each outcome, including modelling reallocation of time between behaviours. ResultsThe average daily composition of the sample(age:53.7{+/-}9.7years; 54.7%female) was 7.7hrs sleeping,10.4hrs sedentary,3.1hrs standing,1.5hrs LIPA and 1.3hrs MVPA. A greater proportion of MVPA time and smaller proportion of SB time was associated with better outcomes. Reallocating time from SB,standing,LIPA or sleep into MVPA had the largest theoretical improvement across all outcomes. For example, replacing 30min of SB, sleep, standing or LIPA with MVPA was associated with -0.63 (95%CI -0.48,-0.79), -0.43 (-0.25,-0.59), -0.40 (-0.25,-0.56) and -0.15 (0.05,-0.34)kg/m2 lower BMI, respectively. A larger proportion of standing time was beneficial for outcomes; sleep had a detrimental association when replacing LIPA or MVPA and positive association when replacing SB. The minimal displacement into MVPA for improved cardiometabolic health ranged from 3.8 (HbA1c) to 12.7 (triglycerides) min/day. ConclusionsCompositional data analyses revealed a distinct hierarchy of behaviours. MVPA demonstrated the strongest, most time-efficient protective associations with cardiometabolic outcomes. Theoretical benefits from reallocating SB into sleep, standing or LIPA required substantial changes in daily activity.