Physical Activity, Gut Microbiota, and the Risk of Dyslipidemia in a Community‐Based Cohort Study

1. In this cohort of adults, moderate-to-vigorous physical activity (MVPA) was associated with a decreased risk of developing dyslipidemia while also promoting gut microbial diversity, while sedentary behaviour was associated with an increased risk. 

Evidence Rating Level: 1 (Excellent) 

Atherosclerotic cardiovascular disease is a leading cause of death globally, and dyslipidemia is a major modifiable risk factor. Physical activity (PA) is known to improve lipid levels and is protective for overall cardiovascular health. Although PA on its own is effective, sedentary behaviour is harmful, even if one meets exercise guidelines. Some previous studies suggest that less sedentary behaviour may improve cholesterol levels; however, few studies have investigated how moderate-to-vigorous physical activity (MVPA) and sedentary time together affect dyslipidemia risk. To address this research gap, this study aimed to investigate how MVPA and sedentary behaviour influence dyslipidemia risk. A total of 306 incident cases of dyslipidemia were diagnosed over a median time of 4 years. There was an inverse association between total physical activity (TPA) and dyslipidemia risk (per 1‐SD increase, HR, 0.88 [95% CI, 0.79–0.98], P=0.026). Participants in the highest levels of MVPA had a 29% lower risk of developing dyslipidemia compared to those with the lowest levels of MVPA (HR 0.71; 95% CI: 0.52-0.96; P=0.03). Prolonged sedentary time was linked to a 63% greater risk of developing dyslipidemia for those in the highest sedentary group compared to those in the lowest (HR 1.63; 95% CI: 1.19-2.22; P=0.002).  Compared to those with longer sedentary periods and lower PA, the risk of dyslipidemia was 30% lower in those with short sedentary periods and high PA (HR: 0.70; 95% CI: 0.50-0.98), about the same in those with short sedentary periods and low PA (HR: 0.99; 95% CI: 0.71-1.37), and 17% lower in those with longer sedentary periods but high PA (HR: 0.83; 95% CI: 0.60-1.16). In the low MVPA group, microbial ⍺-diversity decreased (P=0.024), and low and high MVPA groups had significant shifts in β-diversity (P≤0.005). In summary, this prospective cohort study found that MVPA weakens the association between sedentary time and the risk of dyslipidemia, while also influencing gut microbiota diversity in richness in this population of adults. 

Click here to read this study in Journal of the American Heart Association

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