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Original article Physical activity, sedentary behavior, and cardiovascular disease risk:a trajectory analysis
Jina Hanorcid , Yeong Jun Juorcid , Soon Young Leeorcid
Epidemiol Health 2022;e2023028
DOI: https://doi.org/10.4178/epih.e2023028 [Accepted]
Published online: February 22, 2023
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Ajou Univiersity School of Medicine, Suwon, Korea
Corresponding author:  Soon Young Lee,
Email: solee5301@gmail.com
Received: 16 November 2022   • Revised: 26 January 2023   • Accepted: 8 February 2023

Objectives
To identify the distinct trajectories of sedentary behavior (SB) and explore whether reduced cardiovascular disease (CVD) risk was associated with a distinct trajectory of physical activity (PA).
Methods
We analyzed data from 6,425 people who participated in the Korean Health Panel Survey over a period of 10 years. The participants’ self-reported SB and PA were assessed annually, and trajectory groups were identified using a group-based trajectory model for longitudinal data analysis. Logistic regression analysis was performed to assess the association between CVD risk (10-year cumulative incidence) and the trajectories of SB and PA. The adjusted variables included sociodemographic factors, the predisposing diseases of CVD, and baseline health behaviors.
Results
Trajectory analysis identified 4 SB trajectory groups: SB group 1 (low and slightly increasing trend, 53.1%), SB group 2 (high and rapidly decreasing trend, 14.7%), SB group 3 (high and slightly decreasing trend, 9.9%), and SB group 4 (low and rapidly increasing trend, 22.2%). The 3 PA trajectory groups were PA group 1 (moderate and slightly decreasing trend, 32.1%), PA group 2 (low and slightly decreasing trend, 57.3%), and PA group 3 (maintained inactivity, 10.7%). By the 10-year follow-up, 577 cases of incident CVD had occurred. We also noted a 50% reduction in the risk of CVD when SB group 4 was accompanied by PA group 1 (odds ratio, 0.50; 95% confidence interval, 0.28–0.90).
Conclusions
Despite increased time spent in SB, maintaining PA approximately 3 days a week reduced the occurrence of CVD.


Epidemiol Health : Epidemiology and Health