Abstract：
BACKGROUND: Studies examining the joint associations of lifestyle exposures can reveal novel synergistic and joint effects, but no study has examined the joint association of diet and physical activity (PA) with type 2 diabetes (T2D) and hypertension. The aim of this study is to examine the joint associations of PA and diet with incidence of type T2D and hypertension, as a combined outcome and separately in a large sample of UK adults.
METHODS: This prospective cohort study included 144,288 UK Biobank participants aged 40-69. Moderate to vigorous PA (MVPA) was measured using the International Physical Activity Questionnaire and a wrist accelerometer. We categorised PA and diet indicators (diet quality score (DQS) and energy intake (EI)) based on tertiles and derived joint PA and diet variables. Outcome was major cardiometabolic disease incidence (combination of T2D and hypertension).
RESULTS: A total of 14,003(7.1%) participants developed T2D, 28,075(19.2%) developed hypertension, and 30,529(21.2%) developed T2D or hypertension over a mean follow-up of 10.9(3.7) years. Participants with middle and high self-reported MVPA levels had lower risk of major cardiometabolic disease regardless of diet, e.g. among high DQS group, hazard ratios in middle and high MVPA group were 0.90 (95%CI:0.86-0.94), and 0.88(95%CI:0.84-0.92), respectively. Participants with jointly high device-measured MVPA and high DQS levels had lower major cardiometabolic disease risk (HR: 0.84, 95%CI:0.71-0.99). The equivalent joint device-measured MVPA and EI exposure analyses showed no clear pattern of associations with the outcomes.
CONCLUSIONS: Higher PA is an important component in cardiometabolic disease prevention across all diet quality and total EI groups. The observed lack of association between diet health outcomes may stem from a lower DQS.
METHODS: This prospective cohort study included 144,288 UK Biobank participants aged 40-69. Moderate to vigorous PA (MVPA) was measured using the International Physical Activity Questionnaire and a wrist accelerometer. We categorised PA and diet indicators (diet quality score (DQS) and energy intake (EI)) based on tertiles and derived joint PA and diet variables. Outcome was major cardiometabolic disease incidence (combination of T2D and hypertension).
RESULTS: A total of 14,003(7.1%) participants developed T2D, 28,075(19.2%) developed hypertension, and 30,529(21.2%) developed T2D or hypertension over a mean follow-up of 10.9(3.7) years. Participants with middle and high self-reported MVPA levels had lower risk of major cardiometabolic disease regardless of diet, e.g. among high DQS group, hazard ratios in middle and high MVPA group were 0.90 (95%CI:0.86-0.94), and 0.88(95%CI:0.84-0.92), respectively. Participants with jointly high device-measured MVPA and high DQS levels had lower major cardiometabolic disease risk (HR: 0.84, 95%CI:0.71-0.99). The equivalent joint device-measured MVPA and EI exposure analyses showed no clear pattern of associations with the outcomes.
CONCLUSIONS: Higher PA is an important component in cardiometabolic disease prevention across all diet quality and total EI groups. The observed lack of association between diet health outcomes may stem from a lower DQS.
摘要：
背景：研究生活方式暴露的联合关联可以揭示新的协同和联合效应，但是没有研究检查饮食和体力活动（PA）与2型糖尿病（T2D）和高血压的联合关联。这项研究的目的是检查PA和饮食与T2D型和高血压发病率的联合关联。作为综合结果，并在大量英国成年人样本中单独使用。
方法：这项前瞻性队列研究包括144,288名年龄在40-69岁的UKBiobank参与者。使用国际身体活动问卷和腕部加速度计测量中度至剧烈的PA（MVPA）。我们根据三元组和衍生的联合PA和饮食变量对PA和饮食指标（饮食质量评分（DQS）和能量摄入（EI））进行分类。结果是主要的心脏代谢疾病发病率（T2D和高血压的组合）。
结果：共有14,003（7.1％）参与者出现了T2D，28,075（19.2%）发展为高血压，在平均10.9(3.7)年的随访时间内,30,529(21.2%)发生了T2D或高血压.无论饮食如何，具有中高自我报告的MVPA水平的参与者患主要心脏代谢疾病的风险较低。例如，在高DQS组中，中高MVPA组的风险比为0.90（95CI：0.86-0.94），和0.88（95CI：0.84-0.92），分别。具有高设备测量的MVPA和高DQS水平的参与者具有较低的主要心脏代谢疾病风险(HR:0.84,95CI:0.71-0.99)。等效的联合装置测量的MVPA和EI暴露分析显示与结果没有明确的关联模式。
结论：在所有饮食质量和总EI组中，高PA是心脏代谢疾病预防的重要组成部分。观察到的饮食健康结果之间缺乏关联可能源于较低的DQS。
方法：这项前瞻性队列研究包括144,288名年龄在40-69岁的UKBiobank参与者。使用国际身体活动问卷和腕部加速度计测量中度至剧烈的PA（MVPA）。我们根据三元组和衍生的联合PA和饮食变量对PA和饮食指标（饮食质量评分（DQS）和能量摄入（EI））进行分类。结果是主要的心脏代谢疾病发病率（T2D和高血压的组合）。
结果：共有14,003（7.1％）参与者出现了T2D，28,075（19.2%）发展为高血压，在平均10.9(3.7)年的随访时间内,30,529(21.2%)发生了T2D或高血压.无论饮食如何，具有中高自我报告的MVPA水平的参与者患主要心脏代谢疾病的风险较低。例如，在高DQS组中，中高MVPA组的风险比为0.90（95CI：0.86-0.94），和0.88（95CI：0.84-0.92），分别。具有高设备测量的MVPA和高DQS水平的参与者具有较低的主要心脏代谢疾病风险(HR:0.84,95CI:0.71-0.99)。等效的联合装置测量的MVPA和EI暴露分析显示与结果没有明确的关联模式。
结论：在所有饮食质量和总EI组中，高PA是心脏代谢疾病预防的重要组成部分。观察到的饮食健康结果之间缺乏关联可能源于较低的DQS。
