Highlights
- •Trajectories of physical activity and lipids were identified in midlife women.
- •Consistently low physical activity was most prevalent.
- •Consistently low high-density lipoprotein cholesterol and triglycerides were most prevalent.
- •Consistently moderate low-density lipoprotein cholesterol was most prevalent.
- •No associations were observed between physical activity and lipid trajectories.
Abstract
Background
Physical activity (PA) has the potential to attenuate cardiovascular disease risk
in midlife women through multiple pathways, including improving lipid profiles. Longitudinal
patterns of PA and blood lipid levels have not been studied in midlife women. Our
study identified trajectories of PA and blood lipids across midlife and characterized
the associations between these trajectories.
Methods
We evaluated 2,789 participants from the Study of Women’s Health Across the Nation
(SWAN), a longitudinal cohort study with follow-up over the menopause transition.
Women reported PA using the Kaiser Physical Activity Survey at seven study visits
across 17 years of follow-up. Serum high-density lipoprotein (HDL) cholesterol, low-density
lipoprotein (LDL) cholesterol, and triglycerides were measured at eight study visits
across the same 17-year follow-up period. We used group-based trajectory models to
characterize trajectories of PA and blood lipids over midlife and dual trajectory
models to determine the association between PA and blood lipid trajectories adjusted
for race/ethnicity, body mass index category, smoking, and lipid-lowering medication
use.
Results
Women were 46 years old, on average, at study entry. Forty-nine percent were non-Hispanic
white; 32 % were Black; 10 % were Japanese; and 9 % were Chinese. We identified four
PA trajectories, three HDL cholesterol trajectories, four LDL cholesterol trajectories,
and two triglyceride trajectories. The most frequently occurring trajectories were
the consistently low PA trajectory (69 % of women), the low HDL cholesterol trajectory
(43 % of women), the consistently moderate LDL cholesterol trajectory (45 % of women),
and the consistently low triglycerides trajectory (90 % of women). In dual trajectory
analyses, no clear associations were observed between PA trajectories and HDL cholesterol,
LDL cholesterol, or triglycerides trajectories.
Conclusions
The most frequently observed trajectories across midlife were characterized by low
physical activity, low HDL cholesterol, moderate LDL cholesterol, and low triglycerides.
Despite the absence of an association between long-term trajectories of PA and blood
lipids in this study, a large body of evidence has established the importance of clinical
and public health messaging and interventions targeted at midlife women to promote
regular and sustained PA during midlife to achieve other cardiovascular and metabolic
benefits.
Keywords
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Article info
Publication history
Published online: February 06, 2021
Accepted:
February 2,
2021
Received in revised form:
November 9,
2020
Received:
September 11,
2020
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
