Physical Activity Producing Low, but Not Medium or Higher, Vertical Impacts Is Inversely Related to BMI in Older Adults: Findings From a Multicohort Study

Ahmed Elhakeem, Kimberly Hannam, Kevin C Deere, April Hartley, Emma M Clark, Charlotte Moss, Mark H Edwards, Elaine Dennison, Tim Gaysin, Diana Kuh, Andrew Wong, Cyrus Cooper, Rachel Cooper, Jon H Tobias

High impact physical activity (PA) is thought to improve skeletal health but its relation to other health outcomes are unclear. We investigated associations between PA impact magnitude and body mass index (BMI) in older adults. Data were from the Cohort for Skeletal Health in Bristol and Avon (COSHIBA), Hertfordshire Cohort Study and MRC National Survey of Health and Development. Vertical accelerations peaks from seven-day hip-worn accelerometer recordings were used to classify PA as low (0.5<g<1.0g), medium (1<g<1.5g) or higher (≥1.5g) impact. Cohort-specific associations of low, medium and higher impact PA with BMI were examined using linear regressions and estimates combined using random-effects meta-analysis. A total of 1182 participants (mean age=72.7 years, 68% female) were included. Low, medium and higher impact PA were inversely related to BMI in initial models. After adjustment for confounders and other impacts, low, but not medium or higher, impacts were inversely related to BMI (-0.31, P<0.001: overall combined standard deviation change in BMI per doubling in number of low impacts). In adjusted analyses of body composition measured by dual-energy X-ray absorptiometry in COSHIBA, low, but not medium or higher, impacts were inversely related to total body fat mass (-0.19, P<0.001) and android:gynoid fat mass ratio (-0.16, P=0.01) whereas high impact PA was weakly and positively associated with lean mass (0.05, P=0.06). Greater exposure to PA producing low magnitude vertical impacts was associated with lower BMI and fat mass at older age. Low impact PA may help reduce obesity risk in older adults.