Accelerometer-derived physical activity in those with cardio-metabolic disease compared to healthy adults: a UK Biobank study of 52,556 participants

Cardio-metabolic disease and physical activity are closely related but large-scale objective studies which measure physical activity are lacking. Using the largest accelerometer cohort to date, we aimed to investigate whether there is an association between disease status and accelerometer variables after a 5-year follow-up. 106,053 UK Biobank participants wore a wrist-worn GENEactiv monitor. Those with acceptable wear time (> 3 days) were split into 4 cardio-metabolic disease groups based on self-report disease status which was collected 5 +/- 1 years prior. Multiple linear regression models were used to investigate associations, controlling for confounders and stratified for gender. Average daily acceleration was lower in men ('healthy'-42 +/- 15 mg v 'Type 2 diabetes + cardiovascular disease (CVD)'-31 +/- 12 mg) and women ('healthy'-44 +/- 13 mg v 'Type 2 diabetes + CVD'-31 +/- 11 mg) with cardio-metabolic disease and this was consistent across both week and weekend days. Men and women with the worst cardio-metabolic disease perform around half of moderate to vigorous physical activity on a daily basis compared to healthy individuals, and spend almost 7 h per day in 30 min inactivity bouts. Significant associations were seen between cardio-metabolic disease and accelerometer variables 5 years on when controlling for confounders. In the largest accelerometer cohort to date, there are significant associations between cardio-metabolic disease and physical activity variables after 5 years of follow-up. Triaxial accelerometers provide enhanced measurement opportunities for measuring lifestyle behaviours in chronic disease.