Sex Difference In Adherence To Physical Activity Guidelines And Chronic Diseases

Sex-stratified association of adherence to aerobic physical activity (PA) along with muscle-strengthening guidelines (MSA) with chronic diseases (hypertension, diabetes, and dyslipidemia) remain unclear. PURPOSE: To investigate sex differences in the association of adherence to both aerobic PA and MSA guidelines with chronic diseases. METHOD: Using data from the Korea National Health and Nutrition Examination Survey (2014-2022), we analyzed 44,944 participants (women: n = 25,392; age ≥ 19 years). PA guideline adherence was assessed via self-reported Global Physical Activity Questionnaire (GPAQ) for aerobic PA and weekly frequency for MSA. Participants were categorized into four groups based on current PA guidelines (aerobic PA: ≥150 min/wk; MSA: ≥2 days/wk): neither, MSA only, aerobic PA only, or both. Chronic diseases were defined as: hypertension (Systolic blood pressure/Diastolic Blood Pressure ≥ 140/90 mmHg or use of antihypertensive medication), diabetes (fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, or use of insulin/antihyperglycemic agent), and dyslipidemia (cholesterol ≥240 mg/dL, triglycerides ≥200 mg/dL, HDL <40(men)/<50(women)mg/dL, LDL ≥160 mg/dL, or use of lipid lowering drug). Multivariable logistic regression analyses examined associations between PA guideline adherence and chronic diseases, using the neither as reference. RESULTS: Adherence to both PA guidelines was low (men: 19.7%, women: 9.4%). For hypertension, men who met both guidelines only showed lower OR (OR = 0.86, 95% CI: 0.78-0.95) compared to the neither. In contrast, women demonstrated lower OR in the MSA only(OR = 0.82, 95% CI: 0.71-0.95), aerobic PA(OR = 0.90, 95% CI: 0.84-0.98), both(OR = 0.79, 95% CI: 0.69-0.91) relative to the neither. For diabetes, men exhibited lower OR in both (OR = 0.85, 95% CI: 0.75-0.96) and MSA only (OR = 0.75, 95% CI: 0.65-0.87), whereas women showed lower OR only in the MSA only (OR = 0.82, 95% CI: 0.67-0.99) compared to neither. For dyslipidemia, both sexes showed lower OR in the both and MSA only compared to the neither, with sex-based differences being less prominent than those observed for hypertension and diabetes. CONCLUSION: Sex-specific associations of adherence to PA guidelines with hypertension and diabetes were observed, whereas these differences were less distinct for dyslipidemia.