Associations between Physical Activity and Metabolic Syndrome among Veterans with and without Posttraumatic Stress Disorder

ABSTRACT Introduction Posttraumatic stress disorder (PTSD) is associated with an increased risk for metabolic syndrome (MetS). PTSD is also associated with low physical activity, an important determinant of cardiovascular and metabolic health. This study examined cross-sectional associations between MetS, PTSD, and self-reported global physical activity and moderate-to-vigorous physical activity (MVPA) to determine the extent to which PTSD and global physical activity and MVPA independently contribute to MetS. Methods Participants ( n = 191) were recruited from an ongoing longitudinal cohort study of veterans at the Translational Research Center for TBI and Stress Disorders (TRACTS). Logistic regression analyses were conducted to examine associations among MetS, PTSD symptoms, global physical activity, and MVPA. MetS and contributing risk factors (i.e., obesity, dyslipidemia, hypertension, and high blood glucose) were modeled as the dependent variables; PTSD symptoms, global physical activity, and MVPA as the independent variables (step 1); and age, sex, race, ethnicity, and nicotine and alcohol as the covariates (step 2). Results A significant interaction between PTSD symptoms and MVPA was observed for MetS (odds ratio (OR) = 0.92, 95% confidence interval (CI) = 0.86–0.99, P = 0.02), such that greater PTSD severity was associated with higher odds of MetS in insufficiently active participants, but not active individuals. A similar significant interaction between PTSD symptoms and MVPA was observed for obesity (OR = 0.95, 95% CI = 0.90–1.00, P = 0.05). Greater levels of global physical activity were associated with significantly lower odds of meeting the criteria for obesity (OR = 0.55, 95% CI = 0.35–0.85, P < 0.01) and high triglycerides (OR = 0.64, 95% CI = 0.39–1.00, P < 0.05). Greater MVPA was associated with significantly lower odds of having low-level high-density lipoproteins (OR = 0.42, 95% CI = 0.20–0.89, P < 0.05). Conclusions Higher levels of both global physical activity and MVPA were associated with a lower risk of MetS, obesity, and dyslipidemia in military veterans. Additionally, this study provides preliminary evidence that MVPA moderates the relationship between PTSD, MetS, and obesity.