Objectively measured movement behaviors, cardiorespiratory fitness, and health among adults with and without a history of preexisting comorbidity conditions.
The importance of lifestyle movement behaviors in promoting the health is widely recognized. However, existing evidence is largely based on studies examining the univariate association of the time spent in each movement component without consideration of the compositional nature of time-use data. That is, within a 24-hour activity paradigm, time-use movement behaviors are intercorrelated and have compositional rather than independent associations with health outcomes. Recently, an advanced analytic approach has been proposed to overcome the such limitation. Particularly, a compositional isotemporal substitution model has been successfully employed to examine the hypothetical effects of reallocating the time between movement behaviors while accounting for the compositional nature of the time-use data; and there is a need to apply the such method to elucidate the complex, intercorrelated associations of time-use movement behaviors with various health outcomes. Additionally, cardiorespiratory fitness is a strong prognostic marker associated with various health outcomes, particularly among patients with comorbid conditions. Previous studies also demonstrated that lifestyle movement behaviors such as physical activity and sedentary behaviors are predictors of cardiorespiratory fitness. This suggests that cardiorespiratory fitness may play the mediating role when explaining the associations of movement behaviors with health outcomes, which, however, has not been systematically examined while accounting for the compositional nature of the time-use movement data. Taken together, this project will explore the role of lifestyle behaviors as primary, secondary, and tertiary prevention against the incidence of adverse health outcomes among adults with varying levels of clinical conditions. We aim to investigate: 1) objectively measured 24-hour movement behaviors in relation to the incidence of cardiovascular diseases and mortality among adults with and without a history of preexisting comorbidity conditions; and 2) an interplay between movement behaviors and cardiorespiratory fitness predicting health outcomes among adults with different preexisting comorbidity conditions. As a secondary aim, we will explore a wide range of individual- and socio-ecological-level factors associated with 24-hour movement behavioral patterns, particularly among those with preexisting comorbidity conditions. We expect to expand the analysis to examine the potential moderating/mediating role(s) of movement behaviors in improving health outcomes. The results will inform the future development of evidence-based lifestyle behavioral intervention strategies across a wide range of population groups, including those patients with irreversible comorbid conditions (e.g., heart failure, cancer).