The association between different leisure-time physical activity patterns and the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio in adults: national health and nutrition examination survey 2007–2018

Abstract Background Despite the potential superiority of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) as a diagnostic and predictive marker, no study has investigated the link between different leisure-time physical activity (LTPA) patterns and the NHHR. This study aims to explore this relationship. Methods Data was extracted from the National Health and Nutrition Examination Survey (NHANES) cycles spanning from 2007 to 2008 to 2017–2018. Participants (N = 14,211) were classified into four groups based on their LTPA patterns: (1) inactive (LTPA = 0 min/week); (2) insufficiently active (LTPA < 150 min/week); (3) weekend warrior (LTPA ≥ 150 min/week within 1 or 2 sessions); and (4) regularly active (LTPA ≥ 150 min/week in more than 2 sessions). Weighted multiple linear regression analysis was employed twice, using inactive and regular active groups as reference groups, respectively. Weighted stratification analyses and interaction tests were performed by demographics. Results Compared to the inactive group, each additional unit of LTPA time was associated with a significant 0.23-unit greater decrease in the NHHR in the regularly active group [-0.23 (-0.29; -0.16)]. However, no significant decrease was observed in the “Weekend Warrior” [-0.11 (-0.22; 0.008)] or insufficiently active groups [-0.03 (-0.11; 0.04)]. Moreover, compared to the regularly active group, the insufficiently active [0.21 (0.13; 0.29)], “Weekend Warrior” [0.13 (0.004; 0.25)], and inactive [0.26 (0.20; 0.32)] groups had significantly higher NHHR. The associations between the NHHR and various LTPA patterns did not significantly differ by demographic factors, except for race. Conclusion The regularly active pattern is significantly associated with a lower NHHR, but no significant difference in the NHHR was detected between the insufficiently active and “Weekend Warriors” patterns. The study suggests that frequency and regularity of PA are crucial for optimal lipid management, supporting clinical recommendations to meet or exceed 150 min of PA in more than two sessions per week.