Cardiometabolic conditions often develop sequentially, beginning with a first cardiometabolic disease and potentially progressing to cardiometabolic multimorbidity and increased mortality risk. A cohort analysis published in the Mayo Clinic Proceedings examined whether objectively measured physical activity (PA) influences transitions from a healthy status to the first occurrence of cardiometabolic disease (FCMD), subsequent cardiometabolic multimorbidity (CMM), and mortality.

The study included 59,161 participants with wrist-worn accelerometer data collected over 7 consecutive days between 2013 and 2015. Cardiometabolic multimorbidity was defined as the presence of at least two cardiometabolic conditions, including type 2 diabetes, ischemic heart disease, and stroke. Multistate statistical models were used to examine associations between physical activity levels and disease progression.

Over a median follow-up of 7.9 years, 4,074 individuals developed FCMD, 295 progressed to CMM, and 2,893 participants died. Participants meeting guideline-recommended moderate-intensity physical activity (MPA) levels (150–300 minutes per week) had a 29% lower risk of developing FCMD (hazard ratio [HR] 0.71; 95% CI 0.62–0.81) and a 40% lower risk of developing CMM (HR 0.60; 95% CI 0.39–0.93). The association between moderate-intensity PA and the transition from healthy status to FCMD was stronger than the transition from FCMD to CMM. Each additional 244.7 minutes per week of moderate-intensity PA was associated with HRs of 0.75 (95% CI 0.71–0.80) for the transition from healthy baseline to FCMD and 0.92 (95% CI 0.87–0.98) for progression from FCMD to CMM.

Comparable trends were observed when FCMD was analyzed separately for each cardiometabolic disease.

Moderate-intensity PA was associated with lower risks of both incident cardiometabolic disease and progression to multimorbidity. These findings suggest that increased PA may contribute to prevention of cardiometabolic multimorbidity.