{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T16:34:14Z","timestamp":1793464454440,"version":"4.5.0"},"reference-count":36,"publisher":"Human Kinetics","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:p><jats:italic><jats:bold>Objective<\/jats:bold>:<\/jats:italic> To evaluate the paths between lifelong physical activity levels and the development of cardiometabolic disease. <jats:italic><jats:bold>Methods<\/jats:bold>:<\/jats:italic> The ATTICA is a population-based cohort study with a 20-year follow-up conducted in the Attica region, Greece and included, 3042 adult males and females (45 [11]\u00a0y). Participants physical activity levels\u2019 tracking together with data regarding cardiovascular disease, obesity, hypertension, hypercholesterolemia, and diabetes incidence, were available in 1988 participants (45 [12]\u00a0y old, 987 males and 1001 females), at 20-year follow-up. Physical activity levels were evaluated using the validated International Physical Activity Questionnaire, in all examinations (2001\u20132002, 2006, 2012, and 2022). Four physical activity trajectories were defined, that is, consistently active\/inactive and changed from active\/inactive. Path analysis was applied using structure equation models. <jats:italic><jats:bold>Results<\/jats:bold>:<\/jats:italic> 54% of participants were classified as always inactive, 5% classified as became inactive from physically active, 38% as became active and, only 3% sustained physical activity levels. Participants who reported being consistently physically active throughout the 20-year period were 6% (OR, 0.94, 95% CI, 0.89\u20130.99) less likely to develop cardiovascular disease as compared with those who remained consistently physically inactive, had 21% lower risk of developing hypercholesterolemia (OR, 0.79, 95% CI, 0.59\u20131.04), 33% lower risk of obesity (OR, 0.67, 95% CI, 0.44\u20131.02), and 30% lower risk of diabetes (OR, 0.70, 95% CI, 0.48\u20131.03). <jats:italic><jats:bold>Conclusions<\/jats:bold>:<\/jats:italic> Lifelong physical activity was strongly associated with reduced fatal or nonfatal cardiovascular disease events, as well as reduced risk of developing other cardiometabolic disorders, hypercholesterolemia, obesity, and diabetes.<\/jats:p>","DOI":"10.1123\/jpah.2024-0537","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T19:44:34Z","timestamp":1739389474000},"page":"599-607","source":"Crossref","is-referenced-by-count":2,"title":["Exploring the Path Between Life-Course Trajectories of Physical Activity Levels and Cardiometabolic Disease Incidence: Insights From the ATTICA Cohort Study (2002\u20132022)"],"prefix":"10.1123","volume":"22","author":[{"given":"Nikos","family":"Dimitriadis","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giannis","family":"Arnaoutis","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos D.","family":"Tambalis","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Chrysohoou","sequence":"additional","affiliation":[{"name":"First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fotios","family":"Barkas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Liberopoulos","sequence":"additional","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros P.","family":"Sfikakis","sequence":"additional","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Pitsavos","sequence":"additional","affiliation":[{"name":"First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costas","family":"Tsioufis","sequence":"additional","affiliation":[{"name":"First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demosthenes","family":"Panagiotakos","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"100","reference":[{"key":"r1","series-title":"Global Action Plan on Physical Activity 2018\u20132030: More Active People for a Healthier World","year":"2018","unstructured":"World Health Organization. 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