{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T23:31:18Z","timestamp":1784590278207,"version":"3.55.0"},"reference-count":25,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background\/Objectives: Physical activity (PA) and body mass index (BMI) are two central modifiable determinants of cardiometabolic health and functional performance across the adult lifespan. Excess adiposity and physical inactivity frequently coexist and may interact in determining functional aging trajectories. However, evidence from real-world primary care populations examining whether PA\u2013cardiometabolic associations are consistent across BMI categories\u2014including individuals with obesity\u2014remains limited. This study evaluated the associations between self-reported PA categories and LDL-C concentrations and timed up and go (TUG) functional performance across three WHO-defined BMI categories and formally tested whether BMI category modified these associations. Methods: This cross-sectional observational study included 863 adult primary care patients stratified into normal weight (BMI &lt; 25 kg\/m2, n = 241), overweight (BMI 25\u201329.9 kg\/m2, n = 348), and obese (BMI \u2265 30.0 kg\/m2, n = 274) groups. PA was categorized as low, moderate, or high based on World Health Organization recommendations. LDL-C and TUG were the primary outcomes. BMI-category-stratified analyses included one-way ANOVA with Bonferroni post hoc correction and multivariable linear regression adjusted for age, sex, arterial hypertension (AH), and diabetes mellitus (DM). An interaction term (PA \u00d7 BMI category) formally tested BMI modification. Results: Age, LDL-C, TUG, sex, AH, DM, and PA distribution did not differ significantly across BMI categories (all p &gt; 0.05). Higher PA categories were associated with significantly lower LDL-C in all three BMI categories (normal: F = 8.93, p &lt; 0.001; overweight: F = 10.53, p &lt; 0.001; obese: F = 9.35, p &lt; 0.001) and with significantly better TUG performance (normal: F = 18.17, p &lt; 0.001; overweight: F = 41.62, p &lt; 0.001; obese: F = 21.14, p &lt; 0.001). PA was the only consistently significant independent predictor of both LDL-C (all p &lt; 0.001) and TUG (all p &lt; 0.001) in all three BMI categories after multivariable adjustment. The interaction term (PA \u00d7 BMI category) was not statistically significant for LDL-C (p = 0.972) or TUG (p = 0.475). The proportion of patients with TUG \u226512 s among low-PA patients increased across BMI categories: 33.7% in patients with normal weight, 37.5% in patients with overweight, and 42.3% in patients with obesity. Conclusions: PA\u2013cardiometabolic and PA\u2013functional performance associations were consistent across all three BMI categories, with no statistically significant BMI modification detected. These findings support the potential clinical utility of routine PA assessment as a BMI-independent indicator of cardiometabolic risk and functional health in primary care, including in individuals with obesity, and are relevant to healthy aging and maintaining mobility and functional independence across the adult lifespan.<\/jats:p>","DOI":"10.3390\/life16071107","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T10:04:44Z","timestamp":1782986684000},"page":"1107","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Physical Activity, Functional Performance, and Healthy Aging Across Body Mass Index Categories: A Real-World Primary Care Cross-Sectional Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6532-0935","authenticated-orcid":false,"given":"Peter Mari\u00e1n","family":"Kalanin","sequence":"first","affiliation":[{"name":"Institute of General Medicine, Faculty of Medicine, Pavol Jozef \u0160af\u00e1rik University in Ko\u0161ice, Rastislavova 45, 040 01 Ko\u0161ice, Slovakia"},{"name":"MED-KAL, s.r.o., Rastislavova 45, 040 01 Ko\u0161ice, Slovakia"},{"name":"Institute of Physical Education and Sport, Pavol Jozef \u0160af\u00e1rik University in Ko\u0161ice, Ondavsk\u00e1 21, 040 11 Ko\u0161ice, Slovakia"},{"name":"Department of Physiotherapy, Faculty of Health, Catholic University in Ru\u017eomberok, N\u00e1mestie A. Hlinku 48, 034 01 Ru\u017eomberok, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.1016\/S0140-6736(17)31634-3","article-title":"The effect of physical activity on mortality and cardiovascular disease in 130,000 people from 17 countries","volume":"390","author":"Lear","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"l4570","DOI":"10.1136\/bmj.l4570","article-title":"Dose-response associations between accelerometry measured physical activity and sedentary time and all-cause mortality","volume":"366","author":"Ekelund","year":"2019","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s40279-024-02115-z","article-title":"The effect of exercise training on blood lipids: A systematic review and meta-analysis","volume":"55","author":"Smart","year":"2025","journal-title":"Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1001\/jama.2018.14854","article-title":"The physical activity guidelines for Americans","volume":"320","author":"Piercy","year":"2018","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/S0140-6736(16)30383-X","article-title":"The economic burden of physical inactivity: A global analysis of major non-communicable diseases","volume":"388","author":"Ding","year":"2016","journal-title":"Lancet"},{"key":"ref_6","unstructured":"World Health Organization (2026, June 10). 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